Final answer:
In pemphigus, the high-priority nursing diagnosis is the risk of infection due to compromised skin integrity, necessitating meticulous wound care and monitoring for signs of infection.
Step-by-step explanation:
The unusual nursing diagnosis that is a high priority in pemphigus is the risk of infection due to the integrity of the skin being compromised. Pemphigus is an autoimmune disorder where blisters form on the skin and mucous membranes, leading to a high risk of infection if they burst or are improperly managed. Providing wound care, monitoring for signs of infection, and educating the patient on skin care are crucial nursing interventions.
In the context of necrotizing fasciitis, as described, it becomes especially critical since the patient mentioned is already showing signs of an out-of-control infection.
Systemic disorders like diabetes, or patients receiving immunosuppressive treatments such as chemotherapy or prolonged critical illness could also heighten the risk of infection, making meticulous care imperative.