Clinical Report: Management of an Elderly Patient with Toxic Epidermal Necrolysis

Overview

This report details the successful management of an 84-year-old female patient with toxic epidermal necrolysis (TEN), highlighting the importance of individualized nursing care and multidisciplinary collaboration. Following a comprehensive nursing strategy, the patient achieved nearly complete wound healing and was transferred to a rehabilitation ward after 17 days of treatment.

Background

Toxic epidermal necrolysis is a rare but severe mucocutaneous disorder often triggered by medications, with high mortality rates, particularly in elderly patients with multiple comorbidities. Effective management is crucial to improve outcomes and reduce complications. This case underscores the need for tailored nursing interventions and strict infection control measures in vulnerable populations.

Data Highlights

No numerical data available.

Key Findings

• The patient had 55% body surface area involvement and a SCORTEN score of 3.
• Individualized nursing care included staged wound management and mucosal protection strategies.
• Yellow light irradiation and epidermal growth factor were utilized to promote wound healing.
• Full-process protective isolation and strict aseptic techniques were implemented to prevent infection.
• The patient showed significant improvement with nearly complete epithelialization after 17 days.

Clinical Implications

This case highlights the importance of a comprehensive nursing strategy in managing TEN, particularly in elderly patients. Clinicians should prioritize individualized care plans that include meticulous wound management and infection control to enhance recovery and minimize complications.

Conclusion

The successful management of this elderly patient with TEN illustrates the effectiveness of a multidisciplinary approach and tailored nursing interventions in improving clinical outcomes. Such strategies can serve as a reference for future clinical practice in similar cases.

References

1. Concurrent Toxic Epidermal Necrolysis and Acute Ulcerative Colitis: Distinct Disorder or Extraintestinal Manifestation?—A Case Study
2. Ustekinumab Shows Significant Efficacy in Crohn’s Disease Diagnosed in Older Adults: A Case Study
3. Drugs - Real World Outcomes — Analysis of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis Cases in Patients at Kenyatta National Hospital: A Retrospective Cross-Sectional Investigation
4. Diagnosing and Managing Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis in Adults: Review of Evidence 2017–2023
5. Clinical Rheumatology — Management and Long-Term Outcomes in Children with Hypocomplementemic Urticarial Vasculitis Syndrome (HUVS): A Review of Case Studies
6. VANDERBILT UNIVERSITY - SJSTEN Guidelines 2025
7. Diagnosing and Managing Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis in Adults: Review of Evidence 2017–2023 - ScienceDirect
8. Randomized, controlled trial of TNF-α antagonist in CTL-mediated severe cutaneous adverse reactions - PubMed