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  • Title: [Lyell's disease (author's transl)].
    Author: Kint A, Geerts ML, de Weert J.
    Journal: Dermatologica; 1981; 163(6):433-54. PubMed ID: 7333400.
    Abstract:
    In Lyell's disease different clinical patterns can be observed: (a) an acute scarlatiniform erythema, on which more or less extended bullae rapidly appear; (b) a morbilliform erythema, with bullae; (c) the dermatosis can start under the features of an erythema exsudativum multiforme; (d) the eruption may begin as a psoriasis pustulosa. From an internal point of view, disturbances of the liquid balance and the blood electrolyte level may appear as a consequence of the important loss of water and serum. Toxic hepatitis, nephritis or myocarditis are possible complications. The origin of the disease is toxic or bacterial. This differentiation is important because the prognosis is much more favorable when the origin is bacterial than when the disease is due to medicines. A differential diagnosis between both etiologies may be achieved by histological examination: when the origin is a toxic one, we can find subepidermal blisters, while the blisters are located under the horny layer when the disease is of bacterial origin. The disease process is not clear in the toxic form. In cases induced by staphylococci, the epidermal lesions are caused by an epidermolytic toxin. The treatment will especially tend to restore the fluid and electrolyte balance; if there is a bacterial etiology, antibiotics will be necessary. Corticoids are to be avoided.
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