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Spot Diagnosis

Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Jan 2, 2013.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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  2. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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    Erythema multiforme. Its Stevens Johnson syndrome.
     

  3. dupuytren

    dupuytren Bronze Member

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    Stevens Johnson Syndrome
     

  4. neo_star

    neo_star Moderator

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    Yes, I agree with both the docs above - this is most likely to be - Steven Johnson's syndrome ( although the classical 'bulls-eye' lesion is not seen - but that is usually seen in the earlier phase and once you have a full-fledged severe case, adjoining lesions merge into one another and the rash looks more morbilliform, like in this case. )

    The most likely etiology is drugs, with the sulfonamides being particularly notorious.


    If the rash involves more than 30% body surface area, then I will call it 'toxic epidermal necrolysis'.

    Since the rash is morbilliform, I would like to keep - Measles as my second differential
    ( always imp. to keep this in mind as the patient population falling prey to measles is gradually shifting to higher age groups and there may be a need to consider re-vaccination of adults in the future ).

    Third differential would be the viral hemorrhagic fevers.
     

  5. dr.angela

    dr.angela Bronze Member

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    Syndrome de Steven Johnson
     

  6. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Answer ; Stevens Johnson Syndrome

     

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