OnlineMedEd: Dermatology - "Hypersensitivity"

Question 1

Hives are often described as _____________.

Answer 1

annular, erythematous papules that blanch

Question 2

With hives, you need to assess _______________.

Answer 2

for hypotension and airway compromise (signs of anaphylaxis)

Question 3

How do you treat hives?

Answer 3

• In the presence of anaphylaxis: IM epinephrine

* Without anaphylaxis: topical steroids

Question 4

Drug reaction rashes typically occur when?

Answer 4

7-14 days after taking a medicine

Question 5

How do drug reaction rashes present?

Answer 5

• Widespread (whole body)
• Symmetric
• Morbilliform (meaning measles-like)

Question 6

Treat drug reaction rashes with ______________.

Answer 6

systemic antihistamines and topical steroids

Question 7

What is a fixed drug reaction?

Answer 7

A rash that appears in the same place every time a drug is given

Note: it is not a contraindication to giving that drug again.

Question 8

Erythema multiforme is treated with ____________.

Answer 8

topical steroids

However, need to rule out syphilis.

Question 9

Compare and contrast SJS and toxic epidermal necrolysis.

Answer 9

SJS:

• Dusky and just to basal layer
• ≤ 10% of body surface area

TEN:

• Full thickness (i.e., through basal layer)
• ≥30% body surface area

Question 10

How do you treat SJS and TEN?

Answer 10

1) Stop all medications (even steroids)
2) Transfer to burn unit (replete with fluids)
3) Close opthalmologic and airway monitoring

Question 11

Which drugs are most commonly associated with SJS and TEN?

Answer 11

• Bactrim
• Penicillin
• Carbamazepine
• Phenytoin

Question 12

Staphylococcus scalded-skin syndrome generally starts in _______________.

Answer 12

skin folds