By Daniel Creamer
Specializes in dermatoses with a surprising onset, quick development or with neighborhood or systemic morbidity. This name covers a number of universal inflammatory and infective dermatoses, rarer stipulations: rashes, tumours, connective tissue disorder, travelllers' dermatoses and drug eruptions.
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Additional resources for Acute Adult Dermatology: Diagnosis and Management: A Colour Handbook
Azathioprine, mycophenolate mofetil) plus intermittent courses of oral corticosteroids. Other secondline drugs which can be useful in urticarial vasculitis are methotrexate, colchicine, dapsone, and antimalarials. Urticarial vasculitis 63 75 Urticarial vasculitis. These persistent weals in a patient with SLE showed the features of vasculitis on skin biopsy. The patient described burning, rather than itching. 75 76 Urticarial vasculitis. The legs of the same patient in 75. The weals in urticarial vasculitis resemble those in ordinary urticaria, but they persist for more than 24 hr and resolve with bruising.
Sézary syndrome (p. 194, T cell lymphoma with confluent erythema and marked lymphadenopathy). • Pityriasis rubra pilaris (p. 40, confluent erythema with follicular prominence and islands of sparing). 64 65 • Pemphigoid/pemphigus (pp. 66, 68, widespread erythema with blisters and erosions). • Graft-versus-host disease (p. 218, widespread erythema following haematopoietic allogeneic stem cell transplantation). • Paraneoplastic erythroderma (widespread erythema associated with underlying tumour).
COMPLICATIONS • Fever and malaise. • Lymphadenopathy. • Arthralgia. INVESTIGATIONS Skin biopsy is performed for histopathology (interface and upper dermal wedge-shaped lymphocytic infiltrate with erythrocyte extravasation and, in advanced lesions, epidermal necrosis). IMMEDIATE MANAGEMENT Topical therapy • General emollient therapy. • Corticosteroid ointment, twice per day (use for a restricted period): trunk and limbs: moderately potent or potent. g. prednisolone 20–30 mg/day for 5 days and reducing by 5 mg each week).
Acute Adult Dermatology: Diagnosis and Management: A Colour Handbook by Daniel Creamer
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