Hypersensitivity Syndromes Flashcards Preview

Habif 18: Hypersensitivity syndromes and vasculitis > Hypersensitivity Syndromes > Flashcards

Flashcards in Hypersensitivity Syndromes Deck (18):
1

Erythema Multiforme Etiology

Infections, HSV, Mycoplasma, fungal infections, and medications

2

Erythema Multiforme acute management

Observation and oral antihistamines, topical steroids

3

Erythema Multiforme recurrent management

Antivirals (oral acyclovir, etc), Dapsone, hydroxychloroquine, azathioprine, cyclosporine, thalidomide

4

Erythema Multiforme classic patient

Male, aged 20-40 with few systemic symptoms with symmetric target lesions on dorsal hands/feet/extremities

5

SJS/TEN spectrum grading

1: SJS with <10% epidermal detachment
2. SJS-TEN overlap with 10-30%
3. TEN with >30%

6

MCC of SJS/TEN

Lamotrigene, carbamazepine, phenytoin, phenobarbitol, co-trimoxazole, sulfasalazine, allopurinol, Oxicam NSAIDs

7

Timing of SJS/TEN

Onset 4-28 days post initiation of medication is classic timing

8

SJS lesions

Start on trunk (unlike EM) and see flat atypical targets/purpuric macules that develop bullae. Ulcerative stomatitis leading to hemorrhagic crusting

9

SJS common patient

Children and young adults

10

SJS tx

?Oral corticosteroids with cool compresses (not topical steroids in eroded areas)

11

TEN vs. SSSS

Split in SSSS is just under the stratum corneum while split in TEN is at the dermoepidermal junction

12

SKin findings in TEN

Diffuse, hot erythema covering wide areas, skin becomes painful and + Nikolsky's sign. Mucous membrane including oral and vaginal mucosa is common. Purulent conjunctivitis.

13

Prognostic scoring system for SJS/TEN

SCORTEN

14

Tx of TEN

Cyclosporine can be considered, treatment at a burn center

15

Erythema Nodosum associated symptoms

Arthralgias (Rheumatoid factor negative), malaise

16

Skin findings in erythema nodosum

poorly demarcated red, nodules that are painful on legs and arms. Individual lesions last ~2 weeks

17

Etiology of erythema nodosum

probably delayed hypersensitivity, most common associations now are strep infection, coccidiodomycosis, and sarcoidosis, IBD, Lofgren's syndrome (EN or periarticular ankle inflammation w/ hilar or paratracheal LAD), lymphoma

18

Erythema nodosum tx

Mild: naproxen
Recurrent/very painful: potassium iodide in orange joice