Rash + Red Eye Flashcards
SLE Sx + who does it commonly effect
Commonly in females of reproductive age
Sx:
Constitutional
Cutaneous
Alopecia
Oral ulcers
Photosensitivity rash
Malar rash
Discoid rash
Raynauds
MSK
Arthralgia
Myalgia
Cardiorespiratory
Pericarditis, myocarditis, endocarditis
Pleurisy
Pneumonitis
Neuro
Sz
Psychosis
Chorea
Transverse myelitis
Renal
Proteinuria
Nephrotic syndrome
ESRD
GI
Ascites
Liver dz
Haem
Hemolytic anemia (reticulocytes, reduced haptoglobin, raised indirect bili, raised LDH)
Leukopenia
Thrombocytopenia
Thrombosis
Dx criteria for SLE
ACR
SLICC
Ix for SLE
ANA
Anti-dsDNA antibody
Low complement levels
Anti-Smith
Antiphospholipid antibodies
Rx for SLE (mild, mod, severe)
Avoid sun
Flu shot annually
Mild
Antimalarials
Methotrexate
NSAIDs
Prednisone
Moderate
Prednisone
Triamcinolone IM
Azathioprine
Severe
Methylprednisone
Mycophenolate mofetil
Cyclosporine
Tacrolimus
Rituximab
Dx of celiac
sx, HLA-DQ2/DQ8 gene, ab in serum, duodenal histology
RF for celiac
family history, women more common, T1DM, autoimmune thyroiditis, Downs, Turners, IgA deficiency
Complications of celiac
Complications: anemia, growth failure, T cell lymphoma
peripheral neuropathy, arthritis, aphthous stomatitis, hyposplenism, higher risk of osteoporosis
Sx of celiac
Sx: anorexia, constipation/ diarrhea, growth failure, abdo pain/ distension, steatorrhea, wt loss, dermatitis herpetiform (intensely pruritic papulovesicular rash on extensor surfaces)
Ix, Rx + monitoring for celiac
Ix: Anti-tTG IgA + intestinal biopsy
Rx: gluten free diet, refer to RD, repeat serology in 6 months, screen for FDR
Monitoring: annual anti-tTG, Q2yr TSH
Sx of chickenpox, incubation + infectivity period
Starts on face, spreads inferiorly to trunk + extremities
Papules evolve into vesicles then pustules that crust
Incubation 14-21d, infectivity 1-2d pre-rash
Rx for Kawasaki’s
Management
IVIG + ASA 100mg/kg/d divided QID
Reduce ASA to 5mg/kg/d x 6 weeks post fever
Lyme pathogen, sx + rx
Borrelia Burgdorferi
Reportable
Sx:
Macule or papule at tick bite site
Progresses to erythema migrans (bulls eye red patch that expands)
Rx: doxycycline 100mg BID, amox for kids
Measles sx
Begins on face + shoulders, spread inferiorly
Macular rash
Fades in 4-6d, incubation 10-14d, infectivity 4d pre rash
URTI prodrome w/ fever, rash starts 4th day of fever
Koplik’s spots 1-2d pre rash
Parvovirus sx + complications
Fifth disease/ slapped cheek
Sx
Bright red facial rash, progresses to lacy reticular rash
Complications
Severe aplastic anemia in pts w/ chronic hemolytic anemia
Rocky mountain spotted fever sx
Evolves from pink macules to red papules to petechiae
Starts on wrists + ankles then spreads towards centre
Hx of tick exposure
Prodrome of fever, severe HA, myalgias
Rash starts 4d later
Associated w/ bradycardia + leukopenia
Roseola - cause, sx
HHV 6
Fever
Diffuse macular rash, face sparing
Rubella sx + name of specific finding (petechiae soft palate)
Pink macules + papules start on forehead then spread down to extremities within 1d
Forchheimer spots (petechiae on soft palate)
Rosacea sx + rx
Sx
Central face w/ transient erythema, telangectasia, inflammatory papules and pustules
Flushing
Management
Avoid triggers
Photoprotection
Topical metronidazole or azelaic acid
Scarlet fever sx + signs on exam + cause
Sandpaper rash, starts on trunk, spreads to extremities
Flushed face w/ perioral pallor
Rash fades in 4-5d, followed desquamation
Acute strep infection
Pastia’s sign (linear petechiae in antecubital + axillary folds)
White strawberry tongue then red strawberry tongue
Ix for persistent rash
Ix - scraping, culture, biopsy, labs