STEVEN JOHNSON SYNDROME
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Steven Johnson Syndrome (SJS) is a rare but severe drug reaction and skin disease characterized by painful rashes and blistering of the skin and mucous membranes. It begins with flu-like symptoms and spreads to cause erosion of the skin and mouth. SJS is caused by certain infections or drug reactions, especially antibiotics like penicillin or pain medications like diclofenac. It requires removing the triggering cause, providing supportive care including fluids and antibiotics, and managing complications like vision loss which can be permanent. SJS ranges in severity from minor cases with under 10% body surface area detachment to toxic epidermal necrolysis with over 30% detachment which is life-threatening.
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Steven johnson syndrome & ten
Steven-Johnson syndrome (SJS) is a severe skin reaction typically caused by drug reactions. It is characterized by painful sores and blisters in the mouth, eyes, and other mucus membranes. SJS progresses to toxic epidermal necrolysis (TEN) when over 30% of the skin is affected and shows widespread damage. Both SJS and TEN can cause blindness, infection, and death if not properly treated with fluid replacement, antibiotics, steroids, and stopping the causative drug. Prompt diagnosis and management are important to prevent complications and improve prognosis of these potentially life-threatening conditions.
Staphylococcal scalded skin syndrome
This case report describes a male infant who developed staphylococcal scalded skin syndrome (SSSS) caused by methicillin-sensitive Staphylococcus aureus producing exfoliative toxin B. He presented with fever, irritability, and an erythematous rash on his trunk and face that progressed to tender, painful skin and flaccid bullae. Standard treatment of systemic antibiotics was supplemented with application of Suprathel, a synthetic wound dressing, as a whole-body covering. This innovative treatment relieved pain, prevented heat loss and infection, accelerated healing, and did not require frequent changes.
Lyell's syndrome or Toxic epidermal necrolysis
Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a rare, life-threatening skin condition usually caused by an adverse drug reaction. It causes the top layer of skin to detach from the lower layers all over the body, leaving the body susceptible to severe infection. TEN progresses from a rash and blisters to large areas of skin sloughing off and can involve mucous membranes. It has overall mortality rate of around 30% and treatment aims to discontinue the causative drug and provide supportive care to protect the skin and monitor fluid and electrolyte balance.
Atopic dermatitis
1. Atopic dermatitis is the most common type of dermatitis, which is a chronic, pruritic inflammatory skin disease that varies in severity. It primarily causes intense itching.
2. The pathogenesis is multifactorial involving genetic predisposition, skin barrier dysfunction, and immune abnormalities.
3. Treatment focuses on managing flares with topical corticosteroids and infections, while remission involves long-term emollient use and trigger avoidance.
NEPHRITIC SYNDROME / APSGN IN CHILDREN
This document provides information about Acute Poststreptococcal Glomerulonephritis (APSGN). It begins by describing the features of acute nephritic syndrome which is characterized by gross hematuria, edema, hypertension, and renal insufficiency. It then discusses the pathology, clinical manifestations, diagnosis, and management of APSGN. APSGN is caused by a previous streptococcal infection and results in immune complex deposition in the glomeruli. It presents abruptly with hematuria, edema, hypertension, and sometimes renal insufficiency. Treatment focuses on supporting kidney function and controlling blood pressure while the patient recovers over 6-8 weeks. Prognosis is generally good with complete recovery in over 95
Stevens-Johnson syndrome and toxic epidermal necrolysis
Stevens-Johnson syndrome and toxic epidermal necrolysisChulalongkorn Allergy and Clinical Immunology Research Group
Stevens-Johnson syndrome and toxic epidermal necrolysis
Presented by Kullapornpas Benyajirapach, MD.
June7, 2019What is stevens johnson syndrome?
SJS and TEN are life-threatening mucocutaneous diseases within the spectrum of severe cutaneous adverse reactions (SCAR) that can be caused by drugs, infections, or unknown factors. They involve epidermal necrosis and sloughing of the skin and mucosal surfaces. SJS usually presents as less severe than TEN. While no treatment can halt skin detachment progression, supportive care including fluid replacement, nutrition, analgesics, and antibiotics when needed is crucial, though mortality increases with severity and underlying patient conditions.
Stevens johnson syndrome & toxic epidermal necrolysis
Stevens johnson syndrome & toxic epidermal necrolysisChulalongkorn Allergy and Clinical Immunology Research Group
Stevens johnson syndrome & toxic epidermal necrolysis
Presented by Jintana Chataroopwijit, MD.
September23, 2016Recommended
Steven johnson syndrome & ten
Steven-Johnson syndrome (SJS) is a severe skin reaction typically caused by drug reactions. It is characterized by painful sores and blisters in the mouth, eyes, and other mucus membranes. SJS progresses to toxic epidermal necrolysis (TEN) when over 30% of the skin is affected and shows widespread damage. Both SJS and TEN can cause blindness, infection, and death if not properly treated with fluid replacement, antibiotics, steroids, and stopping the causative drug. Prompt diagnosis and management are important to prevent complications and improve prognosis of these potentially life-threatening conditions.
