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Erythroderma History, Epidemiology, Pathogenesis
Erythroderma Clinical Features
Figurate Erythema (General)
EAC & Erythema Marginatum
Erythema migrans & EGR
100
Of the following, which is them most common cause of erythroderma? -Dermatitis -Psoriasis -Drug -CTCL
What is Dermatitis
100
Erythroderma is defined clinically by the presence of erythema and scaling involving more than what % of the skin surface?
What is 90%
100
Name the 4 classic figurate erythemas
What are EAC, erythema marginatum, erythema migrans, erythema gyratum repens
100
There have been a bunch of BS case reports on various treatments for EAC. What is the first line treatment?
What is treat the underlying disorder
100
2 part question: Why is lyme disease called lyme disease? Why was the spirochete named B. burgdorferi?
- There was an epidemic form of childhood arthritis preceded by erythema migrans in several communities in the vicinity of Lyme, Connecticut. - In the 1980's, Burgdorfer isolated a new spirochete in lesions of erythema migrans and the organism was subsequently named B. burgdorferi
200
Which of the following represents the chronically persisting form of erythroderma? -Wilson–Brocq -Hebra -Savill
What is Hebra -chronically relapsing (Wilson–Brocq) -chronically persisting (Hebra) -self-limiting epidemic (Savill)
200
What is the most frequent complaint of patients with erythroderma? -Burning -Hunger -Itching -Flaking/Desquamation -Stinging -Cosmetic Appearance
What is pure-itis (itching)
200
This figurate erythema classically appears as erythematous annular lesions that migrate centrifugally with ‘trailing’ white scale
What is EAC
200
Rheumatic fever is characterized by an abnormal immunologic response to a preceding infection with what bacteria?
What is group A β-hemolytic streptococci
200
What is the other name for Gammel's disease?
What is EGR
300
Name the disease and mutation seen in infants that presents initially with formation of superficial blisters and erosions in the first days of life, with later developement of corrugated hyperkeratosis in flexural areas
What is bullous CIE, keratins 1 and 10
300
Palmoplantar keratoderma appears in approximately 30% of erythrodermic patients, and it is often an early sign of what underlying etiology? *Hint: Alternating parakeratosis and orthokeratosis, and shoulder parakeratosis seen on histology
What is pityriasis rubra pilaris
300
Erythema marginatum is one of the cutaneous manifestations of what disease?
What is acute rheumatic fever
300
Jones originally established the criteria for the diagnosis of rheumatic fever: major criteria are carditis, migratory polyarthritis, Sydenham's chorea, erythema marginatum and subcutaneous nodules. Minor criteria include fever, arthralgias and abnormal laboratory findings (elevated ESR, elevated C-reactive protein, or prolonged PR interval on an ECG). To establish the diagnosis of acute rheumatic fever, two major or one major and two minor criteria must be accompanied by evidence of what?
What is an antecedent group A streptococcal infection, e.g. a positive culture or raised or rising antistreptolysin O or antideoxyribonuclease B titer
300
A patient presents with classic EGR, having a wood grain or zebra like rapidly migrating erythema, as well as a chronic "smokers" cough. what is your first step? - Tell patient to lose weight and stop smoking, and then give him some salve - Obtain CXR - Send to Dr. Wood, the patient may have Sezary - KOH
What is KOH, followed by providing patient with a salve
400
Name the hair finding in this cause of erythroderma seen in neonates and infants in which patients typically have atopic-like dermatitis, food allergies, and immune deficiency. Erythroderma may persist or ichthyosis linearis circumflexa can develop.
What is trichorrhexis invaginata (‘bamboo hair’)
400
Patients with erythroderma due to a variety of causes can begin to develop numerous of these unsightly lesions Hint: These lesions are a typical reason for urgent inpatient consult at UW hospital
What are seborrheic keratoses
400
Does erythema migrans typically first develop at the site of initial tick bite, or at a distal location?
What is the site of the initial tick bite
400
EAC favors what anatomic sites?
What are the thighs and hips
400
What is the natural host for borrelia?
What are white footed mice and white tailed deer
500
Infections in neonates and infants such as staph scalded skin, toxic shock syndrome, nad congenital cutaneous candidiasis can all be causes of erythroderma. Name the toxins involved in staph scalded skin syndrome
What are Exfoliative Toxins A & B
500
Name atleast 3 scary systemic complications resulting from erythroderma
What are tachycardia, high output cardiac failure, thermoregulatory disturbance, cachexia, anemia
500
What is the most common malignancy associated with EGR?
What is lung carcinoma
500
Aside from erythema marginatum, what is the other cutaneous manifestation associated with rheumatic fever?
What are subcutaneous nodules
500
What is the first line treatment for Lyme in the following situations: - Early localized disease - Children <8 with mild disease - Severe disease
What is: - Doxy 100mg po q12hrs 14-21 days - Amoxicillin 500mg po q8hrs 14-21 days - Ceftriaxone 2g IV qd 14-28days