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SS: Dermatology > Dermatological Emergencies > Flashcards

Dermatological Emergencies Flashcards

(47 cards)

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1
Q

Conditions in Dermatological Emergencies

A 
Eczema herpeticum
Drug Eruptions
Erythroderma
Erythem Multiforme
Urticaria & angioedema
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2
Q

Eczema Herpeticum

A

Serious complication of Eczema caused by Herpes Simplex Virus

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3
Q

Presentation of Eczema Herpeticum

A

Extensive blisters, fever and malaise

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4
Q

Treating Eczema Herpeticum

A

IV Aciclovir and antibiotics

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5
Q

Complications of Eczema Herpeticum

A

Hepatitis
Encephalitis
Disseminated intravascular coagulation

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6
Q

Presentation of Drug eruptions

A

Facial involvement, widespread erythema, skin pain, blistering, purpura, necrosis, fever, lymphadenothpathy, arthralgia, shock

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7
Q

Type 1 Anaphylactic drug reactions

A

Anaphylaxis, urticaria, angioedema

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8
Q

Type 2 Cytotoxic drug reactions

A

Pemphigoid, Pemphigus, Thrombocytopenia

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9
Q

Type 3 Immune Complex Mediated drug reaction

A

Serum sickness, vasculitis

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10
Q

Type 4 Cell-mediated drug reaction

A

Contact allergy, DRESS, Morbilliform rash, TEN

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11
Q

Morbilliform

A

rash that looks like measles, 5-10 day onset, fever, malaise, maculopapula, symmetrical, can progress to erythroderma

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12
Q

Drugs causing Morbilliform

A 
Penicillin
Erthromycin
Carbamazepine
Allopurinol
NSAIDs
Phenytoin
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13
Q

Treating Morbilliform

A

Antihistamine
Emoillents/ Soap Substitution
Topical Steroid

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14
Q

Acute Generalised Exanthematous Pustulosis (AGEP)

A

Skin reaction with rapid onset, starting in face and flexures, fever, malaise, neutrophil leucocytosis

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15
Q

Drugs causing AGEP

A 
Tetracylines
Antifungals
Calcium channel blockers
Paracetamol 
Hydroxychloroquine
Carbamazepine
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16
Q

Treating AGEP

A

Antihistamine
Emoillents/ Soap Substitution
Topical Steroid

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17
Q

Drug hypersensitivity syndrome (DRESS)

A

Drug reaction with eosinophilia and systemic symptoms. Severe reaction 2-8 weeks following drug initiation

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18
Q

Presentation of DRESS

A

Widespread rash: Maculopapular, pustules, erythroderma

Multi-organ involvement: lymphadenopathy, hepatitis, pericarditis, interstitial nephritis, pneumonitis

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19
Q

Drugs causing DRESS

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A

Antiepileptics
Sulphonamides
Allopurinol

20
Q

Diagnostic criteria for DRESS

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A 
Hospitalisation
Suspected drug reaction 
Acute skin rash 
Fever >38C
Lymphadenopathy at 2 sites 
At least 1 other organ involved
Thrombocytopenia/ Eosinophilia
21
Q

Treatment of DRESS

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A

Antihistamine
Emoillents
Topical Steroids

22
Q

Erythroderma

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A

Inflammation of entire skin surface, pruritis, hair loss, hyperkeratosis palms, lymphadenopathy

23
Q

Complications of Erythroderma

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A 
Secondary infection
Loss of thermoregulation
High cardiac output failure
Fluid and electrolyte imbalance
Hypoalbuminaemia
24
Q

Causes of erythroderma

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A 
Drugs
Dermatitis: atopic eczema, contact dermatitis
Psoriasis
Immunobullous disorders
Pityriasis rubra pilaris (PRP)
Cutaneous T-Cell Lymphoma
Systemic Malignancy 
HIV
25
Emoillents for Erythroderma
Hydromol ointment | Dermol 500 lotion
26
Erythema Multiforme (EM)
Type 4 Hypersensitivity reaction, eruption of 3 zoned target lesions. Usually second to infection: HSV< viruses, vaccines
27
Drugs causing Erythema Multiforme
Sulphonamides Anticonvulsants Allopurinol Antibiotics
28
Risk factors for Erythema Multiforme
Male, pregnancy, live vaccines, Slow acetylators, SLE, IBD, chemotherapy
29
Features of Erythema Multiforme
Prodromal flu-like illness Acral rash May Koebnerise (formation of linear lesions)
30
Investigations for Erythema Multiforme
Biopsy | FBC: leucocytosis, lymphocyted, eosinophilia, neutrophilalia, thrombocytopenia
31
Treatment of Erythema Multiforme
``` Withdrawal of cause Antihistmaines Analgesia Mouthwashes Topical Steroids Aciclovir for 6-12 months ```
32
Erythema Multiforme Minor
- Typical targets, oedematous plaques | - Acral distribution
33
Erythema Multiforme Major
- Typical targets, oedamtous plaques - Acral distribution - Mucous membrane involvement - <10 % of total body surface area (TBSA) epidermal detachment
34
Steven Johnsosns and Toxic Epidermal Necrolysis
- Widespread blisters - Erythematous or pruritic macules - Mucous membrane involvement - Epidermal detachment: <10% for SJS, >30% for TEN
35
Signs of SJS and TEN
Erythroderma, facial oedema, skin pain, palpable purpura, skin necrosis, blisters, mucous membrane erosion, swelling of tongue
36
Complications of SJS and TEN
``` Lack of thermoregulation Hypotension Reduced consciousness Oliguria Labile glucose readings Respiratory compromise Ocular problems Mucosal scarring Oesophageal stricturing Pain Arthralgia ```
37
SCORTEN
Severity illness score for TEN. 1 point each: - Age>40 - Malignancy - Tachycardia >120 - Initial TBSA >10% - Urea >10 - Glucose >14 - Bicarbonate >20
38
Treatment of SCORTEN
ICU if SCORTEN >3
39
Urticaria (Hives)
- Type 1 Hypersensitivity - Wheals: recurrent, transient oedematous lesions persisting <24 hours - Asymptomatic, pruritic, painful
40
Angioedema
- Oedema of dermis and subcatenous tissue | - Associated with urticaria (40%) or alone (10%)
41
Causes of Urticaria and Angioedema
Drugs, foods, contact reaction (latex, hairdye), insect stings, infections, connective tissue disease, internal malignancy, C1 esterase inhibitor deficiency
42
Management of Type 1 Hypersensitivity (if anaphylaxis)
- 1:1000 Adrenaline IM (0.5ml) - Airway Management Oxygen - IV fluid challenge - IV antihistamine (10mg chlorphenamine) - Systemic steroid (200mg IV hydrocortisone)
43
Management of Type 1 Hypersensitivity (without anaphylaxis)
- Antihistamines - Systemic steroids - Anti-pruritic emollients
44
Sedating Antihistaimes
Chlorphenamine 4mg QDS | Hydroxyzine 50mg OD
45
Non-sedating Antihistamines
Cetirizine 10mg OB-BD | Fexofenadine 180mg OD-BD
46
Systemic Steroid
Prednisolone 5mg/kg 5 days then stop
47
Anti-pruritic emollients
``` Balneum plus (Lauryl Macrogols) Dermacool (menthol in aqueous) ```

SS: Dermatology (12 decks)

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