Staphylococcal scalded skin syndrome
This case report describes a male infant who developed staphylococcal scalded skin syndrome (SSSS) caused by methicillin-sensitive Staphylococcus aureus producing exfoliative toxin B. He presented with fever, irritability, and an erythematous rash on his trunk and face that progressed to tender, painful skin and flaccid bullae. Standard treatment of systemic antibiotics was supplemented with application of Suprathel, a synthetic wound dressing, as a whole-body covering. This innovative treatment relieved pain, prevented heat loss and infection, accelerated healing, and did not require frequent changes.
Lyell's syndrome or Toxic epidermal necrolysis
Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a rare, life-threatening skin condition usually caused by an adverse drug reaction. It causes the top layer of skin to detach from the lower layers all over the body, leaving the body susceptible to severe infection. TEN progresses from a rash and blisters to large areas of skin sloughing off and can involve mucous membranes. It has overall mortality rate of around 30% and treatment aims to discontinue the causative drug and provide supportive care to protect the skin and monitor fluid and electrolyte balance.
Atopic dermatitis
1. Atopic dermatitis is the most common type of dermatitis, which is a chronic, pruritic inflammatory skin disease that varies in severity. It primarily causes intense itching.
2. The pathogenesis is multifactorial involving genetic predisposition, skin barrier dysfunction, and immune abnormalities.
3. Treatment focuses on managing flares with topical corticosteroids and infections, while remission involves long-term emollient use and trigger avoidance.
NEPHRITIC SYNDROME / APSGN IN CHILDREN
This document provides information about Acute Poststreptococcal Glomerulonephritis (APSGN). It begins by describing the features of acute nephritic syndrome which is characterized by gross hematuria, edema, hypertension, and renal insufficiency. It then discusses the pathology, clinical manifestations, diagnosis, and management of APSGN. APSGN is caused by a previous streptococcal infection and results in immune complex deposition in the glomeruli. It presents abruptly with hematuria, edema, hypertension, and sometimes renal insufficiency. Treatment focuses on supporting kidney function and controlling blood pressure while the patient recovers over 6-8 weeks. Prognosis is generally good with complete recovery in over 95
Stevens-Johnson syndrome and toxic epidermal necrolysis
Stevens-Johnson syndrome and toxic epidermal necrolysisChulalongkorn Allergy and Clinical Immunology Research Group
Stevens-Johnson syndrome and toxic epidermal necrolysis
Presented by Kullapornpas Benyajirapach, MD.
June7, 2019What is stevens johnson syndrome?
SJS and TEN are life-threatening mucocutaneous diseases within the spectrum of severe cutaneous adverse reactions (SCAR) that can be caused by drugs, infections, or unknown factors. They involve epidermal necrosis and sloughing of the skin and mucosal surfaces. SJS usually presents as less severe than TEN. While no treatment can halt skin detachment progression, supportive care including fluid replacement, nutrition, analgesics, and antibiotics when needed is crucial, though mortality increases with severity and underlying patient conditions.
Stevens johnson syndrome & toxic epidermal necrolysis
Stevens johnson syndrome & toxic epidermal necrolysisChulalongkorn Allergy and Clinical Immunology Research Group
Stevens johnson syndrome & toxic epidermal necrolysis
Presented by Jintana Chataroopwijit, MD.
September23, 2016Systemic sclerosis
A 60-year-old woman presented with painful, sclerotic hands and fingers due to progressive cutaneous scleroderma. She was started on a compounded topical cream containing ketamine, baclofen, gabapentin, verapamil, and pentoxifylline, which provided significant pain relief and improved sensation within a month. At a 6-month follow up, she had been largely weaned off opioid pain medications. The customized treatment targeted the pathophysiology of the condition and helped manage her debilitating symptoms.
Erythema nodosum
This document discusses the approach to erythema nodosum, a panniculitis condition presenting as subcutaneous nodules. It is most commonly caused by infections such as streptococcal infections or tuberculosis. The nodules typically appear on the shins and resolve within a few weeks. For chronic or recurrent cases, thorough investigation is needed to rule out underlying causes like sarcoidosis or inflammatory bowel disease. Treatment involves managing the triggering infection or condition with medications like NSAIDs, potassium iodide, or steroids. Biopsy may be needed to confirm the diagnosis. Prognosis is generally good if an underlying cause is identified and treated.
Atopic dermatitis in children
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by dryness, itchiness, redness, and sometimes oozing. It is one of the most common skin disorders in children, affecting up to 30% of preschoolers. The exact causes are unknown but include genetic susceptibility and environmental triggers weakening the skin barrier. Treatment focuses on moisturizing to repair the barrier, identifying and avoiding triggers, and controlling flares with topical corticosteroids or other immunosuppressants. While there is no cure, many children outgrow eczema by adolescence.
