Toxická epidermální nekrolýza v kontextu závažných bulózních onemocnění – Lipový Břetislav (2025)

The issue of "dermatological disasters" – severe bullous diseases – is becoming an increasingly relevant topic. With the rising number of medications introduced into clinical practice, the likelihood of drug-induced dermatological reactions is also increasing. The most severe condition in this relatively heterogeneous group of diseases is toxic epidermal necrolysis (TEN).

It is a very rare disease that manifests as varying degrees of skin exfoliation and often also involves mucosal damage. The fundamental pathophysiological basis of this disease is the induction of massive apoptosis of keratinocytes, predominantly in the area of the dermal-epidermal junction. Unfortunately, a complete and satisfactory description of the pathophysiological background of this syndrome is still lacking. This fact is subsequently reflected in often futile therapy, which results in a very high mortality rate. With a bit of exaggeration, one could say that the more we know about TEN, the more complex the syndrome seems to be. To this day, a reliable therapeutic concept has not been established that would demonstrate significant effectiveness against the underlying disease, namely stopping the progression of local and systemic changes, while minimally compromising the function of the immune system in reduction...