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Toxic Epidermal Necrolysis Rapid Differentiation Between Staphylococcal- and Drug-Induced Disease

Robert B. Amon, MD, MPH; Robert L. Dimond, MD
Arch Dermatol. 1975;111(11):1433-1437. doi:10.1001/archderm.1975.01630230035004.
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• Based on the difference in the level of epidermal split, staphylococcal-induced toxic epidermal necrolysis (TEN) can be rapidly differentiated from drug-induced TEN. The microscopic pathologic findings of the staphylococcal-induced disease shows epidermal cleavage high in the malpighian layer, while the non-staphylococcal-induced disease shows a subepidermal split. Rapid differentiation is accomplished by histologically examining a frozen section of peeled skin obtained from a fresh lesion of TEN and by performing a Tzanck preparation on the denuded base.

In order to illustrate these techniques, we present the cases of two adult patients with TEN; in one the disease was staphylococcal-induced while in the other it was drug-induced.

(Arch Dermatol 111:1433-1437, 1975)


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