Flashcards in Acute and Emergency Dermatology Deck (36):
What is erythroderma?
Any inflammatory skin disease affecting >90% of total skin surface
What are the causes of erythroderma?
What are the consequences of skin failure?
Hypo and hyperthermia
Protein and fluid loss
What is the management for erythroderma?
Remove any offending drugs
Careful fluid balance
Oral and eye care
Anticipate and treat infection
Treat underlying cause
At what point in time are drug reactions likely to occur?
1-2 weeks after drug
What are some common drug causes of skin disease?
Stevens Johnson syndrome
Toxic epidermal necrolysis
What are the clinical features of Stevens Johnson syndrome?
Fever, malaise, arthralgia
Ulceration of other mucous membranes
What are the clinical signs of toxic epidermal necrolysis?
Prodomal febrile illness
Ulceration of mucous membranes
Sloughing of large areas of epidermis
What is the management for SJS and TEN?
Identify and stop culprit drug
High dose steroids
Anti TNF therapy
What are the long term complications of SJS and TEN?
Pigmentary skin changes
Eye disease and blindness
Nail and hair loss
What scale is used to determine and prognosis for SJS and TEN?
What type of reaction is erythema multiforme?
Hypersensitivity reaction triggered by infection
What is the management of eyrthema multiforme?
Symptomatic and treat underlying cause
What does DRESS stand for?
Drug reaction with eosinophilia and systematic symptoms
What is the onset time of DRESS?
2-8 weeks after drug exposure
What are the clinical signs of DRESS?
Fever and widespread rash
Eosinophilia and deranged liver function
What is the treatment for DRESS?
Stop causative drug
What are the clinical features of pemphigus?
Flaccid blisters, rupture very easily
Ill defined erosions in mouth, nose, eyes and genital areas
What are the clinical signs of pemphigoid?
Tense and intact blisters
What area is targeted in pemphigus?
Antibodies targeted at desmosomes
What area is targeted in pemphigoid?
Antibodies targeted demo epidermal junction
What are the common causes of erythrodermic psoriasis and pustular psoriasis?
Sudden withdrawal of oral steroids or potent topical steroids
What are the clinical features of eyrthrodermic psoriasis and pustular psoriasis ?
Cluster of pustules
Rapid development of generalised erythema
What is the management for erythrodermic and pustular psoriasis?
What is eczema herpeticum?
Disseminated herpes virus infection on a background of poorly controlled eczema
What are the clinical features of eczema herpeticum?
Monomorphic blisters and punched out erosions
Fever and lethargy
What is the management for eczema herpeticum?
Mild topical steroid
Treat secondary infection
What are the clinical features of staphylococcal scalded skin syndrome?
Diffuse erythematous rash with skin tenderness
Fever and irritability
Blistering and desquamation
What is the treatment for staphylococcal scalded skin syndrome?
Admission for IV antibiotics
What is angioedema?
Deeper swelling of the skin or mucous membranes
What are the clinical features of urticaria?
Itching sometimes burning
What are the causes of acute urticaria?
Drugs (IgE mediated)
Food (IgE mediated)
What is the treatment for acute urticaria?
Short course oral steroid
Avoid opiates and NSAIDs
What are the causes of chronic urticaria?
What type of reaction is chronic urticaria?
Type 1 hypersensitivity reaction