Search
dermatology
The branch of medicine that focuses on diseases of the skin.
Indications:
- skin disease
Management:
- indications for urgent referral to dermatology [1,2]
a) acute erythroderma: concern for:
1] drug hypersensitivity reaction
2] Stevens Johnson syndrome
3] toxic epidermal necrolysis
4] toxic shock syndrome
5] Staphlococcal scalded skin syndrome
b) high fever, wide spread rash: concern for:
1] severe drug eruptions
2] rickettsial disease; Rocky Mountain spotted fever
c) broad areas of skin pain out of proportion to clinical manifestations: concern for:
- necrotizing fasciitis
d) widepread or dark purple areas of skin pain: concern for:
1] Stevens Johnson syndrome
2] toxic epidermal necrolysis
3] toxic shock syndrome
4] Staphlococcal scalded skin syndrome
e) widespread purpura in a reticulated pattern with central necrosis (retiform purpura): concern for:
1] acute vascular compromise
2] disseminated intravascular coagulation
f) purpura in lacey pattern: concern for:
1] vasculitis
2] autoimmune disease
g) angulated purpura of distal extremities: concern for:
1] sepsis
2] autoimmune disease
h) palpable purpura: concern for:
1] small vessel vasculitis from infection
2] drug reaction
3] autoimmune reaction
i) acute widespread pustular eruption: concern for:
1] drug eruption
2] pustular psoriasis
j) acute widespread vesicles, bullae or denudation (rupture of bullae leaving exposed dermis), diffuse peeling or sloughing of skin: concern for:
1] Stevens Johnson syndrome
2] toxic epidermal necrolysis
3] pemphgus vulgaris
4] bullous pemphigoid
k) immunosuppressed patients especially with febrile neutropenia & idiopathic skin lesion
l) necrotic eschar in an immunosuppressed host
- concern for deep fungal infection
m) rapidly growing skin lesion in an immunosuppressed host: concern for:
1] skin infection
2] skin cancer
n) mucosal inflammation, erosions or ulcerations: concern for:
1] drug eruption
2] autoimmune blistering disease
o) widespread blistering disease: concern for:
1] drug eruption
2] autoimmune blistering disease
3] skin infection
p) worrisome pigmented lesions warrant urgent, not emergent referral & evaluation: concern for:
- melanoma
Related
dermatologic surgery
dermatologist
skin disease (dermatologic disorder, dermatopathy, dermatosis)
skin lesion
General
medical specialty
References
- Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18.
American College of Physicians, Philadelphia 2009, 2012, 2015, 2018.
- Usatine RP, Sandy N.
Dermatologic emergencies.
Am Fam Physician. 2010 Oct 1;82(7):773-80.
PMID: 20879700
- Ashton RE
Teaching non-dermatologists to examine the skin: a review of
the literature and some recommendations.
Br J Dermatol. 1995 Feb;132(2):221-5
PMID: 7888358
- DermNet. Skin Disease Atlas (images)
http://www.dermnet.com
- DermNet NZ (images)
http://www.dermnetnz.org/sitemap.html
- Tyler KH, Zirwas MJ.
Pregnancy and dermatologic therapy.
J Am Acad Dermatol. 2013 Apr;68(4):663-71
PMID: 23182064
- Yalcin B, Tamer E, Toy GG, Oztas P, Hayran M, Alli N
The prevalence of skin diseases in the elderly: analysis of
4099 geriatric patients.
Int J Dermatol. 2006 Jun;45(6):672-6.
PMID: 16796625
- Ferner RE.
Adverse drug reactions in dermatology.
Clin Exp Dermatol. 2015 Mar;40(2):105-9;
PMID: 25622648