Emergencies in dermatology are uncommon but can cause significant long-term morbidity or even be life-threatening. Three patients illustrate the need for early recognition and urgent referral for treatment of staphylococcal scalded skin syndrome, toxic epidermal necrolysis and pyoderma gangrenosum.
- Dermatological emergencies are uncommon but can cause devastating complications if not recognised and treated early.
- Many patients require early referral to a tertiary hospital with a dermatology department.
- Staphylococcal scalded skin syndrome is a spot diagnosis in children aged under 5 years and responds well to flucloxacillin.
- In toxic epidermal necrolysis, identification and cessation of the causative drug is key, which requires a careful history of any prescribed and over-the-counter medications the patient is taking.
- In pyoderma gangrenosum, clues to the diagnosis include pain disproportionate to lesion morphology and rapid progression; however, pyoderma gangrenosum is a diagnosis of exclusion and infective causes must be ruled out.
Picture credits (top to bottom): Toxic epidermal necrolysis © Phototake RM/Dennis Kunkel Microscopy, Inc; Pyoderma © Science Source/Biophoto Associates; Staphylococcus aureus © Science Photo Library RM/Steve Gschmeissner (all from Diomedia.com).