Dermatological Emergencies
About 50% of patients with true dermatologic emergencies go straight to an ER. But since the majority of cutaneous outbreaks are not life-threatening, ER personnel are oftentimes less equipped to diagnose these acute conditions correctly. Most emergent rashes are caused by medication - Robert Buka MD
image by: James Heilman, MD
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Redefining Emergency Dermatology
There are some cutaneous syndromes that can be life-threatening if not diagnosed quickly. Outside dermatology, the term “dermatologic emergency” is often regarded as an oxymoron. Unless a patient’s skin is sloughing off — as in Stevens-Johnson syndrome/toxic epidermal necrolysis — a dermatologist is not typically the first physician called when a patient presents in the emergency room. Yet, according to Ronni Wolf, MD, there are such emergencies, which are “best categorized into primary skin diseases and severe systemic disorders with cutaneous manifestations.”
Resources
Can't Miss Dermatology Diagnoses
Red flags of Dermatology: Fever, very young/elderly, toxic-appearing/hypotension, immunocompromised adenopathy, diffuse erythroderma, petechiae/purpura (does the rash blanch with pressure?). Nikolsky sign – top layers of skin slip away from lower layers when rubbed
Drug Rashes: Not always so simple…
Most (90%) drug rashes are morbilliform drug eruptions. Treat symptomatically with topical steroids and oral antihistamines. Patients with DRESS will have hepatic or renal involvement, usually eosinophilia and are treated with antipyretics and antipruritics. SJS/TEN involve mucous membranes and are a life-threatening rash not to miss!
Neonatal dermatological emergencies
The neonates are unique in several ways in comparison with older children and adults which render them highly susceptible to severe, sometimes life threatening dermatological disorders. The neonatal dermatological emergencies are a diagnostic and therapeutic challenge.
When a Rash is Deadly
Critical dermatologic processes are divided into two categories: cutaneous manifestation of a critical illness and acute skin failure. The presence of a dermatologic abnormality does not itself represent a life threat. Instead, the skin lesion suggests the presence of an underlying critical process. The prototypical example would be the petechiae and purpura in meningococcemia. As with any other organ system failure, acute skin failure carries significant morbidity and mortality, and is characterized by derangements in normal skin function.
Life-threatening emergency cases in dermatology
True dermatological emergencies are caused by allergic reactions or infections (bacterial or viral). Rapid management may be required in the case of severe drug reactions, infections, allergic reactions and flares of inflammatory dermatoses.
Critical Rashes to Identify in the Emergency Department
Rashes are common in the emergency department and may be a challenge diagnostically. The authors review rashes that the clinician cannot afford to miss.
Dermatological Emergencies
Although uncommon, dermatological emergencies are important to recognise as they can be life-threatening and easily missed in clinical practice.
From Chemical Burns to Cold Sores, Here's What To Do In An Emergency Skin Situation
If you've got a little time on your hands and don't believe your skin or your health is in danger, 48 hours can provide you with time to gain perspective while allowing your skin to calm from a specific trigger or irritant.
Neonatal and Pediatric Dermatologic Emergencies
A wide variety of neonatal and childhood dermatologic conditions can be emergencies. These may arise from genetic disorders, including those causing skin structural protein and keratin dysfunction, vascular birthmarks with systemic associations, autoimmune disorders, and infections.
Redefining Emergency Dermatology
There are some cutaneous syndromes that can be life-threatening if not diagnosed quickly..
10 Dermatologic Emergencies You Should Know About
Dermatologic emergencies are rare but often progress quickly and lead to significant morbidity and mortality. Most dermatologic emergencies result from an allergic reaction or infection, but some primary skin diseases can also become life-threatening.
Five Dermatologic Emergencies Physicians Should Recognize
Recognizing the signs of deadly skin emergencies and knowing when to call for a dermatology consult can save lives, said Steven Chen, MD, a dermatologist at Massachusetts General Hospital in Boston.
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