Dermatological Emergencies Flashcards Preview

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Flashcards in Dermatological Emergencies Deck (10):

Drugs associated with maculopapular drug eruptions

  • Antibiotics
  • Anti-seizure medication


Course of maculopapular drug eruption

  • Red maculopapular rash with generalized distribution that spares the face
  • Often itchy, may involve fever
  • Onset 4-21 days after starting drug, lasts 1-3 weeks
  • Topical steroids and oral antihistamines for symptom releif


Erythema multiforme

Relativley common, acute, often recurrent inflammatory disease

  • Etiology unknown but commonly associate with preceding infections, especially HSV
  • Typical presentation involves red maculopapules appearing suddenly in symmetric pattern on backs of hands and feet and extensor surfaces of forearms and legs
    •  Commonly mucosal lesions (lips and buccal mucosa)
    • Evolve into target lesions with central vesicle
  • Entire episode can last around 1 month


Exfoliative erythroderma

Serious (life threatening) reaction pattern on skin characterized by redness, infiltration, and scaling of almost the entire surface of the skin

  • Acute and chronic forms
  • Issue can be high output cardiac failure
  • Usually in individuals over 50
  • Isolation and supportive therapy


Steven-Johnson Syndrome (SJS) vs Toxic Epidermal Necrolysis (TEN)

Different regions of a single spectrum of disease that are acute, life-threatening mucocutaneous reactions characterized by extensive epidermal necrosis and epidermal detachment

  • Widespread apoptosis of keratinocytes
  • Often accompanied by fever, tachycardia, renal issues, and sloughing of GI lining
  • SJS is less than 10% epidermal detachment
  • TEN is more than 30% epidermal detachment
  • Both are often results of drug reactions


Pemphigus vulgaris

Chronic blistering disease that involves destruction of desmosomes

Lesions in mouth and on scalp, face, head, and neck


Pemphigus foliaceus

Autoimmune blistering disease

  • Scaly, crusty erosions on eythemetous base
  • Initially presents on face and trunk and then spreads to large areas of body



Autoantibodies bind to calcium-dependent adhesion molecules (desmogleins) 

  • Can treat with systemic glucocorticoids


Bullous pemphigoid

Large bullous lesions (blisters) on skin (generally lower abdomen/groin/flexural areas)

  • Lesions eventually burst and are replaced by erosions with or without crust
  • Elderly are most suceptible
  • Due to autoantibody attack of hemidesmosomes
  • Treat with glucocorticoids


Necrotizing fasciitis

Characterized by rapid progression of infection with extensive necrosis of soft tissues and overlying skin

  • Often from group A strep +/- anaerobes +/- gram-negative bacilli
  • Severe sepsis/fever
  • Clinical manifestations appear 36-72 hours after onset