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Emergency Dermatology This page intentionally left blank EMERGENCY DERMATOLOGY MANY PHYSICIANS and patients do not believe that dermatology involves life-threatening situations. However, there are many emergencies that the dermatologist needs to address and many cutaneous diseases in the emergency room that require rapid dermatologic consultation. The dermatologist is frequently the first physician to examine such patients before a hospital admission and also the first to identify a critical situation, stabilize the patient, and choose urgent and appropriate intervention. The first chapters of this book are directed toward those dermatol- ogists who care for hospitalized patients with severe and dangerous skin diseases. Later chapters are intended for all physicians, including dermatologists, who wish to hone their diagnostic skills, expand their knowledge and understanding of pathological events, and learn treatment options available for acute life-threatening skin diseases. This book brings together top dermatolo- gists from around the world to address the complicated and multifaceted field of dermatologic emergencies for the practicing dermatologist and emergency physician. Ronni Wolf, MD, is Associate Clinical Professor and Head of the Dermatology Unit at Kaplan Medical Center, Rechovot, Israel, and the Hebrew University–Hadassah Medical School, Jerusalem, Israel. Batya B. Davidovici, MD, is Physician in the Dermatology Unit at Kaplan Medical Center, Rechovot, Israel. Jennifer L. Parish, MD, is Assistant Clinical Professor of Dermatology and Cutaneous Biology at Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, and Assistant Professor of Dermatology, Tulane University School of Medicine, New Orleans, Louisiana. Lawrence Charles Parish, MD, MD(hon), is Clinical Professor of Dermatology and Cuta- neous Biology and Director of the Jefferson Center for International Dermatology at Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Parish is also Visiting Professor of Dermatology at Tulane University School of Medicine, New Orleans, Louisiana. EMERGENCY DERMATOLOGY Edited by Ronni Wolf Kaplan Medical Center Batya B. Davidovici Kaplan Medical Center Jennifer L. Parish Jefferson Medical College of Thomas Jefferson University and Tulane University School of Medicine Lawrence Charles Parish Jefferson Medical College of Thomas Jefferson University and Tulane University School of Medicine CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, Sao˜ Paulo, Delhi, Dubai, Tokyo, Mexico City Cambridge University Press 32 Avenue of the Americas, New York, NY 10013-2473, USA www.cambridge.org Information on this title: www.cambridge.org/9780521717335 C Cambridge University Press 2010 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2010 Printed in China by Everbest A catalog record for this publication is available from the British Library. Library of Congress Cataloging in Publication data Emergency dermatology / edited by Ronni Wolf ...[et al.]. p.;cm. Includes bibliographical references and index. ISBN 978-0-521-71733-5 (hardback) 1. Dermatology. 2. Medical emergencies. I. Wolf, Ronni. [DNLM: 1. Skin Diseases – therapy. 2. Emergencies. 3. Emergency Treatment. WR 140 E53 2009] RL72.E443 2009 616.5025 – dc22 2009007871 ISBN 978-0-521-71733-5 Hardback Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors, and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors, and publishers therefore disclaim all liabilty for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use. Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party Internet Web sites referred to in this publication and does not guarantee that any content on such Web sites is, or will remain, accurate or appropriate. Contents CONTRIBUTORS vii Chap. 9. LIFE-THREATENING BACTERIAL PREFACE xi SKIN INFECTIONS 81 Richard B. Cindrich and Donald Rudikoff Chap. 1. CELL INJURY AND CELL DEATH 1 Adone Baroni, Eleonora Ruocco, Maria Chap. 10. BACTEREMIA, SEPSIS, SEPTIC SHOCK, Antonietta Tufano, and Elisabetta Buommino AND TOXIC SHOCK SYNDROME 98 Geeta Patel, Ryan Hawley, and Noah Scheinfeld Chap. 2. CLEAN AND ASEPTIC TECHNIQUE AT THE BEDSIDE 12 Chap. 11. STAPHYLOCOCCAL SCALDED Sapna Amin, Aron J. Gewirtzman, and Stephen Tyring SKIN SYNDROME 109 Eleonora Ruocco, Adone Baroni, Chap. 3. NEW