4th Year Skin Emergencies

Question 1

presentation of SJS

Answer 1

prodrome of respiratory symptoms followed 14 days later by erosions of at least 2 mucosal surfaces with variable degree of cutaneous involvement

Question 2

common causes of SJS

Answer 2

NSAIDs
sulfalazine
anticonvulsants
antibiotics

Question 3

appearance of the rash in SJS

Answer 3

haemorrhagic crusting of oral mucosa
conjunctivitis
pyrexia
dehydration + electrolyte imbalance
secondary infection
target lesions, dusky red macules, blistering, desquamation

Question 4

management of SJS

Answer 4

burns unit
remove cause
supportive

Question 5

how much SA does SJS take?

Answer 5

<10%

Question 6

what is toxic epidermal necrolysis (TEN)?

Answer 6

keratinocyte necrosis with >30% body surface affected by epidermal and mucosal detachment
death of cells triggers inflammatory response and whole epidermis can necrose and detach

Question 7

presentation of TEN

Answer 7

dusky red macules which coalesce
painful skin
mucosal involvement
fever/pyrexia
sore eyes

Question 8

management of TEN

Answer 8

withdrawal of cause (almost always drugs)
burns unit
minimise handling
IVIg
ciclosporin
cyclophosphamide

Question 9

define erythroderma?

Answer 9

erythema of at least 90% of the body’s SA

Question 10

causes of erythroderma

Answer 10

dermatitis
psoriasis
drug reaction
cutaneous T cell lymphoma

Question 11

why is erythroderma bad?

Answer 11

increased blood flow to the skin surface causes high CO and hyperthermia

Question 12

management of erythroderma

Answer 12

treat cause
emollients
antihistamines