Toxic epidermal necrolysis (TENS) is a severe form of Stevens-Johnson syndrome.

These rare disorders affect the skin and mucous membranes, causing the skin to blister and detach. TENS is typically caused when someone has a severe reaction to a medication or infection.

The symptoms resemble those associated with a burn injury, including blistering of the skin, a burning sensation, redness and peeling of the skin. Early signs of TENS may include fever, flu-like illness, eye itching and burning, joint pain and cough. Later, the patient may develop patches of painful red/purple skin with peeling blisters, which are often painful. This may affect the mucosal lining, such as the inside of your mouth, lips, windpipe, lungs and gastrointestinal tract. Symptoms may include sores on the lining of the mouth, eyes and genitals, as well as difficulty breathing. When a patient's skin is sloughed off, their body is unprotected from surrounding infections and bacteria. Patients may also not be able to take in enough nutrition and fluid on their own.

When traumatic wounds or blistering skin diseases become serious, get infected or fail to heal, Shriners Children’s has experienced staff to help contribute to better outcomes. Shriners Children’s offers innovative treatments such as skin grafting and specialized wound care.

Treatment for very severe toxic epidermal necrolysis can be like that developed for burn wounds. Shriners Children’s uses advanced burn care and plastic surgery techniques to save skin tissue, reduce the risk of infections, and provide the best appearance for patients.

Children with very severe cases of TENS are likely to end up in a burn unit, where the critical care and wound management expertise of our staff can be applied to the organ failures and wounds seen in children with severe TENS.
Robert L. Sheridan, M.D., Shriners Children’s Boston Chief of Staff and Director of the Burn Service
female provider speaking with patient and mother

Wound Care and Skin Disorders

Shriners Children’s medical staff treat various wounds and skin disorders through surgical and non-surgical techniques to correct skin differences. Through the help of the Shriners Children’s, our team supports the self-esteem of each child to help them reach their dreams and goals.

Innovative Treatments

View All

Burn Care

Shriners Children’s treats all levels and types of burns, including chemical burns, electrical burns and flame burns. Our pediatric burn care treatment plans are personalized and can include wound care, scar management and reconstruction.

Plastic Surgery

Shriners Children’s experienced pediatric plastic surgeons use reconstructive plastic surgery techniques to bring hope and healing to families dealing with differences involving the face, jaw, eyelids, ears, breasts or skin.

Next Steps

Request an Appointment

Families and caregivers seeking treatment should start by contacting us for an appointment.

Log in to the Patient Portal

Parents and guardians of existing patients can email, request records, schedule appointments and more.

Refer a Patient

Physicians and healthcare providers can request appointments, start transfers or contact us with questions.