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Dermatologic Emergencies

»	“Dermatologic emergencies” sounds like an oxymoron. Are there dermatologic emergencies?
»	What are the major groups of dermatologic emergencies?
Vesiculobullous Disorders and Drug Reactions
»	How does toxic epidermal necrolysis differ from the Stevens-Johnson syndrome or erythema multiforme major?
»	How do you treat TEN?
»	How do you treat Stevens-Johnson syndrome?
»	What is pemphigus vulgaris?
»	Describe Nikolsky’s sign and its relationship to pemphigus vulgaris.
»	How is pemphigus vulgaris treated?
»	What is the DRESS syndrome?
Infectious Diseases
»	Are any dermatologic emergencies infectious in origin?
»	Can emergent infections be differentiated by their cutaneous presentations?
»	What is the differential to consider in hemorrhagic lesions other than infection?
»	What causes necrotizing fasciitis?
»	Describe the clinical presentation of necrotizing fasciitis.
»	Can other cutaneous infections look like necrotizing fasciitis?
»	Are there any parasitic disease “emergencies” that have cutaneous manifestations?
»	Are there any other parasitic disease emergencies?
»	Do mycobacterial infections cause any dermatologic emergencies?
Autoimmune Disorders
»	What collagen vascular diseases may become dermatologic emergencies?
»	What are the cutaneous findings in acute and bullous SLE?
»	How does neonatal lupus erythematosus (NLE) present?
»	Why are prompt recognition and treatment of NLE important?
»	Why is dermatomyositis considered an emergency?
»	What is leukocytoclastic vasculitis?
»	What are the skin signs of Still’s disease?
Inflammatory Cutaneous Disorders
»	Why is pyoderma gangrenosum a dermatologic emergency?
»	How does pyoderma gangrenosum present?
»	Under what circumstances do childhood vascular anomalies become dermatologic emergencies?
»	How are hemangiomas treated?
»	Is acne fulminans a dermatologic emergency?
»	What is the treatment for acne fulminans?
»	Are there drug eruptions that are dermatologic emergencies?
»	What are the mucocutaneous findings in Kawasaki’s disease?
»	How do you treat Kawasaki’s syndrome?
Environmental Disorders
»	Is heatstroke considered a dermatologic emergency?
»	What are the cutaneous signs of child abuse?
»	What are the skin signs of a lightning strike?
»	What is scleredema neonatorum?
»	What are the cutaneous findings in cholesterol emboli?
»	How are cholesterol emboli diagnosed?

What is the DRESS syndrome?

DRESS stands for drug rash with eosinophilia and systemic symptoms, and it is a life-threatening reaction. It is characterized by a papulosquamous eruption, fever, enlarged lymph nodes, leukocytosis with eosinophilia, and liver or kidney involvement. Typical drugs that induce this reaction include anticonvulsants, allopurinol, and other sulfa drugs. The syndrome develops several weeks after drug initiation and can persist and recur for prolonged periods after the drug has been stopped. Therapy includes high-dose steroids and cyclophosphamide.