skip to main content

Toxic epidermal necrolysis — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAcute Rheumatological and Dermatological EmergenciesToxic epidermal necrolysisSCE Acute Medicine

A 34-year-old woman presents with rash, allergic features, visual symptoms or systemic inflammation. Relevant history includes recent drug exposure, autoimmune disease or allergen exposure. On assessment, skin, mucosal or vascular findings suggest systemic disease. Investigations show epidermal detachment over 45 percent with mucosal erosions. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Stop culprit drug and transfer to burns or specialist dermatology unit

The key discriminator is that epidermal detachment over 45 percent with mucosal erosions, which makes Stop culprit drug and transfer to burns or specialist dermatology unit the single best answer. Arrange routine outpatient follow-up is less appropriate because it does not address the dominant acute risk in the vignette; Start broad-spectrum intravenous antibiotics would fit a different presentation or later stage of care. Give targeted antidote or reversal therapy and Provide supportive care and close monitoring are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: BAD SJS/TEN guideline