• Severe exfoliative skin conditions leading to major skin loss are rare, yet associated with significant morbidity and mortality, and often necessitate critical care input. • These conditions are complex and need a multidisciplinary approach to management with input from intensivists, plastic surgeons, dermatologists, ophthalmologists, dieticians, psychologists, and physiotherapists. • Skin failure from widespread skin loss constitutes another organ failure. It should be treated like a major burn. • Strict attention to fluid and electrolyte balance, temperature management, eye care, wound care, pain control, nutrition, and prevention of infection are key. • Early referral with subsequent transfer to a burns centre for specialist wound management is highly recommended and improves outcomes.

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