Old age, extensive skin lesions, neutropenia and impaired renal function are poor prognostic factors. The recovery period is usually prolonged. While Staphylococcal Scalded Skin Syndrome is seen predominantly in children, TEN affects adults more than children. In addition to characterizing the physical, constitutional and mucocutaneous symptoms, a detailed history should focus on known etiologies of TEN, such as medication or chemical agent use, maternal-fetal transfusion, blood product administration, recent infections, measles immunization or recent radiotherapy. Prodromal symptoms may precede skin lesions by 1-2 weeks.
Fever is the most common symptom.
URI-like symptoms are present, such as malaise, anorexia, headache, sore throat, cough, nausea, vomiting and diarrhea. The skin is diffuse, erythematous, painful and with tender skin lesions, usually sparing the scalp. Mucous membranes have a painful inflammation and blistering of mucosal surfaces, especially the oropharynx, which may limit oral intake. Pain and photophobia are common ocular findings, which result from purulent conjunctivitis. This usually begins 1-2 days prior to the onset of the rash.