Dermatology

Question 1

EM, SJS, TENS

Answer 1

Attributed to severe immune response. Exact mechanism of pathophysiology is unknown. All disease processes are on continuum.

Question 2

Erythema Multiforme Minor

Answer 2

Acute onset of target lesions on extremities, palms, and soles of feet with little or no mucosal involvement.

• Resolves within one week without therapy.
• Low mortality and no systemic manifestations.

Question 3

Stevens Johnson Syndrome

Answer 3

Also known as Erythema Multiforme Major.

• Rare, with HIGH mortality.
• Associated with anti epileptic medications as well as other identified medications.

S/S: Cutaneous lesions follow prodrome of flu-like syndromes. Rash presents with edema, erythema and pain, with ulcer development in any skin or mucous membrane areas. Ocular, buccal, urogenital, pulmonary, and gastrointestinal involvement are frequent and lead to long-term complications, including blindness.

Tx: Requires hospitalization, often in ICU, wound care, debridement, and ongoing systemic evaluation.

Question 4

Toxic Epidermal Necrolysis Syndrome

Answer 4

Involves detachment of more than 30% of body surface area, preceded by fevers and flu-like symptoms with 24 hour skin lesions appearing. Lesions progress to masses leading to large areas of full-thickness epidermal necrosis.

Tx: Requires hospitalization, often in ICU, wound care, debridement, and ongoing systemic evaluation.

Question 5

Abscess

Answer 5

An area of nonfunctioning tissue that is contained, most often resulting from persistent bacterial infection.

Tx: Incision and drainage and culturing of the wound and or fluid.

Question 6

Wound Management

Answer 6

See pg 359