2 - Derm - Skin + Systemic disease - Drug eruption - Erythema multiforme

Question 1

Erythema multiforme

• skin change?
• where?
• common in who?

Answer 1

erythematous target lesions
typically extremities, mucous membranes less commonly (EM major if there is)
more common in younger pts

Question 2

Erythema multiforme

-causes and mgmt

Answer 2

infection - HSV
drugs - penicillin, suphonamides, NSAIDs, allopurinol, anticonvulsants

treat/remove cause

Question 3

SJS - pre- skin changes?

Answer 3

prodrome of fever, weakness, respiratory symptoms

Question 4

SJS - skin changes?

Answer 4

target lesions

red macules>papules>plaqes>darkening blistering crusting

Question 5

SJS - where?

Answer 5

may start on backs of hands/feet>progress proximally

always affects mucosal sites - lips tongue cheeks

Question 6

SJS - causes

Answer 6

infection - HSV

drugs - penicillin, suphonamides, NSAIDS, allopurinol, anticonvulsants

Question 7

Toxic epidermal necrolysis (TEN) what happens and where?

Answer 7

widespread erythema, then necrosis and detachment of epidermis (>30% of body area)

mucosal, respiratory and GI involvement

Question 8

TEN - mortality rate? what increases risk a lot?

Answer 8

~30% mortality

x1000 risk in HIV+

Question 9

TEN - causes

Answer 9

Drugs - penicillin, sulphonamides, NSaids, allopurinol, anticonvulsants

Question 10

TEN mgmt

Answer 10

burns unit/ITU
withdraw drug
hydrate
nutritional support
short term dexamethasone, IV Ig