Which medications in the drug class Corticosteroids are used in the treatment of Toxic Epidermal Necrolysis (TEN)?

Updated: Jul 01, 2021
  • Author: Samantha P Jellinek-Cohen, PharmD, BCPS (AQ-ID); Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Corticosteroids

While corticosteroids may be used, their use is highly controversial. Although high-dose corticosteroids used early in the course of TEN (within 24-48 hours of onset) may halt the progression of the reaction, many experts believe that corticosteroids should not be used because they predispose patients to infection, mask early signs of sepsis, encourage GI bleeding, and impair or delay wound healing.

If corticosteroids are used, the initial high dose is titrated down as quickly as possible and tapered off, usually over 7-10 days.

Dexamethasone (Baycadron)

Dexamethasone decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability. Other corticosteroids, such as methylprednisolone, prednisone, and hydrocortisone, also may be used.

Methylprednisolone (Solu-Medrol, Medrol, A-Methapred)

Methylprednisolone is a highly potent synthetic glucocorticoid that causes diverse metabolic effects and modifies the body's immune responses to various stimuli.

Prednisone

Prednisone, a synthetic glucocorticoid analog, acts as a potent immunosuppressant. It May inhibit cyclooxygenase, which, in turn, inhibits prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.

Hydrocortisone (A-Hydrocort, Solu-Cortef, Cortef)

Hydrocortisone elicits anti-inflammatory properties and causes profound and varied metabolic effects. This agent modifies the body's immune response to diverse stimuli.


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