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Vesiculobullous Dis.
Vesiculobullous Disorders
Question | Answer |
---|---|
Erythema Multiforme lesions look like ? | *self limited hypersensitivity disorder with target lesions with central vesicles (big with dot in the middle) |
Top way we Erythema Multiforme ? | * reactivation of HSV |
What would we see upon biopsy ? | * focal liquefaction of epidermal keratinocytes |
Ery. Multi. Prodrome = ? | * NONE, but look for a Hx of HSV |
Ery. Multi. CxSx = ? | * can have mucosal involvement in up to 50%... * See the rash with the centered vesicles....* see extensive target lesions with a dark purple center (almost looks like what would happen if an octopus attached itself to you) |
What is Stevens-Johnson Syndrome ? | * Serious systemic disorder in which TWO or more mucous membranes AND the skin ... * They are SUPER sick with high fever and have Epidermal detachment at 2 or more sites |
SJS Prodrome = ? | * 1-14 days of fever, malaise, and URI symptoms |
What we see in SJS ? | * raw, denuded skin... * Nikolsky Sign... * Painful mucosal crusting with hemorrhagic crusting |
What do we have to take a good Hx with SJS ? | * B/c early SJS resembles Ery. Multi.... * BUT, SJS has a prodrome and is wayyy worse. |
Stevens-Johnson Syndome vs. Toxic Epidermal Necrolysis = ? | * SJS = <10% of body affected.... * SJS-TEN = 10-30%.... * TEN = >30%.... So, SJS can become TEN ! |
SJS agent in KIDS and ADULTS = ? | * Kids = Mycoplasma Infections..... * Adults = medications, esp. anti-convulsants |
SJS Management = ? | * Is life threatening... * Need to treat eyes and mouth to resolve their involvement in the disease and place patient in the ICU/Burn unit for fluid loss |
What is SJS commonly confused with, Dx wise ? | * Staphylococcal Scalded Skin Syndorme (SSSS) |
What is SSSS ? | * Exfoliative toxin A and B of S. aureus cause the superficial skin to blister.... * Cultures will show nothing and sampling a busted bullae will show nothing also(sterile fluid). |
What is Toxic Shock Syndrome ? | * develop a red, flat rash, in which the sin peels 1 - 2 weeks after the syndrome |
How will TSS patients present and what is usu the cause of TSS? | * These patients have SUDDEN onset fever, rash, hypotension, and toxic appearance (No Prodrome)... * The major cause is Tampons in women or packing, such as nose bleeds where they leave them in or WAYYY too long.... * They need lots of IV fluids |
The factors that increase susceptibility to TSS = ? | * Menstruation -- recent birth -- recent surgery -- Foreign bodies or packings -- Tampons -- Infection by S. Aureus |