Drug Eruptions and the Skin in Systemic Disease Flashcards
Causes and features of maculopapular drug eruptions (3)
penicillins, cephalosporins, anti-epileptics
generalised erythematous macules and papules +/- fever and raised eosinophils
eruption w/i 2wks of taking drug
Causes and features of urticarial eruptions (4)
wheals+/- angiodema and anaphylaxis
rapid onset after taking drug
immune (IgE mediated):
- penicillin
- cephalosporin
non-immune (mast cell degranulation):
- morphine
- codeine
- NSAIDs
- contrast
Presentation of erythema multiforme (2)
symmetrical target lesions on palms, soles and limbs
occur 1-2wks after insult
Causes of erythema multiforme (3)
INFECTIONS: main cause-HSV and mycoplasma
drugs-SNAPP:
- sulphonamides
- NSAIDs
- allopurinol
- phenytoin
- penicllin
idiopathic
Features of SJS (2)
more severe form of erythema multiforme
blistering mucosa: conjunctival, oral and genital
Features of TEN (3)
severe form of SJS
nearly always a drug reaction
increased risk in HIV+ve patients
Presentaiton of TEN (3)
severe mucosal ulceration
widespread erythema followed by epidermal necrosis w. loss of large sheets of epidermis
> dehydration
Rx and prognosis of TEN (2)
Rx w. Dexamethasone +IVIg
30% mortality rate
Features and causes of erythema nodosum (5)
painful, blue-red lesions on anterior shins
causes-3Ss:
- sarcoid
- sulphonamides
- strep
also: IBD, TB, bechet’s, OCP
Features of pyoderma gangrenosum (3)
wide, deep ulceration w. violaceous border, purulent surface and undermined edge
commonly occurs on legs
heals w. cribriform/pitted scars
Assoc. of pyoderma gangrenosum (5)
IBD
AIH
RA
Wegener’s
Leukemia
Rx of pyoderma gangrenosum
high-dose systemic steroids
Features and association of vitilligo (3)
chalky, white patches w. hyperpigmented borders
itch under sunlight
assoc. w. autoimmune conditions
Features of livedo reticularis (3)
persistent, mottled, red-blue lesions which don’t blanch
found mainly on legs
triggered by cold
Causes of livedo reticularis (4)
idiopathic
vasculitis: SLE, RA, PAN
obstruction: antiphospholipid, cryoglobulinaemia
Sneddon’s syndrome: Livedo reticularis+CVAs
Skin manifestation of rheumatic fever
erythema marginatum
Lyme disease manifestation
erythema chronicum migrans
Crohn’s manifestations (3)
peri-anal ulcers and fistulae
erythema nodosum
pyoderma gangrenosum
Manifestations of dermatomyositis (5)
heliotrope rash on eyelids
Shawl sign (macular rash)
Gottron’s papules
mechanic’s hands
nailfold erythema, telangiectasia
Manifestations of DM (6)
ulcers
candida
Kylre disease
necrobiosis liploidica (shins)
granuloma annulare (hands and feet)
Acanthosis nigricans
manifestations of sarcoid (5)
erythema nodosum
erythema multiforme
lupus pernio
red/violet plaques
hypopigmented areas
manifestations of coeliac disease
dermatitis herpetiformis (elbows)
Grave’s
pre-tibial myxoedema
RA
rheumatoid nodules
vasculitis (palpable purpura)
