Algorism of skin rash

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The sign is present when slight rubbing of the skin results in exfoliation of the outermost layer, forming a blister within minutes.Nikolsky's sign is almost always present in toxic epidermal necrolysis and is associated with pemphigus vulgaris

Nikolsky's sign is a clinical dermatological sign, named after Pyotr Nikolsky (1858–1940), a Russian physician who trained and worked in Ukraine, which was part of the Russian Empire at that time.

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tss

Sand paper

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scalded skin syndrome

SSSS widespread formation of fluid filled blisters that are thin walled and easily ruptured and the patient can be positive for Nikolsky's sign.

SSSS often includes a widespread painful erythroderma, often involving the face, diaper, and other intertriginous areas. Extensive areas of desquamation might be present. Perioral crusting and fissuring are seen early in the course.

Unlike toxic epidermal necrolysis, SSSS spares the mucous membranes.

It is most common in children under 6 years, but can be seen in adults who are immunosuppressed or have renal failure.The diagnosis of SSSS is made clinically.

1-This is sometimes confirmed by isolation of S. aureus from blood, m.m. 2-skin biopsy

toxic epidermal necrolysis

(TEN), also known as Lyell's syndrome is a rare, life-threatening skin condition that is usually caused by a reaction to drugs. The top layer of skin (the epidermis) detaches from the lower layers of the skin (the dermis) all over the body.

TEN is a more severe form of Stevens–Johnson syndrome.

The incidence is between 0.4 and 1.3 cases per million each year.History of medication use exists in over 95% of patients with TEN.

The drugs most often implicated in TEN are antibiotics such as sulfonamides, nonsteroidal anti-inflammatory drugs, allopurinol,methotrexate, antiretroviral drugs, corticosteroids, chlormezanone (anxiolytic) and anticonvulsants such as phenobarbital, phenytoin, carbamazepine, and valproic acid.

The condition might also result from infection with agents such as Mycoplasma pneumoniaeor the herpes virus; and transplants of bone marrow or organs.

Treatment 1-The first line of treatment is early withdrawal of drugs, early referral and management in burn units or intensive care units, supportive management, and nutritional support.

2-The second line is (IVIG).

3-The third line is cyclosporin, cyclophosphamide, ,pentoxifylline, N-acetylcysteine, ulinastatin, infliximab.

4- plasmapheresis

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herald patch of pit.rosea

erythema migrans

Lyme disease is caused by the spirochete Borrelia burgdorferi and is transmitted by the pinhead-sized Ixodes ticks.

It consists of an expanding annular lesion around the original tick bite.

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scabies

Rocky Mountain Spotted Fever is a bacterial infection caused by Rickettsia rickettsii. It is most commonly transmitted via dog ticks

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purpura fulminante

Henoch–Schönlein purpura

Idiopathic Thrombocytopenic Purpura