Biological skin substitutes to treat toxic epidermal necrolysis in a case with human immunodeficiency virus infection

Toxic epidermal necrolysis (TEN) is a rare, but life-threatening medical emergency with signifi cant morbidity and mortality. Current treatment standards for TEN patients include stopping all possible drugs associated with the new onset of symptoms, prompt referral and treatment in a specialized center with fl uid resuscitation, adequate analgesia and maintenance of nutritional needs. Extensive debridement of the involved epidermis followed by coverage with a skin substitute reduces the mortality from a skin infection and also improves the fl uid and electrolyte balance and pain control. Th is is increasingly considered an important part of the intensive care of these patients. Admitting physicians should be aware of this rare but life-threatening emergency, to allow prompt diagnosis and avoid delays in treatment.