Stern and Chan listed criteria for the diagnosis of toxic epidermal necrolysis (TEN).


Criteria – Skin Findings:

(1) Bullae or erosions are present over > 20% of body surface area, OR > 3 different anatomic areas are involved.

(2) Bullae or erosions develop on an erythematous base.

(3) Skin is tender within 48 hours of onset of rash.

(4) Non-sun-exposed skin affected.

(5) Mucous membrane involvement frequent.

(6) Skin peels of in sheets > 3 cm in diameter (i.e., not just erythema and desquamation as is seen in exfolliative erythroderma)

(7) A skin biopsy taken within 48 hours of onset shows basal necrosis, compatible with drug-induced toxic epidermal necrolysis.


Criteria – Other Findings:

(1) Fever (threshold temperature not given)


Criteria - Exclusions:

(1) Staphylococcal scalded skin syndrome excluded.


To read more or access our algorithms and calculators, please log in or register.