All right. So, let's do a few
quick review questions.
I'll ask a question, you can pause the screen,
and unpause it when you're ready to hear the
answer. So, this is a 23-year-old woman
on no medications, who presents
with a symmetrically
distributed rash on her hands, legs, and face,
composed of erythematous circular plaques.
Similar lesions appear on her lips,
but there are no mucosal lesions
and no systemic symptoms.
What's the diagnosis?
Well, a patient with Stevens-Johnson syndrome
should present with mucosal
lesions and also have systemic
symptoms. And since
70%-90% of such patients are
on new medications,
you'd expect that part of the history
as well, and she has not
been started on any new medications.
Angioedema should be more exclusively
involving her face or lips or tongue and
we're not getting that part of the story.
Staphylococcal toxic shock syndrome,
patients present sick,
and she doesn't honestly appear to be that
ill. Erythema nodosum is essentially a
panniculitis involving the peritubular
areas of her legs.
And lastly, erythema multiforme. My
guess here, in this case,
with no recent medications is
that she contracted HSV
and she's now presenting with an erythema
multiforme minor variant presentation.
All right. Next question. Which of
the following is the most
common type of cutaneous drug reaction?
The answer here is exanthematous. That's 90%
of adverse cutaneous drug
reactions. Last question.
Common causes of the rash shown
here include which of the below?
All right. Insect bites can definitely cause
this reaction, which of course is
hives, urticaria. Mycoplasma can cause it.
Recent Staph aureus infection?
Not really. In terms of our
lecture thus far today, a recent Staph
aureus infection could potentially
cause staphylococcal toxic shock syndrome,
but it really shouldn't cause urticaria.
In contrast, cold conditions can cause it
for those who are susceptible to
physical urticaria and beta-lactam antibiotics
are a common culprit as well.
And with that, we've covered the adverse
cutaneous drug reactions.