Drug eruptions

Question 1

Toxic epidermal necrolysis is an extreme form of which condition?

Answer 1

stevens-johnson syndrome

Question 2

List two causes of erythema multiforme?

Answer 2

idiopathic
infection: HSV, mycoplasma
drugs

Question 3

Name two drugs associated with erythema multiforme?

Answer 3

SNAPP
Sulphonamides
NSAIDs
Allopurinol
Penicillin
Phenytoin

Question 4

Name two conditions associated with erythema multiforme

Answer 4

SJS

this is likely wrong, erythema multiforme is now considered a separate condition

Topical epidermal necrolysis

Question 5

Name three categories of dermatological manifestations of drug eruptions

Answer 5

maculopapular
urticaria
erythema multiforme

Question 6

List erythema multiforme, SJS, and toxic epidermal necrolysis in order of severity

Answer 6

erythema multiforme>SJS>toxic epidermal necrolysis

Question 7

How is toxic epidermal necrolysis related to SJS?

Answer 7

SJS is less severe, localised to <10%, TEN is more widespread and is an emergency

Question 8

What is the management of TEN?

Answer 8

analgesia, fluid balance, special mattress and sheets, non adherent dressings

Question 9

What is the mortality rate of TEN?

Answer 9

> 50%

Question 10

Name two features of SJS?

Answer 10

Blistering mucosa: conjunctiva, oral, genital

Question 11

Name two features of TEN?

Answer 11

severe mucosal ulceration, widespread erythema followed by epidermal necrosis, dehydration

Question 12

What is the treatment for TEN?

Answer 12

dexamethasone IV

Question 13

What are the triggers for acute urticaria?

Answer 13

viral infections, medications, food, physical stimulants

Question 14

Define erythroderma. Name two causes.

Answer 14

Description of red appearance of skin. Psoriasis, eczema, drug reaction

Question 15

Is erythema multiforme life-threatening?

Answer 15

no very mild and resolves by itself

Question 16

Name five types of common skin drug reactions

Answer 16

1. Maculopapular (change in colour and raised)
2. Urticaria (hives e.g.nettle rash)
3. Morbilliform (measles erruption)
4. Papulosquamous (raised areas with dry flakiness)
5. Photo-toxic (UV light+drug)

Question 17

Name three features of urticaria

Answer 17

itchy, wheals/hives, non-scarring, <24hr, histamine induced response

Question 18

What is the mechanism of urticaria?

Answer 18

type 1 IgE response (not normally allergy driven!)

Question 19

Treatment for urticaria?

Answer 19

antihistamines, steroids, phototherapy