Bacterial skin infection- dermatology
This document discusses various bacterial skin infections, including:
- Impetigo, which is caused by Staph aureus or Strep and presents as non-bullous or bullous sores;
- Folliculitis, which is the inflammation of hair follicles that can be caused by Staph;
- Furuncles/boils and carbuncles, which are deep Staph infections of hair follicles;
- Cellulitis, a bacterial infection of subcutaneous tissues, and erysipelas, a superficial streptococcal infection;
- Erythrasma, a chronic infection of the skin caused by Corynebacterium minutissimum.
Skin And Soft Tissue Infections
This document provides an overview of common skin and soft tissue infections, including their causes, symptoms, classifications, and treatments. It discusses infections such as impetigo, cellulitis, erysipelas, necrotizing fasciitis, and infections of the bones and joints. The key points covered include the clinical presentations and differential diagnoses of various infections, as well as empirical and organism-based antibiotic therapies.
Dermatomyositis
Dermatomyositis is a chronic inflammatory disorder of the skin and muscles that is characterized by an autoimmune pathogenesis. It commonly presents with characteristic rashes like Gottron's papules and heliotrope rash as well as proximal muscle weakness. Dermatomyositis can also involve internal organs like the lungs, esophagus and heart. Diagnosis involves assessing clinical features, muscle enzymes, electromyography, muscle/skin biopsies and identifying myositis-specific antibodies. Prognosis depends on the severity and organ involvement, with risks of residual weakness, contractures and death from respiratory or cardiac complications.
Erythroderma
Erythroderma is defined as the scaling erythematous dermatitis involving 90% or more of the cutaneous surface.
Also known as exfoliative dermatitis
Idiopathic exfoliative dermatitis – also known as the “red man syndrome”, is characterized by marked palmoplantar keratoderma, dermatopathic lymphadenopathy,increased IgE.
Increased skin perfusion leads to
Temperature dysregulation >
Resulting in skin loss and hypothermia >
High output state >
Cardiac failure
BMR raises to compensate for heat loss
Increased dehydration due to transpiration (similar to burns)
All lead to negative nitrogen balance and characterized by edema, hypoalbuminemia, loss of muscle mass.
Toxic Epidermal Necrolysis
Toxic epidermal necrolysis (T.E.N.) is a rare but life-threatening adverse drug reaction where large areas of the epidermis are sloughed off due to necrosis. It is most commonly caused by drugs such as sulphonamide antibiotics and anticonvulsants. The clinical features include widespread erythema, flaccid blisters, and mucous membrane involvement that can lead to complications affecting the eyes, respiratory tract, and gastrointestinal tract. Treatment focuses on supportive care by discontinuing the causative drug, skin care to prevent infection, and monitoring fluid and electrolyte balance. The mortality rate is high at 30-40% even with treatment.
Pyoderma Gangrenosum
Pyoderma gangrenosum is an uncommon inflammatory skin condition of unknown cause characterized by sterile pustules that form ulcers with necrotic margins. It typically affects adults ages 20-50 and presents as painful lesions that can develop rapidly. While the pathophysiology is poorly understood, it involves dysregulation of the immune system and neutrophils. Treatment involves immunosuppressants like corticosteroids and cyclosporine. Proper diagnosis requires ruling out infection and avoiding biopsy or surgery, as trauma can worsen lesions.
Seborrheic dermatitis
Seborrheic dermatitis (SD) is a common chronic skin condition characterized by redness and scaling in areas with many sebaceous glands like the face, scalp, and skin folds. It causes mild flaking of the scalp known as dandruff. Lesions can be itchy or painful and look deep red or purple with pimple-like bumps or blisters. Treatment involves topical anti-fungal creams, steroid creams, or oral anti-fungal medication for deep infections.
Staphylococcal Scalded Skin Syndrome Made Very Easy
A brief description of a very common bacterial skin condition affecting children and adults. Characterized by fever, rash and peeling of the skin. Useful information for medical students, doctors especially dermatologists and pediatricians and nurses. Helpful information for exam preparation of USMLE, FCPS, MCPS, MRCP derma.
Molluscum contagiosum
Molluscum contagiosum is a common, harmless skin infection caused by a poxvirus that spreads through direct skin-to-skin contact. It presents as small, flesh-colored bumps with a dimpled center that contain a white, curdy core. While generally asymptomatic, the bumps can occasionally itch or cause a skin rash. Diagnosis is made through visual examination of characteristic lesions, and treatment options range from natural resolution to cryotherapy, curettage, laser surgery, or topical medications depending on severity. Left untreated in healthy individuals, molluscum contagiosum will usually clear up on its own within months without scarring.
Cutaneous vasculitis
Cutaneous involvement is very common in the different types of vasculitis. Skin lesions may be the only manifestation or may occur in the context of systemic disease
Seminar hand eczema
Principles of Management of Hand Eczema,
irritant contact dermatitis, allergic contact dermatitis
Pompholyx, Hyperkeratotic palmar eczema, patch test
Leprosy - Dermatology
Leprosy, also known as Hansen's disease, is a chronic bacterial infection caused by Mycobacterium leprae. It primarily affects the skin and nerves. There are approximately 600,000 new cases detected worldwide each year. It is endemic in many developing countries. The disease presentation exists on a spectrum from tuberculoid leprosy to lepromatous leprosy depending on the immune response. Left untreated, leprosy can cause permanent nerve damage and deformities. Standard treatment involves multidrug therapy with dapsone, rifampin, and clofazimine over the course of months or years.
