PEEL HERE
This bedside sign — lateral pressure shears the epidermis off — is positive in TEN and SSSS, but negative in bullous pemphigoid.
Nikolsky sign
3 days after a camping trip, a pt develops fever, severe HA, and petechiae that began on the wrists and ankles. Name the disease and antibiotic of choice.
RMSF and doxycycline
This rash of hundreds of tiny non-follicular sterile pustules erupted in the axilla, 36 hrs after starting amoxicillin.
AGEP
2 days after returning from vacation, a 41yo has crops of tender follicular pustules over his trunk and buttocks, sparing the skin under his swim shorts' waistband.
Pseudomonas hot tub folliculitis
A 55yo has 6 wks of painful mouth erosions that stop him eating, and only now has flaccid blisters on his trunk that rupture into weeping erosions.
Pemphigus vulgaris
A patient from a group home arrives febrile with rapidly coalescing purpura. Name the organism you must treat ASAP and 1st abx you want to administer.
Neisseria meningitidis; CTX
This rash developed 8 weeks after starting allopurinol, along with fever, facial edema, eosinophilia, and transaminitis.
DRESS
Urgent care sends in a 71yo on long-term amiodarone for cyanosis. You see slate-grey discoloration of his face and hands.
Amiodarone-induced pigmentation
12 days after starting lamotrigine, a pt presents with 31% BSA detachment plus erosions of the lips, conjunctivae and glans
TEN
You see retiform purpura with black necrotic centers on the thighs of a hemodialysis patient. Name the diagnosis.
Calciphylaxis
This scoring system is used to estimate the severity of SJS/TEN.
SCORTEN
A 29yo comes in 2 days after a beach day with bizarre streaky, drip-shaped brown patches on her hands and thighs, preceded by a burning erythema. She squeezed limes for margaritas in the sun.
Phytophotodermatitis