Rashes Flashcards
(54 cards)
What is the pathology of eczema/dermatitis/spongiotic disease?
Intraepidermal oedema and inflammatory cell infiltration.
WIth or without:
Vesicles/bula, erythematous lesions, scaling/crust, itch, lichenification, erosion, fissuring.
Name the seven types of eczema.
Contact allergic- T4 H/S reaction Contact irritant- Repeated chemical trauma Atopic- Genetic and environmental Drug related- T1 or 4 H/S reaction Photosensitive- Reaction to UV light. Lichen simplex- Physical trauma to skin Stasis dermatitis- Hydrostatic pressure
Give an example of contact irritant dermatitis.
Nappy rash or repeated hand washing
Give an example cause of photosensitive eczema.
Light sensitive drugs
What are the two forms drug reaction can take?
Immunological and non-immunological
Are non-immunological drug reactions dose dependent?
Yes
Give some examples of non-immunological drug reactions.
Eczema Drug-induced alopecia Phototoxicity Atrophy due to steroids Psoriasis
What is the most common type of immunological drug eruption?
Exanthematous or Type IV
How does an exanthematous drug eruption present?
Mild and self limiting.
Wide spread, symmetrical rash which spares mucous membranes.
Itchy with mild fever
Give five drugs commonly associated with exanthematous drug eruptions.
Penicillins NSAIDs Sulphonamides Erythromycin Streptomycin
What is an urticarial drug reaction?
Type I H/S
How do urticarial drug reactions present?
With urticaria- “Hives” and itchy red dermal swelling.
Name some drugs commonly associated with urticarial drug reactions.
Beta-lactams antibiotics
Opiates
NSAIDs
What is a pustular/bullous drug eruption?
Type II H/S
GIve some examples of pustular/bullous drug eruptions
Acneiform- Glucocorticoids
Drug induced bullous pemphigoid- ACEI, penicillin, furosemide
What are fixed drug eruptions?
Well demarcated plaques that are red and painful. Associated with: Tetracycline/doxycycline, NSAIDs, paracetamol.
Give some examples of severe cutaneous drug eruptions.
Stephen Johnson Syndrome + Toxic Epidermal Necrolysis- Sulfonamides, cephalosporins, NSAIDs.
What gene is eczema associated with?
Filaggrin.
How does atopic eczema usually present?
Widespread rash (often in flexures) or fissures in ears.
How is atopic eczema diagnosed?
Itchiness + three of the following:
Flexure rash/history of, history of atopy (or relative if U4YO), general dry skin, onset before 2YO.
Describe a Type I H/S reaction.
IgE mediated which binds mast cells causing histamine release.
Give the symptoms of a Type I H/S reaction
Urticaria- Compressible dermal swelling/itchcy lesions
Angiodema- Localised swelling of sub cut tissue of mucosal membranes
Anaphylaxis- SOB and drop in BP
What can cause a TI H/S reaction?
Allergen such as food or drugs.
WHat drugs are commonly associated with TI H?S reaction?
Opiated, NSAIDs, beta lactams.
