Serious skin signs in sick patients
Overview
In emergency medicine and critical care it is essential to be able to recognise skin signs that signify serious disease, and be able to consider the likely causes.
Signs and causes
Generalized red rash with fever
- Viral exanthems
- Rickettsial exanthems
- Drug eruptions
- Bacterial infections with toxin production
Generalized red rash with blisters and prominent mouth lesions
- Erythema multiforme (major)
- Toxic epidermal necrolysis
- Pemphigus
- Bullous pemphigoid
- Drug eruptions
Generalized red rash with pustules
- Pustular psoriasis (von Zumbusch)
- Drug eruptions
Generalized rash with vesicles
- Disseminated herpes simplex
- Generalized herpes zoster
- Varicella
- Drug eruptions
Generalized red rash with scaling over whole body
- Exfoliative erythroderma
Generalized wheals and soft tissue swelling
- Urticaria and angioedema
Generalized purpura
- Thrombocytopenia
- Purpura fulminans
- Drug eruptions
Generalized purpura that can be palpated
- Vasculitis
- Bacterial endocarditis
Multiple skin infarcts
- Meningococcemia
- Gonococcemia
- Disseminated intravascular coagulopathy
Localized skin infarcts
- Calciphylaxis
- Atherosclerosis obliterans
- Atheroembolization
- Warfarin necrosis
- Antiphospholipid antibody syndrome
Facial inflammatory edema with fever
- Erysipelas
- Lupus erythematosus
References and Links
- Wolff K, Johnson RA. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, Fifth Edition, McGraw Hill, 2009.
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Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC
Great article. Would be even more helpful with pictures to accompany diagnoses