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Rapid Differentiation Between Staphylococcal- and Drug-Induced Disease

Robert B. Amon, MD, MPH; Robert L. Dimond, MD

Arch Dermatol. 1975;111(11):1433-1437.

Abstract
• 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)

Author Affiliations
From the Department of Dermatology, University of Oregon Health Sciences Center, Portland.

Footnotes
Accepted for publication March 26, 1975.

Reprint requests to 3181 SW Sam Jackson Park Rd, Portland, OR 97201 (Dr Amon).

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