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Harry L. Arnold, Jr, MD
San Francisco

JAMA. 1985;254(2):231-232.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Saying there are "two types of TEN [toxic epidermal necrolysis]," although it has been done scores of times, does not make it so.¹

There are not two types of TEN. There are two totally different diseases that superficially resemble one another: TEN and staphylococcal scalded skin syndrome (SSSS). They have different populations at risk, different causes, different pathogenesis, different pathological lesions, different treatments, and different prognoses.

Toxic epidermal necrolysis is diffuse erythema multiforme, usually affecting adults, usually caused by drug sensitivity, causing peeling of the full thickness of the epidermis, responsive to corticosteroids in the earliest phase only, and carrying a guarded prognosis. Treatment is that for an extensive, severe, second-degree burn.

Staphylococcal scalded skin syndrome is a toxic-enzymatic dissolution of the epidermis in the upper granular layer that occurs almost always in infants or children, is never due to drug sensitivity, but is caused by . . . [Full Text PDF of this Article]

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