Błona śluzowa jamy ustnej u dzieci z zespołem toksycznej nekrolizy naskórka

*Dorota Olczak-Kowalczyk¹, Ewa Krasuska-Sławińska², Anna Wieteska-Klimczak³, Magdalena Siemieńska³, Marta Daszkiewicz², Lidia Ruszkowska⁴

Summary
Toxic epidermal necrolysis (TEN) is a disease of the skin and the mucosa caused by drugs, chemicals and infections. Erythematous and purpuric macules, blisters and mucous membranes erosions are the basic symptoms of the illness and may lead to life-threatening complications and therefore hospital treatment is required in all cases.
Objective: To present our experience in treatment of children with TEN with a special interest in oral mucosa lesions.
Material and method: Causes, clinical picture and therapeutic methods of TEN as well as location and type of oral lesions were analyzed in 8 children (3 months up to 12 years old) treated in Children’s Health Memorial Institute in Warsaw.
Results: Causes of TEN: drugs, virus, unknown. Oral lesions were found in all patients, skin lesions in 7 patients and in 4 they covered 80-100% of the body surface. In 2 patients perineum mucosa was affected. Depending on the clinical state of the patients, systemic treatment consisted of immunoglobulins, corticosteroids, antibiotics, analgesics, antihistaminic and anti-inflammatory drugs, immunosupresants, parenteral nutrition. In local treatment – antiseptics, normal saline, linseed and vaseline were administered. In spite of using aseptic beddings, Staphylococcai were cultured from 2 patients’ wounds and in one’s blood Staphylococcus epidermidis. One child died.
Conclusions: Mucosal lesions cause pain, can make feeding difficult and may be the source of systemic infection, therefore local treatment should be a constant element of the therapy.

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