Key admission findings included severe metabolic derangement (BMI 13.2 kg/m<sup>2</sup>, serum albumin 20 g/L, handgrip strength 12 kg), uncontrolled intra-abdominal and gluteal abscesses with multidrug-resistant organisms, complex skin integrity issues (chronic sacrococcygeal pressure injury, incontinence-associated dermatitis), and anatomical complications (presacral abscess, small bowel dilation of 9.87 × 9.86 cm, right ureteric obstruction). Here, ALB is linked to dermatitis.