Week 3 - Acute Inflammatory Dermatoses Flashcards Preview

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Flashcards in Week 3 - Acute Inflammatory Dermatoses Deck (17)

Acute Inflammatory Dermatoses - Where do they prominently effect?
2. Erythema Multiforme
4. Fixed Drug Eruption
5. Panniculitis
Erythema Nodosum
Erythema Induratum

1. Dermis
2. Epi/dermis
3. Epi/dermis
4. Epidermis
5. Subcut.


What is urticaria and what mediates it?

-Hives, transient raised wheals that persist for 24 hours
-IgE & Histamine mediated
-Pruritic (need to ask patient for this info)


What is angioedema and why is it dangerous?

-It is deep dermal and subcutaneous swelling
-Burning & painful
-Dangerous: Laryngeal Involvement - swelling of tounge, larynx after swelling of mouth and/or eyes
-Epi is used for these reactions
-Lips, eyes, groin, soles/palms are most common


What is acute urticaria?

It occurs in 2/3 of people and lasts less than 6 weeks. Its usually type I IgE mediated and resolves within hours-days


What are different types of Uritcaria?

-Type I IgE mediated (food, latex, stings, medications, aeroallergins)
-Infectious - viral - HIV, hep C
-Physical (solar, cholinergic, cold, dermographism-scratching skin, aquagenic, pressure)
-Direct mast cell degranulation (medications)
-Foods high in histamine


Urticaria Management: What medications are our first and second choices? What do we use for Type I IgE mediated reactions?

First choice: 2nd generation, non-sedating H1-blockers
-Cetrizine (Zyrtec)
-Fexofenadine (Allegra-D)
-Desloratadine (Clarinex)
-Loratidine (Claritin)
Second choice: If symptoms not controlled, add second generation, sedating H1 blockers
-Hydroxyzine (Atarax) at night
-Diphenhydramine (Benadryl) at night
Cyproheptadne (Periactin) -Cholinergic and cold urticarial


What is erythema multiforme?

-Usually associated with prescription medications
-Circular lesions on palms, soles of feet, multiple confluent lesions (coming together), raised, erythematous, bilateral (both hands)
-Classic 'target' lesions with multiple spots, inflammatory middle-soft, uneven boarder
-Usually occurs in people under 20


What typically causes erythema multiforme?

Drugs - sulfonamides, penicillin, barbiturates, etc.
Infection - herpes simplex virus, mycoplasma
Many cases are idopathic


How to treat EM?

Prevent, Supportive therapy, use medication to control herpes simplex, Glucocorticoids like prednisone to treat severe cases


What is the difference between SJS and TEN?

SJS - <10% dermal attachment
TEM - 30% dermal attachment
They overlap in the 10-30% range


What is SJS?

-Drug induced or idiopathic
-Skin tenderness and erythema (skin & mucosa)
-Cutaneous & Mucosa Epiderma Necrosis & Sloughing
-Potentially life threatening
- +2 mucosal membranes effected and <10% epidermal detachment


What is the proposed mech. for SJS and TEN?

Cytotoxic immune reaction aimed at destruction of keratinocytes expressing foreign (drug-related) antigens


What is toxic epidermal necrolysis? (TEN)

-Maximal variant of SJS with 30% epidermal detachment
-Severe hypersensitivity syndrome - life threatening
-Total detatchment of epidermis (like total body second degree burn)


What are fixed drug eruptions?

-Usually face & genitals
-Unknown mech
-Can reoccur in same place
-Localized, sharply demarcated erythematous patch that can itch, burn or be asymptomatic
-Caused by a drug


What are the two types of Panniculitis?

1. Erythema Nodosum
2. Erythema Induratum


What is Erythema Nodosum?

-Painful, tender nodules, with fever, malaise, arthralgia (ankles)
-Resolves on own in 6 wks
-Erythematous tender nodules, anterior shins, no ulceration
-usually occurs in young women
-Can be triggered by infection, meds or autoimmune


What is Erythema Induratum?

-Tender, red nodules, often associated with TB
-Occurs in middle aged females most
-most often posterior legs
-Chronic, subcutaneous plaques & nodules with ulceration
-Immune complex mediated

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