Table 4.
Clinical manifestations and treatment of mucosal involvement and their sequelae(24)
| Organs/systems | Complication | Management |
|---|---|---|
| Tegumentary system | Depigmentation, melanocytic nevus, blistering desquamation, onycholysis, onychodystrophy, and nail and hair thinning and loss | Immediate referral to the specialized unit. |
| Elimination of the devitalized epidermis | ||
| Cover with a non-adherent dressing | ||
| Avoid frequent bandage changes that may prevent re-epithelialization | ||
| Biosynthetic silver biological coverage or impregnated antibiotic dressing | ||
| Monitoring of the infection (cultures of the injured skin every 48 hours) | ||
| Use of prophylactic antibiotics is not indicated | ||
| Control of the environmental temperature | ||
| Aseptic handling | ||
| Peripheral venous access away from affected areas | ||
| Ocular | Dry eye syndrome, sensation of sand in the eye, symblepharon, corneal scars, trichiasis, blindness, subconjunctival fibrosis, and photophobia | Ophthalmological consultation |
| Eye drops every 2 hours | ||
| Lubricants and topical antibiotics | ||
| Avoid development of synechiae by debridement with a blunt instrument | ||
| Transplantation of amniotic membrane if there is involvement of the cornea, conjunctiva or edge of the eyelid | ||
| Pulmonary | Bronchitis, bronchiectasis, bronchiolitis obliterans, organizational pneumonia, and respiratory tract obstruction | Monitoring of respiratory function |
| Supplemental oxygen if necessary. | ||
| Tracheal intubation and mechanical ventilation if there is airway involvement | ||
| Saline aerosols, bronchodilators, respiratory physiotherapy | ||
| Oral cavity | Sicca syndrome and reduced salivary and physiological flow Periodontal disease, gingival inflammation, synechiae, and oral discomfort | Frequent application of antiseptics |
| Elimination of oral scabs | ||
| Genitourinary | Dysparemia, adhesions, stenosis of the introitus, vulvovaginitis and erosive balanitis, urethral erosions, and genitourinary tract stenosis | Urological and gynecology consultation |
| Normal manual lysis to minimize adhesions | ||
| Foley catheter to maintain the permeability of the urinary tract | ||
| Gastrointestinal | Esophageal stenosis | Foley catheter to maintain the permeability of the urinary tract |
| Monitoring of nutritional status | ||
| Early enteral feeding | ||
| Prevention of stress ulcers |