Lyell's syndrome is an acute and severe dermatological disease that causes destruction of the epidermis as if the skin had received second degree burns. This serious and painful drug allergy also affects the mucous membranes of the mouth, eyes and genitals. Lyell's syndrome is very rare and affects only 2 in 1 million people a year. Both children and adults can be affected.SYMPTOMSThe onset of Lyell's syndrome is sudden and unpredictable. It often begins with an influenza-like state before bubbles appear on the skin and on the mucous membranes. The lesions extend for about five days and at the slightest friction, the skin detaches and gives way to a red oozing. Early symptoms of Lyell syndrome may suggest a viral rash, such as chicken pox, but the rapid onset of new symptoms should be a clear warning sign of the condition. Here is a list of all these symptoms:- Appearance of redness on the face and body (the rash often begins in the face and upper part of the chest before spreading rapidly on the body)- Erosions on the mucous membranes (mouth, eyes, anus, genitals)- Appearance of blisters filled with fluid- Bursting of blisters and detachment of the epidermis leaving a bright red skin with the appearance of a second degree burn- High fever- Intense fatigue- DehydrationCAUSESThe most common cause of Lyell's syndrome is a drug allergy. Medications such as certain anti-inflammatories (ibuprofen for example), aspirin, certain antibiotics or anti-epileptics have caused an onset of the disease. Certain diseases such as systemic lupus erythematosus, HIV infection, cancer or radiation therapy increase the risk of developing Lyell's syndrome. In very rare cases, no suspicious drug has been identified.TREATMENTWhen Lyell's syndrome is diagnosed, the patient is immediately hospitalized urgently, often in intensive care and sometimes in a burn victims ward. A drip is then immediately installed to rehydrate the patient and when the mucous membranes of the mouth are affected, gastric tube feeding is required. Respiration frequency will also be closely monitored and skin care will be provided. Lyell's syndrome can be fatal in 20-25% of cases.