Atopic dermatitis
hanifin and rajka criteria, entymology, definition of AD, atopy, etiopathogenesis of AD, genetics in AD, filaggrin, epidermal barrier dysfunction, atopic march, hygiene hypothesis, infantile phase of AD, childhood phase of AD, adult phase of AD, pityriasis alba, denne morgan folds, dirty neck appearence, nipple dermatitis, hanifin and rajka criteria, UK refinement of hanifin and rajka criteria, millenium criteria of AD, japanese dermatological association criteria, management of AD, wet wrap therapy,
Tinea versicolor
Tinea versicolor is a common skin infection caused by the Malassezia fungus. It causes patches of discolored skin but is not harmful or contagious. While it may cause emotional distress, the fungus usually lives harmlessly on the skin. Tinea versicolor is more common in teenagers due to hormones and occurs in people of all ages. Factors like weak immune systems, hormones, sweat, and heat can cause the fungus to overgrow and discolor patches of skin.
Atopic dermatitis
Atopic dermatitis is a chronic inflammatory skin disease associated with respiratory allergies. It is characterized by recurrent eczematous lesions and intense itch. Genetic factors like filaggrin mutations cause skin barrier defects allowing allergens and microbes to trigger immune responses. The disease involves type 2 immunity cytokines activating neurons to produce itch. Staphylococcus aureus colonization exacerbates inflammation. Clinical features include erythematous patches and plaques with lichenification in chronic cases.
approach to the patient of Acute Diarrhoea
This document discusses the approach to a patient presenting with acute diarrhea, which is defined as 3-4 loose stools per day lasting less than 2 weeks. The most common causes are infections (90%), with inflammatory causes including Shigella, Salmonella, and Clostridium difficile. The history should inquire about travel, food, and medication exposures. The exam evaluates for dehydration by checking vital signs and skin turgor. Rehydration is the primary treatment, using oral rehydration solution for mild to moderate cases and IV fluids for severe dehydration. Antibiotics may be used for inflammatory cases while anti-diarrheals are only suitable for mild non-inflammatory diarrhea. Prevention involves
Systemic sclerosis..scleroderma
This document provides information on systemic sclerosis (SSc), a chronic autoimmune disease characterized by thickening and hardening of the skin, and involvement of internal organs. It can present as either limited or diffuse cutaneous forms. Key clinical features include Raynaud's phenomenon, skin thickening and tightening, digital pitting scars, and internal organ involvement such as interstitial lung disease, gastrointestinal issues, and renal crisis. Diagnosis involves clinical examination and the presence of autoantibodies. Differential diagnoses include other conditions presenting with similar skin or vascular changes. Complications can affect multiple organ systems and are a leading cause of mortality.
Stevens-Johnson Syndrome
Stevens-Johnson syndrome is a life-threatening skin condition characterized by extensive necrosis and separation of the epidermis from the dermis. It exists on a spectrum of severity from Steven Johnson Syndrome (<10% body surface area involvement) to Stevens Johnson Syndrome-Toxic Epidermal Necrolysis (10-30% involvement) and Toxic Epidermal Necrolysis (>30% involvement). It is typically caused by hypersensitivity drug reactions or infections and presents with painful erosions and blistering of the skin and mucous membranes that can lead to vision loss, respiratory failure, or death in severe cases. Treatment focuses on stopping the offending agent, supportive care in intensive care units, wound care of d
Steven Johnson Syndrome-TEN
Steven-Johnson syndrome (SJS) is a severe skin reaction characterized by lesions and mucous membrane erosions. It is caused by an immune reaction, often to drugs. The symptoms include fever and pain followed by spreading rashes, blisters and sores in the mouth, eyes and genitals. SJS is diagnosed based on its symptoms and skin biopsy. Treatment focuses on supportive care, stopping the triggering drug, and preventing infections. With prompt treatment the prognosis is usually good, but it can be life-threatening in severe cases with extensive blistering over large body areas.
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Systemic sclerosis
A 60-year-old woman presented with painful, sclerotic hands and fingers due to progressive cutaneous scleroderma. She was started on a compounded topical cream containing ketamine, baclofen, gabapentin, verapamil, and pentoxifylline, which provided significant pain relief and improved sensation within a month. At a 6-month follow up, she had been largely weaned off opioid pain medications. The customized treatment targeted the pathophysiology of the condition and helped manage her debilitating symptoms.
Erythema nodosum
This document discusses the approach to erythema nodosum, a panniculitis condition presenting as subcutaneous nodules. It is most commonly caused by infections such as streptococcal infections or tuberculosis. The nodules typically appear on the shins and resolve within a few weeks. For chronic or recurrent cases, thorough investigation is needed to rule out underlying causes like sarcoidosis or inflammatory bowel disease. Treatment involves managing the triggering infection or condition with medications like NSAIDs, potassium iodide, or steroids. Biopsy may be needed to confirm the diagnosis. Prognosis is generally good if an underlying cause is identified and treated.
