Clinical Study of Toxic Epidermal Necrolysis (TEN) in a Tertiary Care Center of Western Nepal: A Descriptive Study

Introduction: Toxic epidermal necrolysis, or TEN, is a rare but very dangerous skin condition that is usually caused by medicines. In South Asia, including Nepal, we do not have much information about it. So we did this study to understand how TEN shows up in patients who come to our big hospital in Western Nepal. Methods: We looked back at the records of all TEN patients who came to our skin department from June 2010 to October 2025. We collected their age, sex, what medicines they took, what treatment they got, and how they did. Results: We found 70 patients with full records. Their average age was about 40 years, and more of them were women than men. Most were in their thirties. The medicines that caused the problem most often were anticonvulsants and antibiotics. All 70 patients got steroid injections and good wound care, and every one of them got better and went home. But we also found that 12 other TEN patients were sent to other hospitals because they were getting worse. We could not follow them, so we did not include them in our study. Conclusion: While all 70 patients in our cohort showed clinical improvement with corticosteroids and supportive care, the referral of 12 deteriorating patients to other centers suggests that the "0% mortality" figure reflects referral bias rather than true treatment success. we need better systems to track patients who get referred.