PMC8085411_01
Extent and location of exfoliated areas before debridement during primary treatment in the operating theater under general anesthesia (A). Partial exposure of the dermis, epidermis separated with necrosis of basal keratinocytes, which turns into complete necrosis of the entire epidermis (100x magnification) (B). Apoptotic bodies (arrowheads) were visualized in the epidermis collected from the affected area at different body locations (630x magnification) (C,D). All histological sections (2 x 2 mm) were prepared from formalin-fixed paraffin-embedded (FFPE) tissue specimens. Scale 20 mum.
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F1
Highly suspicious clinical signs of TEN (Figures 1A,C,D) were confirmed by biopsy (Figure 1B). Sixty per cent of the Total Body Surface Area (TBSA) was exfoliated (face, neck, thorax, upper extremities and proximal parts of lower extremities; Figure 1A).
Facial areas after debridement before application of lyophilized amniotic membrane (A), application of lyophilized amniotic membrane (B,C). Subsequent re-epithelialization in the facial area, 48 h after application of the lyophilized amniotic membrane (D), 7 days after application (E), 14 days after application (F).
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F2
Amnioderm , we observed a rapid re-epithelization within 48 h (Figure 2). All skin defects were healed by re-epithelization within 3 weeks after admission to the BICU.
Local image 3 months after application of lyophilized amniotic membrane - no signs of hyperpigmentation.
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F3
During the 3 months follow-up period, we observed a total regeneration of the skin with no signs of pigmentation or scaring at the area of Amnioderm  application (Figure 3).