ANTIMICROBIALS 18 Sonia Sangiuliano, Giovanna Donnarumma, and Maryann Mikhail and Jeffrey M. Weinberg Vincenzo Ruocco Chap. 4. IMMUNOMODULATORS AND Chap. 12. LIFE-THREATENING CUTANEOUS THE “BIOLOGICS” IN CUTANEOUS VIRAL DISEASES 115 EMERGENCIES 34 Aron J. Gewirtzman, Brandon Christianson, Batya B. Davidovici and Ronni Wolf Anne Marie Tremaine, Brenda L. Pellicane, and Stephen Tyring Chap. 5. CRITICAL CARE: STUFF YOU REALLY, REALLY NEED TO KNOW 50 Chap. 13. LIFE-THREATENING CUTANEOUS Haim Shmilovich and Arie Roth FUNGAL AND PARASITIC DISEASES 126 Marcia Ramos-e-Silva, Carlos Gustavo Costanza, Chap. 6. ACUTE SKIN FAILURE: CONCEPT, and Sueli Coelho Carneiro CAUSES, CONSEQUENCES, AND CARE 62 Robert A. Norman and Gwynn Coatney Chap. 14. LIFE-THREATENING STINGS, BITES, Chap. 7. CUTANEOUS SYMPTOMS AND AND MARINE ENVENOMATIONS 146 NEONATAL EMERGENCIES 66 Dirk M. Elston Daniel Wallach and Pierre-Henri Jarreau Chap. 15. SEVERE, ACUTE ADVERSE Chap. 8. NECROTIZING SOFT-TISSUE CUTANEOUS DRUG REACTIONS I: INFECTIONS, INCLUDING NECROTIZING STEVENS–JOHNSON SYNDROME AND TOXIC FASCIITIS 75 EPIDERMAL NECROLYSIS 154 Ronni Wolf, Yalc¸in Tuz¨ un,¨ and Batya B. Davidovici Ronni Wolf and Batya B. Davidovici v vi CONTENTS Chap. 16. SEVERE, ACUTE ADVERSE CUTANEOUS Chap. 26. SKIN SIGNS OF SYSTEMIC NEOPLASTIC DRUG REACTIONS II: DRESS SYNDROME AND DISEASES AND PARANEOPLASTIC CUTANEOUS SERUM SICKNESS-LIKE REACTION 162 SYNDROMES 265 Ronni Wolf and Batya B. Davidovici Kyrill Pramatarov Chap. 17. SEVERE, ACUTE COMPLICATIONS OF Chap. 27. BURN INJURY 271 DERMATOLOGIC THERAPIES 168 Samuel H. Allen Ronni Wolf, Jasna Lipozenciˇ c,´ and Batya B. Davidovici Chap. 28. EMERGENCY DERMATOSES OF THE ANORECTAL REGIONS 278 Chap. 18. SEVERE, ACUTE ALLERGIC AND Yalc¸in Tuz¨ un¨ and Sadiye Keskin IMMUNOLOGICAL REACTIONS I: URTICARIA, ANGIOEDEMA, MASTOCYTOSIS, AND Chap. 29. EMERGENCY MANAGEMENT OF ANAPHYLAXIS 178 SEXUALLY TRANSMITTED DISEASES AND Samuel H. Allen OTHER GENITOURETHRAL DISORDERS 282 Michael Waugh Chap. 19. SEVERE, ACUTE ALLERGIC AND IMMUNOLOGICAL REACTIONS II: OTHER Chap. 30. EMERGENCY MANAGEMENT OF HYPERSENSITIVITIES AND IMMUNE DEFECTS, ENVIRONMENTAL SKIN DISORDERS: HEAT, INCLUDING HIV 184 COLD, ULTRAVIOLET LIGHT INJURIES 293 Samuel H. Allen Larry E. Millikan Chap. 20. GRAFT VERSUS HOST DISEASE 194 Chap. 31. ENDOCRINOLOGIC EMERGENCIES Jasna Lipozenciˇ c´ and Ronni Wolf IN DERMATOLOGY 298 Margaret T. Ryan, Vincent Savarese, and Chap. 21. ERYTHRODERMA/EXFOLIATIVE Serge A. Jabbour DERMATITIS 202 Virendra N. Sehgal and Govind Srivastava Chap. 32. EMERGENCY MANAGEMENT OF SKIN TORTURE AND SELF-INFLICTED Chap. 22. ACUTE, SEVERE BULLOUS DERMATOSES 313 DERMATOSES 215 Daniel H. Parish, Hirak B. Routh, Snejina Vassileva Kazal R. Bhowmik, and Kishore Kumar Chap. 23. EMERGENCY MANAGEMENT OF Chap. 33. SKIN SIGNS OF POISONING 318 PURPURA AND VASCULITIS, INCLUDING Batya B. Davidovici and Ronni Wolf PURPURA FULMINANS 233 Lucio Andreassi and Roberta Bilenchi Chap. 34. DISASTER PLANNING: MASS CASUALTY MANAGEMENT 327 Chap. 24. EMERGENCY MANAGEMENT OF Lion Poles CONNECTIVE TISSUE DISORDERS AND THEIR COMPLICATIONS 245 Chap. 35. CATASTROPHES IN COSMETIC Kristen Biggers and Noah Scheinfeld PROCEDURES 331 Marina Landau and Ronni Wolf Chap. 25. SKIN SIGNS OF SYSTEMIC INFECTIONS 256 Chap. 36. LIFE-THREATENING DERMATOSES Jana Kazandjieva, Georgeta Bocheva, and IN TRAVELERS 340 Nikolai Tsankov Larry E. Millikan INDEX 345 Contributors Samuel H. Allen, FRCP Elisabetta Buommino, PhD Department of Infectious Diseases Department of Experimental Medicine Ayrshire & Arran Microbiology and Clinical Microbiology Scotland, United Kingdom Section Second University of Naples Sapna Amin, MD Naples, Italy Department of Dermatology Baylor College of Medicine Sueli Coelho Carneiro, MD, PhD Houston, Texas Sector of Dermatology Federal University of Rio de Janeiro Lucio Andreassi, MD Hospital Universitario Clementino Fraga Filho Department of Dermatology School of Medicine University of Siena Rio de Janeiro State University Siena, Italy Rio de Janeiro, Brazil Adone Baroni, MD, PhD Brandon Christianson, MD Department of Dermatology Department of Otolaryngology/Head and Neck Surgery Second University of Naples University of Texas Southwestern Medical Center Naples, Italy Dallas, Texas Kazal R. Bhowmik, MBBS Richard B.
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