Acute/Emergency Dermatology Flashcards Preview

S2.5 Dermatology > Acute/Emergency Dermatology > Flashcards

Flashcards in Acute/Emergency Dermatology Deck (10):
1

What is erythroderma and what can cause it? How is it treated?

Inflammation on >90% of skin
Psoriasis, eczema
Drugs
Cutaneous lymphoma
Hereditary

Consider ITU/burns
Removal of cause
Fluid balance and nutrition
Temperature regulation
Emollients, oral/eye care

2

How does Stevens-Johnson syndrome present? What can cause it?

Fever, malaise, arthralgia
Maculopapular rash
Target lesions, blisters
Erosions <10% of surface

Cause by - antibiotics, anticonvulsants, allopurinol, NSAIDs

3

How does Toxic epidermal necrolysis present?

Prodromal febrile illness
Mucous membrane ulceration
Macular/purpuric/blistering
Becomes confluent, sloughing (30% desquamation)
Causes are same as SJS

4

What is erythema multiforme? What can cause it?

Abrupt onset of 100s of lesions over 24 hours
- distal > proximal
- palms and soles
- mucosal surfaces
Hypersensitivity, usually to infection
Usually self-limiting - symptomatic/causative treatment

5

What is DRESS? What can cause it?

Drug rash with eosinophilia and systemic symptoms syndrome
Fever and widespread rash
Lymphadeonopathy
Up to 10% mortality
2-8 weeks after drug exposure
Symptomatic/causative treatment
Consider systemic steroids/immunosuppression

6

What is the difference between pemphigus and pemphigoid? How are they treated?

Pemphigus blisters are fragile - not usually seen intact
- affects desmosomes
- systemic steroids, supportive therapies

Pemphigoid blisters usually intact
- affects dermo-epidermal junction
- topical steroids (systemic if diffuse)

Pemphigoid more common

7

What are the features of erythrodermic/pustular psoriasis? What causes it and how is it treated?

Rapid generalised erythema +/- pustule clusters
Fever, elevated WCC

Can be caused by infection or sudden steroid withdrawal

Treat with bland emollient
AVOID steroids
Often requires systemic therapy

8

How does eczema present? What causes it and how is it treated?

Monomorphic blisters and punched out erosions
- generally painful, not itchy
Fever and lethargy

Disseminated HSV on background of poorly controlled eczema
Treated with aciclovir
Mild topical steroid for eczema
Treat secondary infection

9

What is staphylococcal scalded skin syndrome? How is it treated?

Diffuse erythematous rash with skin tenderness
More prominent in flexures
Blistering and desquamation follows
Fever and irritability

Can be caused by staph, immunocompromised

Requires admission
- IV antibiotics, supportive care

10

How does urticaria present? What causes it and how is it treated?

Central swelling surrounded by erythema, dermal oedema
- itching, sometimes burning - histamine in dermis

Can be acute/chronic
- acute - idiopathic, viral, drugs/food
-- oral anti-histamine, short oral steroids, avoid opiates/NSAIDs
- chronic - autoimmune, idiopathic, physical, vasculitic, type I hypersensitivity (rarer)
-- non-sedating anti-H1, can add second or increase dose, also LTRA, tranexamic acid, immunomodulants (omazilumab, cyclosporin)