Atopic dermatitis in children
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by dryness, itchiness, redness, and sometimes oozing. It is one of the most common skin disorders in children, affecting up to 30% of preschoolers. The exact causes are unknown but include genetic susceptibility and environmental triggers weakening the skin barrier. Treatment focuses on moisturizing to repair the barrier, identifying and avoiding triggers, and controlling flares with topical corticosteroids or other immunosuppressants. While there is no cure, many children outgrow eczema by adolescence.
Bacterial skin infection- dermatology
This document discusses various bacterial skin infections, including:
- Impetigo, which is caused by Staph aureus or Strep and presents as non-bullous or bullous sores;
- Folliculitis, which is the inflammation of hair follicles that can be caused by Staph;
- Furuncles/boils and carbuncles, which are deep Staph infections of hair follicles;
- Cellulitis, a bacterial infection of subcutaneous tissues, and erysipelas, a superficial streptococcal infection;
- Erythrasma, a chronic infection of the skin caused by Corynebacterium minutissimum.
Skin And Soft Tissue Infections
This document provides an overview of common skin and soft tissue infections, including their causes, symptoms, classifications, and treatments. It discusses infections such as impetigo, cellulitis, erysipelas, necrotizing fasciitis, and infections of the bones and joints. The key points covered include the clinical presentations and differential diagnoses of various infections, as well as empirical and organism-based antibiotic therapies.
Dermatomyositis
Dermatomyositis is a chronic inflammatory disorder of the skin and muscles that is characterized by an autoimmune pathogenesis. It commonly presents with characteristic rashes like Gottron's papules and heliotrope rash as well as proximal muscle weakness. Dermatomyositis can also involve internal organs like the lungs, esophagus and heart. Diagnosis involves assessing clinical features, muscle enzymes, electromyography, muscle/skin biopsies and identifying myositis-specific antibodies. Prognosis depends on the severity and organ involvement, with risks of residual weakness, contractures and death from respiratory or cardiac complications.
Erythroderma
Erythroderma is defined as the scaling erythematous dermatitis involving 90% or more of the cutaneous surface.
Also known as exfoliative dermatitis
Idiopathic exfoliative dermatitis – also known as the “red man syndrome”, is characterized by marked palmoplantar keratoderma, dermatopathic lymphadenopathy,increased IgE.
Increased skin perfusion leads to
Temperature dysregulation >
Resulting in skin loss and hypothermia >
High output state >
Cardiac failure
BMR raises to compensate for heat loss
Increased dehydration due to transpiration (similar to burns)
All lead to negative nitrogen balance and characterized by edema, hypoalbuminemia, loss of muscle mass.
Toxic Epidermal Necrolysis
Toxic epidermal necrolysis (T.E.N.) is a rare but life-threatening adverse drug reaction where large areas of the epidermis are sloughed off due to necrosis. It is most commonly caused by drugs such as sulphonamide antibiotics and anticonvulsants. The clinical features include widespread erythema, flaccid blisters, and mucous membrane involvement that can lead to complications affecting the eyes, respiratory tract, and gastrointestinal tract. Treatment focuses on supportive care by discontinuing the causative drug, skin care to prevent infection, and monitoring fluid and electrolyte balance. The mortality rate is high at 30-40% even with treatment.
Pyoderma Gangrenosum
Pyoderma gangrenosum is an uncommon inflammatory skin condition of unknown cause characterized by sterile pustules that form ulcers with necrotic margins. It typically affects adults ages 20-50 and presents as painful lesions that can develop rapidly. While the pathophysiology is poorly understood, it involves dysregulation of the immune system and neutrophils. Treatment involves immunosuppressants like corticosteroids and cyclosporine. Proper diagnosis requires ruling out infection and avoiding biopsy or surgery, as trauma can worsen lesions.
Seborrheic dermatitis
Seborrheic dermatitis (SD) is a common chronic skin condition characterized by redness and scaling in areas with many sebaceous glands like the face, scalp, and skin folds. It causes mild flaking of the scalp known as dandruff. Lesions can be itchy or painful and look deep red or purple with pimple-like bumps or blisters. Treatment involves topical anti-fungal creams, steroid creams, or oral anti-fungal medication for deep infections.
Staphylococcal Scalded Skin Syndrome Made Very Easy
A brief description of a very common bacterial skin condition affecting children and adults. Characterized by fever, rash and peeling of the skin. Useful information for medical students, doctors especially dermatologists and pediatricians and nurses. Helpful information for exam preparation of USMLE, FCPS, MCPS, MRCP derma.
Molluscum contagiosum
Molluscum contagiosum is a common, harmless skin infection caused by a poxvirus that spreads through direct skin-to-skin contact. It presents as small, flesh-colored bumps with a dimpled center that contain a white, curdy core. While generally asymptomatic, the bumps can occasionally itch or cause a skin rash. Diagnosis is made through visual examination of characteristic lesions, and treatment options range from natural resolution to cryotherapy, curettage, laser surgery, or topical medications depending on severity. Left untreated in healthy individuals, molluscum contagiosum will usually clear up on its own within months without scarring.
