Case Report: An Overview of Toxic Epidermal Necrolysis in A 2-Year-Old Child Clinical Symptoms and Nutritional Therapy

Toxic Epidermal Necrolysis (TEN) is a severe mucocutaneous reaction characterized by extensive necrosis and detachment of the epidermis, which can lead to metabolic disturbances and increased nutritional requirements. Its management necessitates a comprehensive approach, including nutritional support. This report describes the clinical manifestations and nutritional management of a pediatric patient with Toxic Epidermal Necrolysis. It is a descriptive case report based on data from the patient's medical history, physical examination, laboratory findings, diagnosis, treatment, and the monitoring of clinical status and nutritional condition throughout the course of care. The data were analyzed descriptively by comparing the patient's status over the treatment period. The findings indicate that a 2-year-old girl developed a red rash, blisters, and skin peeling following the administration of Novagesik. Examinations revealed epidermolysis covering approximately 89% of the body surface area, a positive Nikolsky sign, and involvement of the ocular, oral (lip), and genital mucosa. The patient presented with malnutrition, leukopenia, hyponatremia, and hypoalbuminemia. Management included fluid therapy, antibiotics, corticosteroids, wound care, and enteral nutritional therapy via a nasogastric tube, utilizing a high-calorie, high-protein formula. Throughout the treatment, there was an improvement in clinical condition and laboratory parameters, as well as an increase in body weight. Recognizing the characteristic clinical manifestations supports a diagnosis of Toxic Epidermal Necrolysis, while enteral nutritional therapy serves as a crucial component of supportive care, helping to meet energy and protein requirements during the recovery process.