Toxic epidermal necrolysis (TEN) is a life-threatening drug reaction that requires immediate medical treatment. Mortality due to TEN cases is quite high until now and the main cause reported is multiple organ dysfunction syndrome. A 7-year-old child, was diagnosed TEN with 86% blistered skin, after receiving Metampiron. Given 20% albumin 50 ml from the first day treated until 20 days, also fluid resucitation, steroids, antibiotics, vitamin C, neurobion, paracetamol, antihistamines, oral hygiene, steroid and antibiotic ointment for body, eye ointment, woundcare, and high nutritions. The other case, 33-year-old woman, was diagnosed TEN with 100% blister skin, due to Phenytoin. Given 25% albumin 100 ml from the first day to 20 days. Both patients recover without complications. In TEN, hypoalbumin often occurs due to eroded skin. Hypoalbumin can reduce organ function and drug effectiveness. Drugs that are usually bound to protein become free in plasma and metabolism in hepatic become more rapid. Immidiate albumin therapy can prevent this and reduce patient mortality. The albumin also plays a role to accelerate skin regeneration.
<p>Uremic frost merupakan kelainan kulit yang jarang, karena ditemukan pada pasien gagal ginjal kronik yang belum menjalani hemodialisis. Kelainan ini ditandai dengan lapisan putih kekuningan akibat kristal urea yang mengendap di permukaan kulit. Seorang wanita 44 tahun datang dengan keluhan utama kulit kering, bersisik, dan gatal seluruh tubuh sejak 1 bulan. Pasien baru didiagnosis gagal ginjal kronis. Pada pemeriksaan dermatologi didapatkan makula hiperpigmentasi, berbatas tegas, multipel, ukuran lentikular-plakat dan krusta putih kekuningan. Tatalaksana dermatologi uremic frost adalah dengan pelembap dan antihistamin oral, pengobatan lebih lanjut untuk penyakit ginjal penyakit ginjal yang mendasari.</p><p>Uremic frost is a rare skin disorder, found in chronic kidney failure patients who have not undergone hemodialysis. This disorder is characterized by yellowish white layer on the skin surface due to urea crystals. A 44-year-old female patient presented with dry, scaly, and itchy skin on the whole body in the last 1 month. The patient has just been diagnosed with chronic kidney failure. Dermatological examination revealed hyperpigmented macules, well-defined, multiple, lenticular-placard size and also a yellowish-white crust. Management in dermatology is with moisturizers and oral antihistamines, further treatment should be given to underlying kidney disease.</p>
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