Cutaneous vasculitis
Cutaneous involvement is very common in the different types of vasculitis. Skin lesions may be the only manifestation or may occur in the context of systemic disease
Seminar hand eczema
Principles of Management of Hand Eczema,
irritant contact dermatitis, allergic contact dermatitis
Pompholyx, Hyperkeratotic palmar eczema, patch test
Leprosy - Dermatology
Leprosy, also known as Hansen's disease, is a chronic bacterial infection caused by Mycobacterium leprae. It primarily affects the skin and nerves. There are approximately 600,000 new cases detected worldwide each year. It is endemic in many developing countries. The disease presentation exists on a spectrum from tuberculoid leprosy to lepromatous leprosy depending on the immune response. Left untreated, leprosy can cause permanent nerve damage and deformities. Standard treatment involves multidrug therapy with dapsone, rifampin, and clofazimine over the course of months or years.
Atopic dermatitis
hanifin and rajka criteria, entymology, definition of AD, atopy, etiopathogenesis of AD, genetics in AD, filaggrin, epidermal barrier dysfunction, atopic march, hygiene hypothesis, infantile phase of AD, childhood phase of AD, adult phase of AD, pityriasis alba, denne morgan folds, dirty neck appearence, nipple dermatitis, hanifin and rajka criteria, UK refinement of hanifin and rajka criteria, millenium criteria of AD, japanese dermatological association criteria, management of AD, wet wrap therapy,
Tinea versicolor
Tinea versicolor is a common skin infection caused by the Malassezia fungus. It causes patches of discolored skin but is not harmful or contagious. While it may cause emotional distress, the fungus usually lives harmlessly on the skin. Tinea versicolor is more common in teenagers due to hormones and occurs in people of all ages. Factors like weak immune systems, hormones, sweat, and heat can cause the fungus to overgrow and discolor patches of skin.
Atopic dermatitis
Atopic dermatitis is a chronic inflammatory skin disease associated with respiratory allergies. It is characterized by recurrent eczematous lesions and intense itch. Genetic factors like filaggrin mutations cause skin barrier defects allowing allergens and microbes to trigger immune responses. The disease involves type 2 immunity cytokines activating neurons to produce itch. Staphylococcus aureus colonization exacerbates inflammation. Clinical features include erythematous patches and plaques with lichenification in chronic cases.
approach to the patient of Acute Diarrhoea
This document discusses the approach to a patient presenting with acute diarrhea, which is defined as 3-4 loose stools per day lasting less than 2 weeks. The most common causes are infections (90%), with inflammatory causes including Shigella, Salmonella, and Clostridium difficile. The history should inquire about travel, food, and medication exposures. The exam evaluates for dehydration by checking vital signs and skin turgor. Rehydration is the primary treatment, using oral rehydration solution for mild to moderate cases and IV fluids for severe dehydration. Antibiotics may be used for inflammatory cases while anti-diarrheals are only suitable for mild non-inflammatory diarrhea. Prevention involves
Systemic sclerosis..scleroderma
This document provides information on systemic sclerosis (SSc), a chronic autoimmune disease characterized by thickening and hardening of the skin, and involvement of internal organs. It can present as either limited or diffuse cutaneous forms. Key clinical features include Raynaud's phenomenon, skin thickening and tightening, digital pitting scars, and internal organ involvement such as interstitial lung disease, gastrointestinal issues, and renal crisis. Diagnosis involves clinical examination and the presence of autoantibodies. Differential diagnoses include other conditions presenting with similar skin or vascular changes. Complications can affect multiple organ systems and are a leading cause of mortality.
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Staphylococcal Scalded Skin Syndrome Made Very Easy
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Stevens-Johnson Syndrome
Stevens-Johnson syndrome is a life-threatening skin condition characterized by extensive necrosis and separation of the epidermis from the dermis. It exists on a spectrum of severity from Steven Johnson Syndrome (<10% body surface area involvement) to Stevens Johnson Syndrome-Toxic Epidermal Necrolysis (10-30% involvement) and Toxic Epidermal Necrolysis (>30% involvement). It is typically caused by hypersensitivity drug reactions or infections and presents with painful erosions and blistering of the skin and mucous membranes that can lead to vision loss, respiratory failure, or death in severe cases. Treatment focuses on stopping the offending agent, supportive care in intensive care units, wound care of d
Steven Johnson Syndrome-TEN
Steven-Johnson syndrome (SJS) is a severe skin reaction characterized by lesions and mucous membrane erosions. It is caused by an immune reaction, often to drugs. The symptoms include fever and pain followed by spreading rashes, blisters and sores in the mouth, eyes and genitals. SJS is diagnosed based on its symptoms and skin biopsy. Treatment focuses on supportive care, stopping the triggering drug, and preventing infections. With prompt treatment the prognosis is usually good, but it can be life-threatening in severe cases with extensive blistering over large body areas.
