Acta Scientific Nutritional Health (ASNH)(ISSN: 2582-1423)

Case Report Volume 7 Issue 1

62-Year-Old Woman with Severe Malnutrition and Toxic Epidermal Necrolysis

Yulin Arditawati1*, Darmono1, Febe Christianto1 and Widyastuti2

1Department of Clinical Nutrition, Diponegoro University, Indonesia
2Department of Dermatovenereology, Diponegoro University, Indonesia

*Corresponding Author: Yulin Arditawati, Department of Clinical Nutrition, Diponegoro University, Indonesia.

Received: December 14, 2022; Published: December 26, 2022


Malnutrition and skin problems are interrelated. Malnutrition may reduce the function of innate and adaptive immunity. There are immune cells in the skin that are crucial for host defense. A 62-year- old female patient was diagnosed with Toxic Epidermal Necrolysis (TEN) due to an unknown drug allergy and moderate to severe malnutrition. The patient had a history of inadequate intake for one year and has worsened during the last two weeks due to blistered and peeling skin, especially in the labium oris area after taking an unknown analgesic medication. Nutrition therapy with a target of 1900 kcal/day was administered and gradually increased to 2200 kcal/day through the enteral and parenteral route with a protein intake of 1.5 grams/kgIBW/day. Due to a history of food aversion to animal protein such as chicken, eggs, fish, cow's milk, and dairy products, soy-based polymeric formula and supplemental parenteral nutrition were administered to achieve nutrition requirements. Micronutrient supplementations including zinc, vitamin A, vitamin B complex, and vitamin C were given on day one of treatment. The patient experienced side effects due to systemic corticosteroids in the form of the moon face, severe muscle wasting, hyperglycemia, and hypertension. At the end of the treatment period, there were metabolic improvements such as wound healing without secondary skin infection and improvement of albumin serum from 2,3g/dL to 3,3g/dL.

Keywords: Aversion, Corticosteroid; Malnutrition; Toxic Epidermal Necrolysis


  1. Yaseen MS., et al. “Efficacy of dietary nucleotides (NucleoforceTM)on growth, haemato-immunological response and disease resistance in pangasianodon hypophthalmus fish (sauvage, 1878) in Egypt”. Egyptian Journal of Aquatic Biology and Fisheries 6 (2020): 405-424.
  2. Sobotka L. “Nutrition and wound healing”. In: Sobotka L, editor. BASICS IN CLINICAL NUTRITION. 5th Czech Republic: House Galen (2019): 520-525.
  3. Cederholm T., et al. “ESPEN guidelines on definitions and terminology of clinical nutrition”. Clinical Nutrition 36 (2017): 49-64.
  4. Pierpont YN., et al. “Obesity and Surgical Wound Healing: A Current Review”. ISRN Obesity 2014 (2014): 1-13.
  5. Venter C., et al. “Nutrition and the immune system: A complicated tango”. Nutrients3 (2020).
  6. Cederholm T., et al. “GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community”. Clinical Nutrition 1 (2019): 1-9.
  7. Abd-el-gawad WM and Rasheedy D. “Nutrition in the Hospitalized Elderly”. Molecular Basis of Nutrition and Aging (2016): 57-72.
  8. Volkert D., et al. “ESPEN Guideline ESPEN guideline on clinical nutrition and hydration in geriatrics”. Clinical Nutrition (2018).
  9. França TGD., et al.Interaction between Nutrition and Infection 3 (2009): 376.
  10. Arabi Shaghayegh and Molazadeh Morteza RN. “Nutrition, Immunity, and Autoimmune Diseases”. In: Nutrition, Immunity, and Autoimmune Diseases (2019): 416-420.
  11. Macallan D. “Infection and malnutrition”. Medicine (Baltimore)10 (2009): 525-528.
  12. Kementerian Kesehatan Republik Indonesia. PNPK Malnutrisi Dewasa. Pedoman Nas pelayanan Kedokt tatalaksana malnutrisi pada dewasa 2 (2019): 1-162.
  13. Williams DM. “Clinical pharmacology of corticosteroids”. Respiratory Care 6 (2018): 655-670.


Citation: Yulin Arditawati., et al. “62-Year-Old Woman with Severe Malnutrition and Toxic Epidermal Necrolysis".Acta Scientific Nutritional Health 7.1 (2023): 96-102.


Copyright: © 2023 Yulin Arditawati., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.316

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US