Toxic epidermal necrolysis or Lyell's syndrome is a life-threatening, drug-induced disorder characterized by severe epidermal injury. Although plasmapheresis is expensive and requires easy venous access, it could be included in the first-line treatment of toxic epidermal necrolysis. The method is safe and effective, providing prompt relief from pain and rapid cessation of necrolysis. Moreover, in our experience plasmapheresis could be used in patients who were unresponsive to corticosteroids, and in patients with severe clinical symptoms.