Skin biopsies to assess response to systemic corticosteroid therapy in early-stage TEN: case report and review of the literature.

Toxic epidermal necrolysis (TEN) is a severe, mucocutaneous, necrolytic reaction to a variety of antigenic stimuli. The use of systemic corticosteroids in the treatment of TEN is controversial because of a lack of randomized, controlled, prospective studies, and because the effects of steroid therapy vary depending on the dosage and time of its administration during the course of TEN. Immediate intervention is crucial, and the response to corticosteroids in early-stage TEN can be difficult to clinically assess.