• Georgios Gaitanis, Panagiota Spyridonos, Konstantinos Patmanidis, Vasilios Koulouras, Georgios Nakos, Margaret Tzaphlidou, and Ioannis D Bassukas.
• Department of Skin and Venereal Diseases, University of Ioannina Medical School, Ioannina, Greece.
• Dermatology (Basel). 2012 Jan 1; 224 (2): 134-9.

BackgroundTherapeutic evidence for toxic epidermal necrolysis (TEN) is indicative for high-dose intravenous immunoglobulin yet inconclusive for corticosteroids.ObjectiveTo describe the combination of corticosteroids, infliximab and a high-dose intravenous immunoglobulin course for TEN.Patients And MethodsIn three patients (SCORTEN survival probabilities: 41.7%, 64.2%, 41.7%) disease control was evaluated by (a) employing quantitative image analysis to measure progression of skin detachment and (b) patients' outcome (complete re-epithelization). Published cases of TEN treatments with infliximab were retrieved from PubMed.ResultsWithin 48 h skin disease progression was arrested in all patients. Two patients were discharged after 3 weeks without any sequels from skin or conjunctivae. One patient passed away on the ninth day, however with noticeably improved skin (mortality rate: 33% observed vs. 50% expected). A PubMed search retrieved five TEN patients treated successfully with infliximab.ConclusionThe described combination presents a feasible therapeutic alternative for TEN that warrants further evaluation.Copyright © 2012 S. Karger AG, Basel.

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