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Z Dermatology Clin Med > Photodermatoses/Mucocutaneous Rxns > Flashcards

Photodermatoses/Mucocutaneous Rxns Flashcards

1
Q

Definition of Photosensitivity

A

abnormal response to UV radiation or visible light that underlies many skin conditions (called photodermatoses)

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2
Q

How is diagnosis of photosensitivity determined?

A
  • Primarily from the history & physical exam
  • Occasionally a skin biopsy
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3
Q

Definition of Sunburn?

A

Exposure to excessive UVA and UVB light, causing an inflammatory response in the skin

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4
Q

Clinical manifestations of Sunburn?

A
  • painful erythema
  • blistering
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5
Q

Timeline of Sunburn?

A
  • Erythema at 3-5 hours following exposure
  • peaks at 12-24 hours
  • subsides at 72 hours
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6
Q

Prevention of sunburn?

A
  • limit sun exposure during summer months b/w 10am-4pm
  • protective clothing
  • broad spectrum sunscreens at least 30 SPF
  • Reapply sunscreen every 2 hours
  • infants <6 months should avoid sun exposure
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7
Q

Treatment for sunburn?

A
  • self-limiting
  • may require hospitalization if severe blistering
  • topical agents (aloe vera, etc)
  • cool compresses
  • Oral OTC analgesics
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8
Q

Definition of Polymorphous Light Eruption (PMLE)?

A

“sun poisoning” or “sun allergy” - a specific photo rash

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9
Q

Clinical manifestations of Polymorphous Light Eruption?

A
  • Papulonodular lesions, symmetrically distributed on sun-exposed skin
  • Pruritic
  • Angular chelitis
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10
Q

Treatment of Polymorphous Light Eruption?

A
  • sun protection/avoidance
  • topical corticosteroids
  • oral corticosteroids
  • phototherapy
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11
Q

What is one possible cause of Polymorphous Light Eruption?

A

There is a genetic component to it!

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12
Q

Cause of Phototoxicity?

A

cellular damage following sun exposure when taking a precipitating compound

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13
Q

Examples of precipitating compounds that cause Phototoxicity?

A

-Tetracyclines (Doxy)

-Thiazides

  • Sulfonamides
  • NSAIDS
  • Griseofulvin
  • Tar compounds
  • Phenothiazides
  • St. Johns Wort
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14
Q

Endogenous causes of phototoxicity?

A
  • SLE (lupus)
  • Porphyria (blood disorder)
  • Dermatomyositis (inflamm. disorder)
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15
Q

Clinical manifestations of phototoxicity?

A

appears as exaggerated sunburn

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16
Q

2 types of Mucocutaneous Reactions

A
  • Stevens-Johnson Syndrome
  • Toxic Epidermal Necrolysis
17
Q

Characteristics of Stevens-Johnson Syndrome?

A
  • Dermatologic Emergency
  • Skin detachment <10% of the body surface area
  • mucous membranes are affected in >90% of patients
  • usually 2 different mucous membrane sites at once:
    • ocular, oral, or genital
18
Q

Characteristics of Toxic Epidermal Necrolysis

A
  • Dermatologic Emergency
  • Same as SJS but more severe
  • Detachment of >30% of body surface area
19
Q

What essentially is happening with SJS/TEN?

A

WORST DRUG ALLERGY EVER

20
Q

Clinical manifestations of SJS/TEN?

A
  • begins with prodrome of fever & flu-like symptoms 1-3 days before skin eruption
  • coalescing erythematous macules
  • vesicles and bullae on skin & mucous membranes
  • finally, skin sloughing
21
Q

Lesion course in SJS/TEN?

A
  • on face and trunk
  • spread rapidly, palms and soles become painful, erythematous, edematous

-

22
Q

Test that determines SJS/TEN?

A

-Positive Nikolsky sign

(Gentle pressure rubbed on the skin results in the formation of a blister)

-no connection between epidermis and dermis

23
Q

Medication triggers for SJS/TEN?

A
  • This is the most common cause of SJS/TEN
  • allopurinol
  • anticonvulsants
  • sulfonamides
  • NSAIDS
24
Q

Infections that can trigger SJS/TEN?

A
  • Mycoplasma
  • CMV (cytalomegalovirus)
25
Q

Complications of SJS/TEN?

A
  • shock
  • hypertension
  • renal failure
  • respiratory failure
  • corneal ulcerations
  • ocular scarring/blindness
  • vulvovaginitis/balanitis
26
Q

Steps to take if develop SJS/TEN?

A
  • Discontinue causative agent
  • referral to a burn center
  • treatment similar to major burn
    • fluid resuscitation, wound care, prevention/treatment of infection

Z Dermatology Clin Med (18 decks)

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