PAMS dermatology reactive erythemas Flashcards
What is erythema multiform minor ?
These are symmetrical target lesions distributed on palms and soles, may spreads to the trunk and mucosa is spared. It is often proceeded by infections and resolves itself.
What is the clinical presentation of Erythema multiform major ?
It involves 2+ mucosal sites with irregularly placed bleeding ulcers. It is more severe than minor, but not life threatening.
What are the aetiologies of erythema multiform major.
It is often associated to HSV or mycoplasma infections. can be due to drugs also.
What is the management of erythema multiform ?
-Self-limited
– Supportive care
– Topical corticosteroids and oral antihistamine may be helpful
What is the management of HSV related erythema multiform major recurrence?
Empirical anti-viral therapy using Acyclovir.
What is the spectrum of SJS- TEN?
10% BSA = SJS
10 to 30 % BSA= SJS/ TEN
> 30% BSA= TEN
What is the pathophysiology of SJS and TEN?
T cell mediated type 04 HSR to mucosa and epidermis.
What are the risk factors associated to SJN-TEN?
It can cause infections and sepsis. It can be life threatening.
What are the causes of SJN- TEN ?
Almost always related to drugs such as NSAIDS, antibiotics, anticonvulsants or immune modulators.
Rarely post infectious.
What is the presentation of SJN-TEN ?
– Fever and flu-like symptoms
– Macules rapidly spread and coalesce
– Epidermal blistering
– Sloughing off of affected skin
– Nikolsky’s sign
How is SJN-TEN diagnosed ?
clinical diagnosis. Skin biopsy maybe helpful in uncertain cases.
What is the Tx of SJN TEN?
Stop the offending drug + antibiotic prophylaxis for sepsis + Immune suppression: IVG, corticosteroids, anti-histamines.
Pain control, IV fluid and wound care.
What are cutaneous drug eruptions ?
It is an immune mediated acute to subacute reaction to drugs can present as morbeliform rashes, utricaria or angioedema.
What is the management of drug eruptions?
Stop offending drugs, medical interventions mayn’t be needed.
Antihistamines for urticaria, oral steroids for angeoedema, topical steroids for morbiliform rashes
record drug allergy in medical records.
