Emergency dermatology

Question 1

What is erythroderma?

Answer 1

This is when redness involves over 95% of the body

Question 2

What are the causes of erythroderma? how is it managed?

Answer 2

IT can be caused by eczema, psoriasis, drugs (allopurinol, carbamazepine) or withdrawl of steroids
It is treated as an inpatient with Supportive care alongside bedrest: IV fluids, warming, monitoring for infection

Question 3

What is Stevens-johnson syndrome and how does it present?

Answer 3

upper respiratory tract infection 2-3 weeks before a painful erythematous rash forms on under 10% of the body. Targen lesions form and there is severe mucosal involvement.

Question 4

What is toxic epidermal necrolysis and how does it present?

Answer 4

Flu like symptoms may precede skin involvement that affects >30% of the body surface. There is necrosis of large sheets of epidermis and severe mucosal involement.

Question 5

How do you treat SJS and TEN?

Answer 5

With supportive treatment in ITU or burns unit. Need to replace skin functions e.g. hydrate and keep warm
Increeased risk of infection, avoid steroids as can worsen infection`

Question 6

How is erythema multiforme different from SJS and TEN?

Answer 6

IT is most commonly caused by herpes simplex whereas SJS and TEN are commonly drug reactions

Question 7

How does erythema multiforme present and what are the types?

Answer 7

It presents with erythematous target lesions on the extensor surfaces
The two types are minor and major, major has more mucosal involvement

Question 8

What is the treatment of erythema mutiforme?

Answer 8

Most resolve without treatment
Treat with steroids to relieve rash discomfort
Treat the cause e.g. aciclovir

Question 9

What is the skin sign of lyme disease?

Answer 9

Erythema migrans - a papule that spreads to become a red ring