What is the classic definition of toxic epidermal necrolysis (TEN)?

Toxic epidermal necrolysis (TEN) is characterized by the extensive sloughing of the epidermis, with the classic definition involving sloughing of greater than 30% of the body surface area. This severe cutaneous drug reaction is often associated with a high rate of morbidity and mortality due to fluid loss, risk of infection, and the potential for systemic complications. The condition can lead to significant damage to the skin's protective barrier, resulting in similar conditions as seen in full-thickness burns.

Understanding the severity of the condition is crucial for diagnosis and management. When the sloughing exceeds 30% of the body surface, it generally indicates a critical condition that necessitates urgent medical intervention and often treatment in a burn unit or specialized facility. This classification helps guide treatment options and prognostication for the patient.

In contrast, the other definitions provided do not align with the established criteria for TEN. Sloughing of less than 10% or between 20-30% body surface area corresponds to other less severe conditions, such as Stevens-Johnson syndrome, whereas localized skin rashes without blisters do not accurately depict the systemic nature and severity associated with TEN. Proper identification of the syndrome's severity is essential for appropriate care