A CASE REPORT ON CARBAMAZEPINE INDUCED STEVEN JOHNSON SYNDROME
Drug induced Steven Johnson Syndrome is reported with barbiturates, antibiotics, anticonvulsants, and NSAIDs. Among anticonvulsants the incidence of carbamazepine induced SJS is very low (0.25%). Here we report a case of Steven Johnson Syndrome late onset, induced by carbamazepine.
Case presentation on sjs
Steven Johnson syndrome - patient case presentation. One in 10,000 case mainly an allergic reaction to drugs.
Carbamazepine induced steven johnson syndrome a case report
1) A 25-year-old female patient developed Steven Johnson Syndrome approximately one month after starting treatment with carbamazepine for seizures.
2) She had a previous history of developing Steven Johnson Syndrome after treatment with phenytoin.
3) Her symptoms improved after discontinuing carbamazepine and starting treatment with levetiracetam instead, along with supportive care including calosoft lotion, antibiotics, and paracetamol.
Stevens Johnson syndrome and laboratory diagnostic tools
Stevens Johnson syndrome and laboratory diagnostic toolsChulalongkorn Allergy and Clinical Immunology Research Group
This case study describes a 7-year-old Thai boy who presented with a rash, fever, and seizures. He was initially diagnosed with epilepsy and treated with phenytoin, cef-3, and azithromycin. His condition worsened with the development of Steven Johnson Syndrome. Testing found he was positive for phenytoin on an ELISPOT test. The document discusses SJS pathogenesis, definitions, investigations including the ALDEN algorithm and ELISPOT test, and management of the patient's condition.Lamitrogine
Lamotrigine is an antiepileptic drug approved for use in epilepsy, bipolar disorder, and other conditions. It is chemically unrelated to other AEDs and works by inhibiting sodium channels. Lamotrigine has a low risk of serious rash (under 1%) and is metabolized primarily through glucuronidation. It is effective for bipolar depression and as maintenance therapy to delay mood episodes. Slow titration reduces the risk of rash.
Drug allergy
This document discusses drug allergies, including definitions, pathophysiology, symptoms, diagnosis, and management. It defines drug allergy as an abnormal immunological response to a drug or its metabolites. Common symptoms include various skin eruptions like urticaria, contact dermatitis, and Steven Johnson syndrome. Diagnosis involves taking a detailed medical history and potentially skin or provocation tests. Management consists of discontinuing the suspected drug and treating symptoms with antihistamines, corticosteroids, or epinephrine depending on severity.
Stevens-Johnson Syndrome
A 45-year-old African American woman presented with a two day history of sore throat, eye pain and redness, fever, and malaise. On examination, she had visual acuity of 20/40 in both eyes, round and reactive pupils, and erythema of the eyelids and conjunctiva. The presentation is consistent with erythema multiforme, a spectrum of mucocutaneous disorders that can be drug-induced or due to infection. Management involves supportive care, steroids, immunoglobulins, and addressing both acute ocular involvement and long-term complications.
Emergencies Caused By Psychiatric Drugs
This document discusses several psychiatric medication emergencies including serotonin syndrome, neuroleptic malignant syndrome, extrapyramidal reactions, and lithium toxicity. Serotonin syndrome can be caused by medications that increase serotonin levels and can be fatal if not treated. Neuroleptic malignant syndrome is associated with neuroleptic medications and MAO inhibitors and presents with fever, muscle rigidity, and elevated enzymes. Extrapyramidal reactions include dystonia, parkinsonism, akathisia, and tardive dyskinesia. Lithium toxicity can cause confusion, ataxia, seizures or death at levels over 3 mmol per L. Prompt diagnosis and discontinuation of causative medications are important in treating these potential emergencies.
Stevens-Johnson syndrome/ Toxic epidermal necrolysis emergency guidelines
This document provides guidelines for the diagnosis and management of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). It outlines the definition, epidemiology, etiology, pathogenesis, symptoms, examination findings, investigations, management, complications and prognosis. Key points include that anti-fas drugs may be promising treatments and steroids are still controversial. Management involves supportive care, stopping causative medications, and intravenous immunoglobulin may improve survival. Complications can include infections, ocular issues, strictures and death.
Stevens-Johnson Syndrome
SJS is a rare and serious condition that causes flu-like symptoms and the development of painful sores on the skin, eyes, and mucous membranes. It is usually caused by an allergic reaction to certain medications. The sores spread and the skin dies and falls off, potentially affecting 10-30% of the body's skin. SJS requires testing to diagnose and treatment focuses on fluid replacement, stopping the culprit medication, and cleaning wounds to remove dead tissue. SJS can result in life-long complications like skin scarring and vision problems.
Stevens johnson syndrome
Stevens-Johnson syndrome is a severe mucocutaneous reaction typically caused by drugs involving skin and mucous membranes. It begins with flu-like symptoms followed by distinctive target lesions. Complications can include blindness, infections, and death. Treatment focuses on stopping the causative agent, supportive care, corticosteroids, IVIG, and antibiotics for secondary infections.
