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Daniel Mark Siegel, MD
Department of Dermatology University of Texas Health Science Center 5323 Harry Hines Blvd Dallas, TX 75235

Arch Dermatol. 1985;121(3):305-306.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The overall mortality rate of 70% in Westly and Wechsler's¹ ten patients was relatively high and contrasts with the 30% figure cited by Fritsch and Elias² and the 20% to 50% range cited by Lyell,³ making either their patient population or their manner of treatment different from that of other groups. One possibility in this regard is their use of silver sulfadiazine (Silvadene) to treat some patients. An important factor is the capacity of silver sulfadiazine to attain therapeutic plasma concentrations when used to treat large, denuded skin surface areas, as frequently occurs in TEN.⁴ Moreover, both granulocytopenia and pancytopenia may accompany some toxic effects of sulfonamides by inducing bone marrow maturation arrest at the myoblast stage.⁴ Of particular relevance is the conclusion drawn by the authors that steroids are unwarranted in the treatment of TEN. Since three patients had suspected sulfonamide-related . . . [Full Text PDF of this Article]

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