Contributor: Gordon K. Klintworth
Toxic epidermal necrolysis (Lyell syndrome) is a severe potentially life-threatening form or erythema multiforme major that affects skin in sun and non-sun exposed parts of the body. Frequently the mucous membranes are involved. The skin becomes tender <48 hours of onset. The disorder may follow an infection or the ingestion of a medication and is accompanied by a fever. The epidermis of >20% of the skin is involved and bullae form on an erythematous base. The epidermis becomes sloughed in sheets. Most cases develop extensive cicatrization beginning with the acute phase, and persisting throughout the period of chronic disease and healing. The eyelids, bulbar and palbebral conjunctiva and cornea may be involved and can be severe. The conjunctiva heals with scarring, but this does not follow a progressive course.