Dermatology Emergencies Flashcards
What type of reaction is erythema multiorme
Type 4 hypersensitivity
What is erythema multiforme commonly associated with
HSV
Name some other infections associated with erythema multiforme
TB, mycoplasma pneumoniae, strep
Who usually presents with erythema multiforme
20-40 yrs
Drugs associated with erythema multiforme
Antibiotics
Anticonvulsants
NSAIDs
Allopurinol
Antivirals / antimalarials
What are the 2 categories of erythema multiforme
Major and minor
Minor erythema multiforme
Affects skin
Major erythema multiforme
Affects skin and mucous membranes
How is erythema multiforme characterised
Sudden onset of symmetrical, target-like skin lesions with a central red spot surrounded by concentric rings
Where is erythema multiforme usually seen
On the legs
Symptomatic treatment of erythema multiforme
Oral corticosteroids
Prophylactic acyclovir in recurrence
What is erythroderma
Generalised redness and inflammation
Name drugs that cause erythroderma
Sulphonamides, penicillin, antimalarials, anticonvulsants, allopurinol
Conditions associated with erythroderma
Eczema, allergic contact dermatitis, pityriasis rubra pilaris, pemphigus and bullous pemphigoid
What is major characteristic of erythroderma
Covers >90% of the body
General presentation of erythroderma
Generalised redness and dryness
Keratoderma of palms and soles
Lymphadenopathy
Investigations in erythroderma
Skin swabs, septic screen
FBC, U+Es
HIV test
Echo
Skin biopsy
Main concern when treating erythroderma
Manage fluid balance and body temp
What is toxic epidermal necrolysis
A maximal variant of Stevens-Johnsons syndrome
Name some drugs that cause toxic epidermal necrolysis
Antibiotics
Anticonvulsants
NSAIDs
Allopurinol
Nevirapine
Meticlopramide
Clinical sign of toxic epidermal necrolysis
Positive nikolsky sign
Presentation of TEN
Prodromal rash, necrotic epidermis, raised flaccid blisters
Investigations used in TEN
FBCs, U+Es, skin biopsy
Management of TEN
Avoid skin trauma, IV fluids, analgesia
