Acute Adult Dermatology: Diagnosis and Management: A Colour by Daniel Creamer

By Daniel Creamer

Makes a speciality of dermatoses with a surprising onset, swift development or with neighborhood or systemic morbidity. This identify covers quite a few universal inflammatory and infective dermatoses, rarer stipulations: rashes, tumours, connective tissue illness, travelllers' dermatoses and drug eruptions.

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226, a widespread pustular drug eruption). • Subcorneal pustular dermatosis (an eruption of numerous large flaccid pustules). • Candidiasis (p. 158, areas of flexural erythema with pustules). • Pemphigus foliaceous (p. 68, vesicles, bullae, and scaling, especially on torso). COMPLICATIONS • Erythroderma (see p. 51). • Fever. • Malaise and weight loss. • Hypocalcaemia. • Liver dysfunction. • Acute renal failure. • Hypotension and cardiac failure. • Deep vein thrombosis. • Malabsorption. • Capillary leak syndrome.

Pulmonary function tests (restrictive defect). • Electrocardiogram (ECG) (to exclude cardiac involvement). • Skin biopsy for histopathology (granulomatous infiltrate in the upper dermis composed of lymphocyte-poor granulomas). IMMEDIATE MANAGEMENT Topical therapy • Corticosteroid ointment, twice per day (use for a restricted period): face: moderately potent or potent. trunk and limbs: potent or superpotent. • Intralesional triamcinolone injections. • Tacrolimus ointment. 56 56 Sarcoidosis. Lupus pernio is characterized by diffuse, violaceous infiltration of the nasal tip.

The papules and plaques flatten usually leaving postinflammatory hyperpigmentation which can be prominent and persistent in pigmented skin. g. ciclosporin) may be required. g. ciclosporin, azathioprine). LP of the scalp can result in scarring alopecia, while nail involvement can lead to irreversible scarring of the nail bed, therefore, in these situations, the prompt introduction of systemic immunosuppressant therapy may be necessary. Lichen planus 37 39 39 Lichen planus. In acute LP there is an eruption of violaceous papules.

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