3 - skin emergencies

Question 1

what is cause of erythema multiforme?

Answer 1

infection 90% of time - from HSV or mycoplasma pneumonia

Question 2

what is presentation of erythema multiforme?

Answer 2

common in kids, after infection
- get red target lesion, wheels things
- can be on skin or mucous membrane (severe if mucous membranes involved)

Question 3

what is treatment of erythema multiforme?

Answer 3

= treat underlying cause & symptomatic relief
- might use oral corticosteroids or topical aciclovir is severe

Question 4

what is cause of erythema multiforme?

Answer 4

90% caused by HSV (henoch-schonlein purpura) or mycoplasma pneumonia
- could also be drugs or idiopathic

Question 5

what is presentation of erythema multiforme? treatment?

Answer 5

circle red wheal like lesions, on skin & mucous membrane &more sever if mucous membranes)
- often in kids after infection

treat underlying cause - maybe oral corticosteroids, if recurrent then prophylactic aciclovir

Question 6

what ulcers are associated with SCC?

Answer 6

marjolin’s ulcer

Question 7

what is management of bullous pemphigoid treatment?

Answer 7

pierce blister at base (keeping roof intact)

TOPICAL
- emollients, antiseptic wash, dermovate ointment

SYSTEMIC
- start with oral prednisolone as immunosuppressant since quick acting then swap to doxycycline

Question 8

where is desmoglein 1 and 3?

Answer 8

desmoglein 3 = in mucosa
desmoglein 1 = in skin

(they’re whats attacked in pemphigus vulgaris)

Question 9

what is erythroderma?

Answer 9

skin failure = when get >90% body surface area inflamed & affected

Question 10

what is erythroderma presentation?

Answer 10

• generalised redness & dryness
• keratoderma of palms & soles
• lymphadenopathy
• fever/hypothermia
• heart failure

Question 11

what is management of erythroderma?

Answer 11

• admit
• stop drug (if reaction)
• emollients and mild-moderate steroid
• manage fluid & body temp
• IV antibiotics

Question 12

what is measles? presentation?

Answer 12

infection caused by paramyxovirus

PRESENTS
- koplik spots (small white spots inside cheek)
- blotchy face
- fever
- lymphadenopathy

Question 13

what is toxic epidermal necrolysis? presentation?

Answer 13

= life threatening, rapidly evolving rash. epidermal necrolysis

• caused by a bunch of drugs or infection like mycoplasma pneumonia or herpes

PRESENTS

• involves mucous membranes
• full thickness epidermal detachment with red, fleshy epidermis exposed
• fever, arthralgia, positive nikolsky sign

Question 14

what is overlap and distinction between toxic epidermal necrolysis and steven johnson syndrome?

Answer 14

• <10% desquamation = SJS
• 10-30% = SJS/TEN overlap
• > 30% TEN

Question 15

what is management of toxic epidermal necrolysis?

Answer 15

• emollin spray
• withdraw suspected drug
• avoid skin trauma
• systemic steroids