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Dermatology > Acute and Emergency Dermatology > Flashcards

Acute and Emergency Dermatology Flashcards

1
Q

What is erythroderma?

A

Any inflammatory skin disease affecting >90% of total skin surface

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2
Q

What are the causes of erythroderma?

A 
Psoriasis 
Eczema 
Drugs 
Cutaneous lymphoma 
Hereditary disorders
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3
Q

What are the consequences of skin failure?

A 
Sepsis 
Hypo and hyperthermia 
Protein and fluid loss 
Renal impairment 
Peripheral vasodilation
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4
Q

What is the management for erythroderma?

A 
Remove any offending drugs 
Careful fluid balance 
Good nutrition 
Temperature regulation 
Emollients 
Oral and eye care 
Anticipate and treat infection 
Manage itch 
Treat underlying cause
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5
Q

At what point in time are drug reactions likely to occur?

A

1-2 weeks after drug

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6
Q

What are some common drug causes of skin disease?

A

Stevens Johnson syndrome
Toxic epidermal necrolysis
Morbilliform exanthem

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7
Q

What are the clinical features of Stevens Johnson syndrome?

A

Fever, malaise, arthralgia
Rash
Mouth ulceration
Ulceration of other mucous membranes

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8
Q

What are the clinical signs of toxic epidermal necrolysis?

A

Prodomal febrile illness
Ulceration of mucous membranes
Rash
Sloughing of large areas of epidermis

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9
Q

What is the management for SJS and TEN?

A 
Identify and stop culprit drug 
High dose steroids 
IV immunoglobulins 
Anti TNF therapy 
Ciclosporin
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10
Q

What are the long term complications of SJS and TEN?

A 
Pigmentary skin changes 
Scarring 
Genital scarring 
Eye disease and blindness 
Nail and hair loss 
Joint contractures
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11
Q

What scale is used to determine and prognosis for SJS and TEN?

A

SCORTEN

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12
Q

What type of reaction is erythema multiforme?

A

Hypersensitivity reaction triggered by infection

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13
Q

What is the management of eyrthema multiforme?

A

Self limiting

Symptomatic and treat underlying cause

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14
Q

What does DRESS stand for?

A

Drug reaction with eosinophilia and systematic symptoms

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15
Q

What is the onset time of DRESS?

A

2-8 weeks after drug exposure

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16
Q

What are the clinical signs of DRESS?

A

Fever and widespread rash
Eosinophilia and deranged liver function
Lymphadenopathy

17
Q

What is the treatment for DRESS?

A

Stop causative drug
Systemic steroids
Symptomatic treatment

18
Q

What are the clinical features of pemphigus?

A

Flaccid blisters, rupture very easily

Ill defined erosions in mouth, nose, eyes and genital areas

19
Q

What are the clinical signs of pemphigoid?

A

Tense and intact blisters

20
Q

What area is targeted in pemphigus?

A

Antibodies targeted at desmosomes

21
Q

What area is targeted in pemphigoid?

A

Antibodies targeted demo epidermal junction

22
Q

What are the common causes of erythrodermic psoriasis and pustular psoriasis?

A

Infection

Sudden withdrawal of oral steroids or potent topical steroids

23
Q

What are the clinical features of eyrthrodermic psoriasis and pustular psoriasis ?

A

Fever
Elevated WCC
Cluster of pustules
Rapid development of generalised erythema

24
Q

What is the management for erythrodermic and pustular psoriasis?

A

Bland emollient

Avoid steroids

25
Q

What is eczema herpeticum?

A

Disseminated herpes virus infection on a background of poorly controlled eczema

26
Q

What are the clinical features of eczema herpeticum?

A

Monomorphic blisters and punched out erosions

Fever and lethargy

27
Q

What is the management for eczema herpeticum?

A

Aciclovir
Mild topical steroid
Treat secondary infection

28
Q

What are the clinical features of staphylococcal scalded skin syndrome?

A

Diffuse erythematous rash with skin tenderness
Fever and irritability
Blistering and desquamation

29
Q

What is the treatment for staphylococcal scalded skin syndrome?

A

Admission for IV antibiotics

30
Q

What is angioedema?

A

Deeper swelling of the skin or mucous membranes

31
Q

What are the clinical features of urticaria?

A

Itching sometimes burning

Dermal oedema

32
Q

What are the causes of acute urticaria?

A

Idiopathic
Infection
Drugs (IgE mediated)
Food (IgE mediated)

33
Q

What is the treatment for acute urticaria?

A

Oral antihistamine
Short course oral steroid
Avoid opiates and NSAIDs

34
Q

What are the causes of chronic urticaria?

A

Autoimmune
Physical
Vasculitic

35
Q

What type of reaction is chronic urticaria?

A

Type 1 hypersensitivity reaction

36
Q

What is the management of chronic urticaria?

A

Omalizumab

Dermatology (11 decks)

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