Hyperbaric oxygen treatment of toxic epidermal necrolysis.

Hyperbaric oxygen, useful in treating patients with extensive burns, was used alone in the treatment of three patients with drug-induced toxic epidermal necrolysis. These conditions, although they have different causes, result in a similar biological state of denuded dermis. The therapy was performed in a pressure chamber with pure oxygen at 2 atm for sixty to 120 minutes once a day. Re-epithelialization occurred quickly in all patients and was complete after approximately ten treatments. Our experience, although limited and uncontrolled, points to a beneficial effect of hyperbaric oxygen in the treatment of toxic epidermal necrolysis. Activation of dermal metabolism, enhancement of epidermal regeneration, antishock and antiseptic action, and possibly an immunosuppressive effect are properties of hyperbaric oxygen that may account for its efficacy in the management of toxic epidermal necrolysis.