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Flashcards in Acute and Emergency Dermatology Deck (36):
1

What is erythroderma?

Any inflammatory skin disease affecting >90% of total skin surface

2

What are the causes of erythroderma?

Psoriasis
Eczema
Drugs
Cutaneous lymphoma
Hereditary disorders

3

What are the consequences of skin failure?

Sepsis
Hypo and hyperthermia
Protein and fluid loss
Renal impairment
Peripheral vasodilation

4

What is the management for erythroderma?

Remove any offending drugs
Careful fluid balance
Good nutrition
Temperature regulation
Emollients
Oral and eye care
Anticipate and treat infection
Manage itch
Treat underlying cause

5

At what point in time are drug reactions likely to occur?

1-2 weeks after drug

6

What are some common drug causes of skin disease?

Stevens Johnson syndrome
Toxic epidermal necrolysis
Morbilliform exanthem

7

What are the clinical features of Stevens Johnson syndrome?

Fever, malaise, arthralgia
Rash
Mouth ulceration
Ulceration of other mucous membranes

8

What are the clinical signs of toxic epidermal necrolysis?

Prodomal febrile illness
Ulceration of mucous membranes
Rash
Sloughing of large areas of epidermis

9

What is the management for SJS and TEN?

Identify and stop culprit drug
High dose steroids
IV immunoglobulins
Anti TNF therapy
Ciclosporin

10

What are the long term complications of SJS and TEN?

Pigmentary skin changes
Scarring
Genital scarring
Eye disease and blindness
Nail and hair loss
Joint contractures

11

What scale is used to determine and prognosis for SJS and TEN?

SCORTEN

12

What type of reaction is erythema multiforme?

Hypersensitivity reaction triggered by infection

13

What is the management of eyrthema multiforme?

Self limiting
Symptomatic and treat underlying cause

14

What does DRESS stand for?

Drug reaction with eosinophilia and systematic symptoms

15

What is the onset time of DRESS?

2-8 weeks after drug exposure

16

What are the clinical signs of DRESS?

Fever and widespread rash
Eosinophilia and deranged liver function
Lymphadenopathy

17

What is the treatment for DRESS?

Stop causative drug
Systemic steroids
Symptomatic treatment

18

What are the clinical features of pemphigus?

Flaccid blisters, rupture very easily
Ill defined erosions in mouth, nose, eyes and genital areas

19

What are the clinical signs of pemphigoid?

Tense and intact blisters

20

What area is targeted in pemphigus?

Antibodies targeted at desmosomes

21

What area is targeted in pemphigoid?

Antibodies targeted demo epidermal junction

22

What are the common causes of erythrodermic psoriasis and pustular psoriasis?

Infection
Sudden withdrawal of oral steroids or potent topical steroids

23

What are the clinical features of eyrthrodermic psoriasis and pustular psoriasis ?

Fever
Elevated WCC
Cluster of pustules
Rapid development of generalised erythema

24

What is the management for erythrodermic and pustular psoriasis?

Bland emollient
Avoid steroids

25

What is eczema herpeticum?

Disseminated herpes virus infection on a background of poorly controlled eczema

26

What are the clinical features of eczema herpeticum?

Monomorphic blisters and punched out erosions
Fever and lethargy

27

What is the management for eczema herpeticum?

Aciclovir
Mild topical steroid
Treat secondary infection

28

What are the clinical features of staphylococcal scalded skin syndrome?

Diffuse erythematous rash with skin tenderness
Fever and irritability
Blistering and desquamation

29

What is the treatment for staphylococcal scalded skin syndrome?

Admission for IV antibiotics

30

What is angioedema?

Deeper swelling of the skin or mucous membranes

31

What are the clinical features of urticaria?

Itching sometimes burning
Dermal oedema

32

What are the causes of acute urticaria?

Idiopathic
Infection
Drugs (IgE mediated)
Food (IgE mediated)

33

What is the treatment for acute urticaria?

Oral antihistamine
Short course oral steroid
Avoid opiates and NSAIDs

34

What are the causes of chronic urticaria?

Autoimmune
Physical
Vasculitic

35

What type of reaction is chronic urticaria?

Type 1 hypersensitivity reaction

36

What is the management of chronic urticaria?

Omalizumab