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Vesiculobullous Dis.

Vesiculobullous Disorders

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
Created by: thamrick800