derm emergencies Flashcards
(28 cards)
what is erythema multiforme?
hypersensitivity reaction
- infection -> HSV, mycoplasma pneumoniae
- drugs
- idiopathic
which sites does EM affect?
skin
- limbs > trunk
- asymptomatic or mild itch/burn
mucous membranes
- oral
what does minor EM involve?
skin only
what does major EM involve?
skin + mucous membranes
what is the treatment for EM?
treat cause
symptom treatment
oral corticosteroids
how do you manage large blisters?
pierce with sterile needle to remove fluid
what is bullous pemphigoid?
autoimmune, subepidermal blistering disease
what is bullous pemphigoid associated with?
neuro disease - stroke, dementia and parkinsons
internal malignancy
autoimmune - RA, hashimotos
who does bullous pemphigoid typically affect?
> 80 y/o
what drugs cause bullous pemphigoid?
diuretics
analgesics
antibiotics
potassium iodide
gold
captopril
how does bullous pemphigoid present?
intense itch
widespread blisters
what is erythroderma?
redness >90% of body SA
what are features of erythroderma?
redness, dryness
keratoderma of palms and soles
lymphadenopathy
fever/ hypothermia
HF
fluid and electrolyte imbalance
what are causes of erythroderma?
idiopathic
drugs
eczema
psoriasis
cutaneous T cell lymphoma
piyriasis rubra pilaris
blistering -pemphigus and bullous pemphigoid
what investigations are used for erythroderma?
skin swabs, septic screen
FBC , U+Es
HIV test
echo
skin biopsy
how is erythroderma managed?
admit
emollients
manage fluids and temp
IV antibios if needed
antihistamines
treat cause
what is Henoch-schonlein purpura?
small vessel systemic vasculitis in children
IgA immune complexes in circulation and in vessel walls
what are the triggers of HSP?
infections - mainly URTI
vaccines - MMR, flu
what is the management of HSP?
BP + urine dip
discharge if well
vasculitis screen
what are skin signs of HSP?
palpable purpura starting and mainly affecting lower limbs-buttocks, can start as urticarial-angioedema, rarely haemorrhagic bullae
what is measles?
paramyxovirus
airborne resp droplets
what are the signs?
7 Cs
cough
coryza
conjunctivitis
concurrent rash/fever
coplik
cephalocaudal spreading rash
cervical lymphadenopathy
what is toxic epidermal necrolysis?
life-threatening reaction to med
characterised by epidermal death (necrosis)
what is TEM a maximal variant of?
stevens-johnson syndrome (SJS)
