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Derm Chapt 16 Specialized Erythema

Terms in this set (129)

Is an immunologic reaction in the skin possibly triggered by circulating immune complexes.A variety of skin lesions, erythematous plaques, blisters and target lesions
Recurrent disease is associated with HSV
Involvement of mucous membranes is Erythema Multiforme major, or Stevens-Johnson Syndrome, usually caused by drugs

The most common causes are:
1- Drugs
2- Infection
EM is uncommon, but not rare.
< 1% of dermatology patients
more common in older children and young adults

Rapid onset < 24 hours
50% of time associated with herpes infection
Recurrent HSV infection is associated with recurrent Erythema Multiforme.Lesions are pruritic and have burning sensation;Herpes infection may precede EM by about 1 week
Mycoplasm pneumoniae infection is another precipitating factor for EM, history of preceding fever and cough
Mild to severe presentation;Target lesions on palms and soles and sometimes other areas;Target lesions have 3 zones of color and are diagnostic of EM;Mild form may not be symmetrical;Severe form is generalized and involves mucous membranes, oral mucosa, lips, conjunctivae. Painful oral erosions.

Most severe Stevens-Johnson Syndrome is usually associated with Mycoplasma related or drug-induced
Cause of EM may not always be determined

EM Differential Diagnosis-
Urticaria (2 zones, last < 24 hours)
Viral Exantham( monomorphous, less red, more confluent, more central body)
Staphylococcal Scalded Skin Syndrome
Pemphigus and Pemphigoid

Severe form is generalized and involves mucous membranes, oral mucosa, lips, conjunctivae. Painful oral erosions.
1- Hallmark sign of Lyme disease, the most common tick-borne disease in USA;Caused by ****Borrelia burgdorferi****, which is transmitted by a tick, Ixodes species;Treatment with antibiotics avoids the late complications of notably arthritis
Specific skin lesion associated with Lyme Disease, a tick-borne illness cause by the spirochete, Borrelia burgdorferi.
Onsets as small erythematous macule or papule which expands slowly over days to weeks;Must be > 5cm diameter to be called Erythema Migrans;Occurs in >60% of patients with Lyme Disease;Late complications include musculoskeletal, nervous and cardiovascular systems.

Incidence of Erythema Migrans-
First described in 1977, near Lyme, Connecticut
Most often in northeast states, but has not been reported in all states;Most frequently reported arthropod-borne disease in the USA;Most cases occur from May to September;Erythema Migrans History;

Symptoms onset 3-30 days after tick bite;Some pts do not remember tick bite;Some pts develop fever, myalgia, arthralgia, headache, malaise or fatigue;The Erythema Migrans skin lesion is usually asymptomatic, but spreading

Erythema Migrans Physical Findings
Lesion occurs at site of tick bite, usually waistband, intertriginous areas and extremities;> 5cm, but up to 68cm, average 15cm, expanding over days and weeks
Central punctum of tick bite may be present or absent
Macular border with central clearing;Less common papular border, alternating rings of erythema and clearing and center that is intensely erythematous, vesicular, purpuric, necrotic or even ulcerated;Multiple lesions in 15% of pts
1- Hallmark sign of Lyme disease, the most common tick-borne disease in USA;Caused by ****Borrelia burgdorferi****, which is transmitted by a tick, Ixodes species;Treatment with antibiotics avoids the late complications of notably arthritis
Specific skin lesion associated with Lyme Disease, a tick-borne illness cause by the spirochete, Borrelia burgdorferi.
Onsets as small erythematous macule or papule which expands slowly over days to weeks;Must be > 5cm diameter to be called Erythema Migrans;Occurs in >60% of patients with Lyme Disease;Late complications include musculoskeletal, nervous and cardiovascular systems.

Incidence of Erythema Migrans-
First described in 1977, near Lyme, Connecticut
Most often in northeast states, but has not been reported in all states;Most frequently reported arthropod-borne disease in the USA;Most cases occur from May to September;Erythema Migrans History;

Symptoms onset 3-30 days after tick bite;Some pts do not remember tick bite;Some pts develop fever, myalgia, arthralgia, headache, malaise or fatigue;The Erythema Migrans skin lesion is usually asymptomatic, but spreading

Erythema Migrans Physical Findings
Lesion occurs at site of tick bite, usually waistband, intertriginous areas and extremities;> 5cm, but up to 68cm, average 15cm, expanding over days and weeks
Central punctum of tick bite may be present or absent
Macular border with central clearing;Less common papular border, alternating rings of erythema and clearing and center that is intensely erythematous, vesicular, purpuric, necrotic or even ulcerated;Multiple lesions in 15% of pts