Pediatric emergency medicine trisk 1801 1801

CHAPTER 88 ■ DERMATOLOGIC URGENCIES
AND EMERGENCIES
ALISA McQUEEN, PETER A. LIO

GOALS OF EMERGENCY CARE
The goals in treating dermatologic conditions are to recognize signs of systemic
illness and complications such as secondary infection.
KEY POINTS
The ability to describe a rash precisely and accurately will dramatically
improve the likelihood of a correct diagnosis.
Key features of the history include duration of the rash (acute or
chronic), initial distribution, extent of spread (generalized or localized),
ill contacts (including sexual partners), and any associated systemic
symptoms, including fever.
Key features of the physical examination include a careful systematic
inspection of all mucocutaneous surfaces, with special attention paid to
involvement of the oropharynx, palms and soles, extensor or flexor
surfaces, scalp, and trunk.
RELATED CHAPTERS
Medical, Surgical, and Trauma Emergencies
Infectious Disease Emergencies: Chapter 94
Rheumatologic Emergencies: Chapter 101
Rashes and skin lesions are common presenting complaints. An accurate
diagnosis depends on a systematic approach that requires assessing the skin
carefully and knowing dermatologic terminology, morphology, and differential
diagnoses. Although not always diagnostic, morphology and distribution of
cutaneous lesions are important parts of categorizing and making a differential
diagnosis, and at the very least can help exclude worrisome conditions when
applied correctly. Terminology is an important part of this process. Descriptors
can be divided into primary and secondary. Primary descriptors include macules