Drug eruptions

Question 1

what drugs can be responsible for SJS/TEN?

Answer 1

antibiotics
anticonvulsants
allopurinol
NSAIDS

Question 2

how is SJS/TEN managed?

Answer 2

1st line: IV immunoglobulins

supportive care in ICU

Question 3

what is DRESS?

Answer 3

drug reaction with eosinophilia and systemic symptoms

Question 4

what are the features of DRESS?

Answer 4

onset usually 2-8 weeks after drug exposure

systemic: fever, rash lymphadenopathy
deranged LFT’s
eosinophilia

Question 5

how is DRESS managed?

Answer 5

emollients
systemic steroids
+/- immunoglobulins, immunosuppression

Question 6

what drugs can trigger DRESS?

Answer 6

antibiotics
anticonvulsants
allopurinol
NSAIDS
antiretrovirals

Question 7

what are the features of erythrodermic psoriasis / pustular psoriasis?

Answer 7

erythema +/- pustules
elevated WCC
fever

Question 8

how is erythrodermic psoriasis / pustular psoriasis managed?

Answer 8

avoid steroids
bland emollient
exclude infection
+/- immunosuppression/ immunoglobulins

Question 9

what triggers erythrodermic psoriasis / pustular psoriasis?

Answer 9

rapid withdrawal from oral steroids or potent topical steroids
can occur without a previous history of psoriasis

Question 10

what are features of SJS / TEN?

Answer 10

positive Nikolsky sign (TEN)
systemic upset: fever, tachycardia
mouth ulceration: greyish white membranes, haemorrhage crusting

Question 11

what scoring system is used to determine prognosis of SJS/TEN?

Answer 11

scorten criteria;
age > 40 
malignancy
heart rate > 120
initial epidermal detachment > 10%
serum glucose > 14
serum bicarbonate < 20