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Erythema Multiforme most common causes HSV, Mycoplasma, drug reactions 50% supposedly idiopathic Causes Infection VIRAL - HSV, hepatitis, influenza, mumps FUNGAL- histo, Coccidio BACTERIAL - haemolytic strep, TB, Leprosy, typhoid, mycoplasma CTD - RA, SLE, Dermatiomyositis, PAN DRUGS - Sulphas, penicillin, Barbs, salicylates Pregnancy DXRT for Ca STEVENS JOHNSON SYN = seveer form : fulminant, diseminated, multiorgan vesiculo bullous eruprion skin, mucoius memebranes Pyodema Gangrenosum associated with - IBD, Sero +ve Rheumatoid, Leulaemia, polycythemia vera differential - Necrotizing vasulitis, Bacterial infectio, Spider bites, venous ulcers, neuropathic ulcers Uncommon necrotizing skin condition 50% pxs have underlying systemic disorder painful leg ulcers, well defined undermined borders with surrounding erythema ulcer healing forms cribriform scars Purpura BLOOD PLATELETS ITP, iatrogenic thrombocytopaenia, TTP, DIC, association with Myeloproliferatic=ve dirorders VASCULAR VASCULITIS - Henoch schonlein, CTD, infection - meningococcal, Staph, gonoccocal, Rickettsial, hereditary telangiectasia, ( osler rendu weber) Wegeners granulomatosis OTHER drug Induced ( steroids) trauma ( asphyxial mask) scurvy senile purpura dysproteinaemias Toxic epidermal Necrolysis 2 forms -SSSS - intraepidermal cleavage 5 yoa, LOW, good prognosis - drug/ Ca - dermo epidermo jxtion. adults, deep injury, 25% mortality drugs : Phenytoin, penicillins, sulphas, NSAIDS, aspirin, Allopurinol +ve Nikolsky phenomena = skin falling off when stressed. Desquamation Pemphigus TSS scarlet fever Chemical/ thermal burns TEN Kawasaki's Macukopapular Rash and fever ERYTHEMA MARGINATUM - Rheumatic fever SLE Drug Eruption - eosinophilia, same drug / rash oiver same are(s) SERUM SICKNESS - +VE ln, Arthritis ERYTHEMA MULTIFORME - target lesions , KAWASAKI'S - < 10 yoa, conjunctivitis, LN, strawberry tongue, hands and feet MURINE TYPHUS SALMONELLA - + diarrhoea, rose spots RMSF 2y SYPHILIS TSS SCARLET FEVER - Pastia's lines - capillary fragility along flexoral creases. sudden onset ( < 4 hours).sandpaper skin, strawberry tongue, perioral pallor, desquamaton < 1 month Viral Causes maculopapular rash and fever MEASLES - 3-4 days catarrh, forehead and reticuloauricular . Pre rash Koplik's spots inmouth RUBELLA - FORCHEIMER'S SIGN ( soft palate petechiae0. confluent rash sparing eyes. cervical LN, Arthritis ERYTHEMA INFECTIOSUM - ( 5th Disease) - slapped cheek, reticular rash, otherwise well child EXANTHUM SUBITUM - roseola infantum - < 4 yoa, diffuse rash IXIOS MONONUCLEOSIS - Pharyngitis, LN, fever, hepatitis HEPATITIS OTHER - Cocksackie, Adno, echo Purpuric rash and Fever MENINGOCOCCAEMIA GONOCCOCAEMIA S. AUREUS Bacteraemia STREP VIRIDANS Bacteraemia VASCULITIS - HSP DIC PSEUDOMONAS BACTERAEMIA- Gun netal rash. infants, immunocompromised RMSF Vesicular rash and fever TEN VARICELLA - tzanck smear +ve HZV/ HSV ECZEMA HERPETICUM HAND, FOOT AND MOUTH RICKETTSIAL POX Pityriasis rosacea Herald patch "Christmas tree" dist on back individual lesions may mimic fungal Ix appearance 2y to PICORNA virus - may last for months Dermatitic rash cotact dermatitis seborrheic dermatitis eczema ( atopic) drug eruption photodermatitis Psoriasis rosacea - ETOHic, middle age, rhinophynum, Pityriasis Rosacea Hand nd foot rashes syphilis Erythema Multiforme reiter's Syn Gonococcaemia Mercury and Arsenioc Poisoning Guttate Psoriasis RMSF hand Foot and Mouth Rickettsial pox herpes virus pompholyx ( vesicular eczema) HIV seroconversion illness