Patients can shed the epidermis of the eyelids, as well as eyebrows, fingernails, and toenails. In severe cases the inflammation can extend to the internal organs, causing damage to the intestinal and respiratory tracts. Mary was, in this respect, fortunate. Her internal symptoms were limited to some inflammation in her mouth. A topical ointment helped heal and anesthetize the tender inflamed sites.
Most patients suffer damage only in the epidermis.
Within a month, the skin heals, although some residual redness may linger for a few weeks. In some extremely severe cases the damage may extend past the dermis to the subcutaneous layer of skin. The prognosis for TEN depends on how quickly the disorder is diagnosed and treated. Nearly half of the surviving patients have residual and potentially disabling eye lesions, which can include scarring of the cornea. Mary's chances for recovery were good, given that we identified and treated the disorder quickly.