rashes & systemic disease

facial rash
1. SLE
2. dermatomyositis
Henoch-Schonlein purpura
1. purpura over buttocks, lower limbs & elbows
erythema nodosum
1. tender nodules over the legs
2. fever
3. arthralgia
4. causes
  1. strep infection
  2. primary TB
  3. inflammatory bowel disease
  4. drug rxn
  5. idiopathic
    1. often no cause IDed
  6. sarcoidosis
    1. rare assoc in kids but common in adults
erythema multiforme
1. causes
  1. HSV infection
  2. Mycoplasma pneumoniae infections
  3. other infections
  4. drug rxn
  5. idiopathic
2. lesions
  1. target lesions w/ central papule surrounded by an erythematous ring
  2. may be vesicular or bullous
urticaria (hives)
1. flesh-coloured wheals
2. papular urticaria
  1. delayed hypersensitivity rxn
    1. ff a bite from flea, bedbug, animal/bird mite
  2. most commonly seen on leg
  3. irritation, vesicles, papules & weal appear
  4. may last for weeks or months & may be recurrent
3. hereditary angioedema
  1. rare autosomal dominant disorder
  2. deficiency or dysfunction of C1-esterase inhibitor
  3. presentation
    1. NO URTICARIA
    2. subcutaneous swellings + abdo pain
  4. trigger= trauma
  5. angioedema may cause resp obstruction
  6. Rx of severe acute attack
    1. purified preparation of inhibitor
    2. replacement therapy w/ fresh frozen plasma
      1. short term measure
Stevens-Johnson syn
1. a severe bullous form of erythema multiforme
  1. w/ mucous mb involvement
  2. eye involvement
    1. conjunctivitis
    2. corneal ulceration
    3. uveitis
2. needs ophthal assessment
3. causes
  1. drug sensitivity
  2. infection
4. complications
  1. infection
  2. toxaemia
  3. renal damage

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rashes & systemic disease

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