Acute and Emergency Dermatology Flashcards
List the 9 types of drug reaction.
Maculopapular/morbilliform Papulosquamous Photo-toxic Pustular Lichenoid Fixed drug rash Psoriasiform rash Bullous rash Itch (with no rash)
List 6 types of drug which commonly cause drug reactions.
Antibiotics NSAIDs Chemotherapy agents Psychotropic drugs Anti-epileptic drugs Cardiac drugs
List 6 common causes of urticaria.
Unknown Viral infections Drug induced Foods Parasitic infections Physical stimulants
How would you treat urticaria? (4)
Antihistamines
Steroids
Immunosuppression
Omiluzimab
List 3 causes of erythema multiforme.
Herpes simplex
Epstein Barr virus
Drug reaction
What causes Ritter’s disease?
What is it also known by?
How do you treat it? (2)
Staphylococcal infection
Staphylococcal scalded skin syndrome (SSSS)
TREATMENT:
IV antibiotics
Supportive treatment
List 3 causes of vaculitis.
Polyarteritis nodosa
Acute nephritis
Serum sickness
List 5 causes of erythroderma.
Psoriasis Eczema Drug reactions Cutaneous lymphoma Others
How would you treat erythroderma? (2)
Treat underlying skin disorder
Supportive treatment
List 2 causes of toxic epidermal necrolysis (TEN).
Drug induced
Genetic predisposition to reacting to certain drugs
What does TEN stand for?
Toxic epidermal necrolysis
Describe the clinical features of TEN. (9)
Preceding flu-like illness
Red, painful skin rash
- Macules
- Diffuse erythema
- Target lesions
- Flaccid blisters
- Conversion of blisters into large sheets of peeling skin
- Exposure of dermis
- Nikolsky sign positive
Other organ involvement
How would you manage TEN? (4)
Stop causative drug
Supportive treatment
Appropriate dressings
Immunosuppression (rare)
Define “bullous pemphigoid”
A chronic, itchy, blistering autoimmune skin condition most common in the elderly; blisters most commonly occur on the limbs and may last for several days
Describe the clinical features of bullous pemphigoid. Consider:
a) Features of rash (4)
b) Distribution (4)
RED, ITCHY RASH:
- Large, itchy blisters (up to 5cm diameter)
- Fluid-filled (clear, cloudy or blood-stained)
- Tense (i.e. skin is stretched taut)
- Non-scarring
DISTRIBUTION: Upper arms Thighs Body folds Abdomen
How would you treat bullous pemphigoid? (3)
What is the prognosis?
Steroids
Immunosuppression
Antibiotics
Treatment is NOT curative; but controls symptoms until disease disappears on its own
Define “bullous pemphigus”.
A rare but serious autoimmune disease marked by successive outbreaks of blisters; the blisters are superficial and do not remain intact for long
Describe the clinical features of bullous pemphigus. (4)
Painful
Fragile blisters (burst easily) -Exposes unhealed skin
Non-scarring
Relapsing and remitting disease
How would you manage bullous pemphigus? (3)
What is the prognosis?
Steroids
Immunosuppression
Antibiotics
Disease will NOT go away (unlike pemphigoid), but treatment can control symptoms
Define “dermatitis herpetiformis”.
An uncommon, extremely itchy rash with symmetrical blistering, especially on the knees, elbows, buttocks and shoulders; associated with gluten sensitivity
What causes dermatitis herpetiformis?
Coeliac disease
How would you manage dermatitis herpetiformis? (2)
Dapsone (antibiotic)
Gluten free diet
