Dermatology - Geeky Medics

Question 1

What is toxic epidermal necrolysis (TEN)?

Answer 1

• Severe mucocutaneous blistering disease
• With >30% body surface area involvement
• More severe version of Steven Johnson syndrome (SJS)
• Commonly caused by drugs e.g. allopurinol, sulfonamide ABx

Question 2

What are the causes of generalised pruritus? (no rash)

Answer 2

• Malignancy e.g. Hodgkin’s lymphoma, PRV (polycythaemia rubra vera)
• Renal failure (uraemia)
• Hyperthyroidism
• Drugs e.g. opiates

Question 3

What is Steven Johnson Syndrome (SJS)?

Answer 3

• Severe mucocutaneous blistering disease
• With <10% body surface area involvement
• Less severe version of toxic epidermal necrolysis (TEN)
• Commonly caused by sulfonamide ABx

Question 4

What are the complications of SJS/TEN?

Answer 4

• Volume loss (shock, AKI)
• Electrolyte derangement
• Infection e.g. sepsis, pneumonia
• Hypothermia

Question 5

What is the treatment for SJS/TEN?

Answer 5

1. Resus
   - A+B - consider airway support and O2
   - C - IV fluids, catheter, monitor input/output
   - Consider referral to ICU / burns unit
2. Supportive care e.g. wound care, fluids and nutrition, prevent hypothermia, prevent infections