PMC3355648_01
a Truncal epidermal necrolysis and b flaccid bullae on right upper limb, on admission. c Silver sulfadiazine application, day 7. d Extensive lesioning, day 14. e Re-epithelialisation with altered pigmentation, day 21. Incidental umbilical hernia was untreated.
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F1
Examination revealed truncal epidermal loss and raw, oozing dermis (fig. 1a). Remaining epidermis featured irregular erythematous zones and flaccid bullae (fig. 1b). Local food was supplemented to address protein-deficiency and silver sulfadiazine was regularly applied to skin for infection prophylaxis (fig. 1c). Full recovery took 28 days, with some cutaneous scarring and abnormal pigmentation as final sequelae (fig. 1e).
Facial chronology. a Nikolsky's sign under right eye and haemorrhagic oral erosions, on admission. b Eyelids oedema and lip necrosis, day 5. c Epidermal stripping and ulcerated conjunctivae, day 9. d Silver sulfadiazine application, day 13. e Re-epithelialisation, day 17. f Predominantly healed, with mild facial oedema, day 21.
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F2
Painful erosions of conjunctival, oral and genital mucosa appeared within 24 h of admission (fig. 2a), whilst re-epithelialisation began after ten days. Protein-deficiency oedema and anaemia (haemoglobin was 6.5 g/dl) occurred and resolved during the latter stages of healing (fig. 2f).