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Toxic epidermal necrolysis — SCE Acute Medicine MCQ

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ModerateAcute Rheumatological and Dermatological EmergenciesToxic epidermal necrolysisSCE Acute Medicine

A 59-year-old woman is assessed on the acute medical unit. She has widespread epidermal detachment involving over one third of body surface area after allopurinol. She is febrile and hypotensive. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: D — Toxic epidermal necrolysis

Toxic epidermal necrolysis is the best answer because extensive epidermal detachment with mucosal disease after high-risk drug exposure indicates TEN. Septic shock is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Early burns or dermatology intensive supportive care improves outcomes.

Reference: BAD guideline