Sx Steven - Jhonson + Necrosis Epidermica Toxica
Este documento describe el horizonte clínico de las farmacodermias, incluyendo el síndrome de Stevens-Johnson (SSJ) y la necrólisis epidérmica tóxica (NET). Estos síndromes cutáneos graves pueden ser inducidos por medicamentos e involucran una reacción de hipersensibilidad que causa necrosis epidérmica. El SSJ afecta menos del 30% de la piel mientras que la NET más grave afecta más del 30% y puede ser mortal. Ambos requieren tratamiento agresivo para reemplazar los fluidos per
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A CASE REPORT ON CARBAMAZEPINE INDUCED STEVEN JOHNSON SYNDROME
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Stevens-Johnson syndrome/ Toxic epidermal necrolysis emergency guidelines
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This document discusses salivary gland infections. It notes that salivary gland infections can be viral, bacterial, or fungal, with viruses being the most common cause. The parotid glands are more commonly infected than the submandibular glands. Sialadenitis refers to inflammation of the salivary glands. Mumps is a common viral cause of sialadenitis that infects the parotid glands. Bacterial infections are usually due to retrograde spread of bacteria via the salivary ducts when salivary flow is reduced. Actinomycosis is a rare fungal infection that can affect the salivary glands. Diagnosis involves clinical examination and sometimes
Stevens Johnson Syndrome
Stevens Johnson syndrome (SJS) is a severe immune-mediated reaction involving the skin and mucous membranes. It is characterized by painful red or purplish flat blotches that develop into blisters and ulcers of the skin and mucous membranes. SJS can be caused by infections, certain medications, and some cancers. It affects the skin, eyes, mouth, lungs, and genitals. Treatment focuses on supportive care, withdrawing the triggering medication, and managing complications. The prognosis depends on the extent of organ involvement, with mortality rates reaching 35% in severe cases with over 30% body surface area affected.
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STEVEN JOHNSON SYNDROME
- 1. STEVEN JOHNSON SYNDROME Steven Johnson Syndrome(SJS) –it’s a severe drug reaction & also known as erythema multiforme major. It is a form of toxic epidermal necrolysis. SJS is potentially a rare, deadly skin disease that is usually a result of a violent drug reaction, leading to severe disorder of the skin as well as mucous membrane. SJS begins with a non-specific upper respiratory tract infection. Flu like symptoms appear first, a painful rash that spreads & this leads to blistering & erosion of the skin & mucous membranes specifically in the parts of throat & mouth.SJS is named so after Albert Mason Stevens & Frank Chambliss Johnson, two American physicians(Pediatricians) as they first jointly published its description in the American Journal of Disease for Children. The onset of SJS is marked by fever, soreness of the throat, chills, headache, malaise , conjunctivitis along with inflammation of the eye & eyelid. Ulcers & lesions also start to appear throughout the mucous membranes, the mouth, the lips, it also effects the anal & genital regions. Vomiting & diarrhea are occasionally noted as part of the syndrome. SJS ulcers in the mouth can be drastically painful & it diminishes the ability of the person to eat & drink. SJS severely affects the eye that can root to permanent loss of vision. It is known as immune complex-mediated hypersensitivity complex generally originating due to infections, drugs & medications. Such medications include Allopurinol, Azithromycin, Penicillin, Sulphonamides, Diclofenac. SJS is treated with selective antibiotics supported along with use of I.V.fluids.
- 2. Classification of SJS: SJS- A minor form of TEN with less than 10% body surface are(BSA) detachment. Overlapping SJS/ Toxic epidermal necrolysis (SJS/TEN)- Detachment of 10-30%. Toxic Epidermal necrolysis- Detachment of more than 30% BSA. Infectious Causes: Viral diseases that have been reported to cause SJS include the following : Herpes Simplex Virus (its still a debated issue) AIDS Coxsackie viral infections Influenza Hepatitis Mumps Bacterial etiologies that cause SIS include the following: Group A beta-hemolytic streptococci Diphtheria Brucellosis Lymphogranuloma venereum Mycobacteria Mycoplasma pneumonia Rickettsial infections Tularenia Typoid
- 3. Management of SJS/TEN Diagnosis: Biopsy All suspected cases of SJS and TEN should be confirmed by skin biopsy for histologic and immunefluorescence examinations. Removal of cause In 70% of SJS and TEN drug cause could be identified. Specific Treatment Fluid, electrolyte infection Wound care, pain control Complications managements
- 4. Drugs & SJS/TEN High Risk No reports of SJS/TEN Allopurinol Angiotensin-converting enzyme inhibitors Carbamazepine Aspirin Lamotrigine Aldactone Nevirapine Beta-blockers NSAIDs(Oxicam) Calcium channel inhibitors Phenobarbital Furosemide Phenytoin Sulfonylurea Phenylbutazone Thiazide diuretics Sulphadiazine Sulfapyridine Sulfamethoxazole Sulfasalazine Sarnali Das