Blister fluid composition in a pediatric patient with toxic epidermal necrolysis.

Toxic epidermal necrolysis (TEN) is a rare life-threatening disease mostly related to drug ingestion. Apoptotic keratinocytes lead to separation of the epidermis from dermis and widespread blistering of the skin. This case is a pediatric patient with a seizure disorder who developed TEN after starting carbamezepine. Blister fluid was analyzed for protein, chemical, and mineral content. The TEN blister fluid composition was similar to burn blister, except that the burn blister fluid has a 3-fold increase in albumin and protein. There was a substantial increase in lactate dehydrogenase, calcium, and magnesium in both blister fluid specimens compared with serum levels. To our knowledge, this report is the first in the literature to analyze TEN blister fluid composition and compare it to burn blister fluid.