Erythroderma Flashcards
Staphylococcal toxic shock syndrome patho
S. aureus…rpoduction of superantigen exotoxin
TSST-1 adctivates T cells with lots of cytokines…don’t need APCs…result in direct inding of MHC2 on APCs and TCRs in absence of antigen
Release IL1, IL2, TNF, and IFN
Toxic shock syndrome clinical
Hypotension, diffuse erythroderma, water diarrhea, fever, and myalgia
IV, ABs and draingange of infection
Clindamyic to suppress protein synthesis limiting TSST-1 and Vanc to cover MRSA
Staph scalded skin syndrome, patho, clinical,
Produciton of exfloialtive toxin
Targets epidermis and cleaves keratinocytes apart to separate the zona granulosa layer of the peidermis
Under 6 y/o with absecesses, sinusitis, spesis of septic arthritis
Get fever and irritability followed by diffuse, tender eyrtham
Increased fascular flow
Capillary abnormaliities and vasodilation
Ectactic capillaries (Nevus simplex) has a more subtle pink appearance) where Cpillariy malformation (nevus flammeus) can be deeper redpurple and persist throughout life
Nevus simplex…names, patho, location, exacerbating
Angel kiss (over glabella), stork bite (over the nape) or salmon patch
Persistenc e of fetal circulation and ectacctic dermal capillaries
Most on the head, face, and neck
Any action causing vasodilation will exaggerate
Pressure on area will blanch…most diappear
Nevus flammeus…what it looks like, clinical, location
Post wine stain
Always obvious at birht…do NOT balnch
Persist throughout life
Can be anywhere
Nevus flammeus complications
Over opthalmic regions- Sturge-Weber Syndrome…triad of facial cap MF, angioma of the choioid of the eye and lepomeninges
Angioma of choroid can result in glaucoma
Leptomeningela angioma can calcify and affect cerebral function…result in contralateral hemiplegia
Lower extremity could be Klippel-Trenaunay syndrome…both cap and lymph MFs…Leg hypertrophy and soft tissue and bone overgrowth…can get leg length discrepancy
Erythema nodosum…patho, course
Inflam of SubQ fat…a local panniculitis
Distant infectious or inflam process results in AB production and these deposit on skin
Unfection is predisposing
Prodrome of fever, malaise, and arthralgia with gradual developmetn over months f red, tender nodules
Erythema migrans….patho, sx and course, tx
Infection from borrelia burgdorferi in Lyme dz (spriochete)
Proliferation within dermis gets inflam rxn with lymp0h infiltration
Degins as small macule/papule and expands
Will get systemic sx
Tx with doxy or amoxicillin
Erythema multiforme patho
Cell mediated immune rxn against viral or bacterial antigens that are deposited in the skin
HSV1 and myco penumo are common
Phagocytoses by L cells which go to epidermal kertinocytes and T cells recruited that lyse the keratinocytes
Erythema multiforme…when it appears, sx, course, appearance
Within 2 weeks of recurrent HSV…if with penumo, then concurrent typically
3 zones or target lesions - dark red ring of inflammatioin in middle…pale ring of edema, and erythematous halo on the periph
Beigin on extrmeities and spread to trunk
Uticaria…patho, what to look for, tx
Localized mast cell activation and degranulation releasing histamine
IgE or nonimmunologic activation of mast cells
Direct from Narcotics, NSAIDs, radiocontract
IgE through meds, hymenoptera, latex, foods
Mostly on truk…assymetric, irregular raised plaques with central pallor that appear nad diappear over minutes to hours
Tx - H1 antihistaimne with H2 antihistimaine augmenting
Angioedema
identical to uticaria but localized to lips and eyes
Direct mast cell activation and accumulation of bradykinin
Bradykinin accumulation could be due to def of C1 esterase inhibitor and in response to ACE inhibitor
May also involve larynx and bowels
Irritant contact dermatitis
Partial loss of either epidermis or dermis
Loss of SC - pink
Loss of entire epidermis or deeper - deeper red
Onset usually minutes to hours after exposrue
