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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