Meirong Sun, Yanshuo Wu, Congcong Zhao, Yanling Yin

Department of ICU, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, People’s Republic of China

Correspondence: Yanling Yin, Department of ICU, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, Hebei, 050000, People’s Republic of China, Tel +86 18531117560, Email 47400548@hebmu.edu.cn

Abstract: Acute skin failure (ASF) is a critical condition marked by rapid skin deterioration, catastrophic skin dysfunction due to systemic hypoperfusion, often occurring alongside multi-organ failure. This report presents the case of a 37-year-old woman who developed rapid skin necrosis within less than a week and was diagnosed with ASF. The progression of her condition was categorised into three stages: progressive, necrotic and reparation. A comprehensive skin management strategy was applied at each stage, comprising systemic stabilization (antibiotic therapy/fluid resuscitation), stage-targeted local care (protective foam dressings in the progressive stage, chlorhexidine antisepsis in the necrotic stage, and recombinant human epidermal growth factor [rhEGF] gel in the reparation stage), and early rehabilitation (ankle pump exercises)—was applied at each stage, leading to successful healing and discharge on the 42nd day of hospitalisation. This case highlights the effectiveness of a staged approach to ASF management and emphasises the need for further research to establish standardised diagnostic criteria and a pathophysiological understanding of ASF. Thus, this case describes the patient’s ASF course (skin appearance and the patient’s feelings), together with the care evaluations at each stage and key treatment points. This study aims to improve the medical staff’s ability to recognise and treat ASF in critically ill patients.

Keywords: acute skin failure, skin necrosis, progressive stage, necrotic stage, reparation stage, case report