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Week 9 - Dermatology > Acute and Emergency Dermatology > Flashcards

Acute and Emergency Dermatology Flashcards

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Dermatology Board Prep flashcards
1
Q

Describe the morbilliform rash

A
  • Similar to a measles like rash
  • Erythematous
  • Blanching
  • Truncal/widespread
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2
Q

Describe urticaria

A
  • Red itchy hives
  • Looks a bit like a nettle rash
  • Angiooedema when mucosal surfaces are involved (swollen lips, eyes)
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3
Q

Describe a phototoxic rash

A
  • Patches of erythema -> widespread erythema

* Occurs in areas exposed to UV

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4
Q

Describe a pustular drug rash

A

Monomorphic pustules which look a bit like spots

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5
Q

Describe lichenoid rash

A
  • Purple/brown spots with a. white lacy network

* looks similar to the rash lichen planus (which is normally red)

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6
Q

Describe vasculitis

A
  • Inflammation of the blood vessels making them leaky
  • Can be blisters and ulceration
  • Often localised and not rapidly progressive (also not commonly systemically unwell)
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7
Q

What are the triggers of vasculitis?

A
  • Drugs

* Connective tissue disease e.g. Rheumatoid arthritis

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8
Q

If someone presents with vasculitis what should you check for?

A

Systemic vasculitis i.e. renal BP, urinalysis, any neurological features?

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9
Q

Describe drug induced psoriasiform rash

A
  • Psoriasis like rash
  • Well demarcated pink erythema with scale
  • Sudden onset, no family history
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10
Q

Name two drug/infection induced blistering disorders

A
  • Steven Johnson Syndrome

* Toxic epidermal necrolysis

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11
Q

Name two immunobullous diseases causing blistering disorders

A
  • Bullous pemphigoid

* Bullous pemphigus

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12
Q

What is Steven Johnson Syndrome on a spectrum with?

A

Toxic epidermal necrolysis

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13
Q

Describe toxic epidermal necrolysis

A
  • Dermatolgocial emergency
  • Majority is drug induced
  • most severe is when the mucous membranes are involved
  • Stop using the suspected drug immediately
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14
Q

What is the management fo toxic epidermal necrolysis?

A
  • In patient term/ITU/burns
  • analgesia (full thickness to nerve endings so very very painful)
  • Fluid balance: SCORTEN severity scale
  • Special sheets/mattress/non adherent dressing
  • Infection control and infection prophylaxis
  • Input from urology/gynae/opthalmology
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15
Q

Describe staphylococcal scalded skin syndrome

A
  • blistering skin condition

* Caused by the toxin of the staph bacteria (need to clear bacterial infection to treat)

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16
Q

What is erythema multiforme?

A
  • Self limiting allergic reaction
  • HSV/EBV/occasionally drug cause
  • Taget lesions (rings with circle in centre)
17
Q

What happens in the immunobullous disorders?

A

Autoantibodies to various skin component i.e. basement membrane proteins in BP on skin biopsy

18
Q

name 5 immunobullous disorders

A
  • Bullous pemphigoid
  • Mucous membrane pemphigoid
  • Paraneoplastic pemphigoid
  • Pemphigus
  • Dermatitis herpetiformis (coeliac disease)
19
Q

What is the difference between bullous pemphigoid and pemphigus vulgarisms on immunofluorescene of the skin?

A
  • Bullous pemphigoid: split is between the epidermis and the dermis
  • Pemphigus vulgaris: split is more superficial
20
Q

What is the appearance of bullous pemphigoid?

A

Intact blisters

21
Q

Describe the appearance of pemphigus

A
  • Red blotches, some deeper skin lesions

* Sheared layers have come off, no intact blisters

22
Q

Describe the appearance of dermatitis herpetoformis

A

Tiny vesicle blisters, normally symmetrical and on the extensors of elbow, buttocks or knees

23
Q

What investigtations should be carried out in immunobullous disorders?

A

Skin biopsy with immunofluorescence

24
Q

What is the treatment of immunobullous disorders?

A
  • Reduce autoimmune reaction (topical/oral corticosteroids)
  • Steroid sparing agents (aziothioprine)
  • Burst any blisters
  • Dressings and infection control
  • Check for oral/mucosal involvement
  • Consider a screen for underlying malignancy
25
Q

What is the treatment of dermatitis hepetiformis?

A
  • Topical steroids
  • Gluten free diet
  • Oral dapsone
26
Q

What is the timing for acute vs chronic urticaria?

A
  • Acute <6 weeks

* Chronic >6 weeks

27
Q

What response is immune mediated urticaria?

A

Type 1 IgE

28
Q

What is the mechanisms of non immune mediated urticaria?

A

Direct mast cell degranulation e.g. opiates, antibiotics, contrast media, NSAIDs

29
Q

What is the treatment of urticaria?

A
  • high dose antihistamines
  • Steorids
  • phototherapy
  • Immunosuppression
  • Omalizumab
30
Q

What are the causes of acute urticaria?

A
  • Unknown cause
  • Viral infection
  • Medications
  • Foods and additives
  • Parasitic infections
  • Physical stimulants
31
Q

What is dermographism?

A

May be seen in urticaria, can draw on the skin and it will leave a raised mark

32
Q

What is erythroderma?

A

Widespread erythema, Descriptive term, >80-90% involvement of the body

33
Q

What are the causes of erythroderma?

A
  • Psoriasis
  • Eczema
  • Drug reaction
  • Cutaneous lymphoma
34
Q

What is the treatment of erythroderma?

A

treat the underlying skin disorder, fluid temp balance

Week 9 - Dermatology (8 decks)

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