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

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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 

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