Exfoliative diseases of the integument and soft tissue necrotizing infections

Acute, severe exfoliative, and necrotizing diseases of skin and underlying structures may cause significant morbidity in the afflicted patient. The problems associated with these diseases, such as wound infection, sepsis, inadequate nutrition, and pain, are similar to those seen in patients with major burns. These patients, however, are often more acutely ill than burn patients due to the involvement of more internal surfaces and systems. Burn centers provide expertise in the treatment and management of critically ill patients with skin loss from all causes, not solely from thermal injury. This chapter describes the pathophysiological processes of severe exfoliative skin disorders, their diagnosis, and the specialized treatment offered by burn units.