Lecture 14 Part 2
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Questions and Answers

What is a common presentation of small and medium vessel vasculitis?

  • Severe abdominal pain (correct)
  • Skin rashes on the trunk
  • Excessive hair growth
  • Persistently high blood pressure

    • What is the most common treatment approach for idiopathic cases of cutaneous vasculitis?

  • Surgical intervention
  • Anti-inflammatory and immunosuppressive medications (correct)
  • Antibiotic treatment
  • Radiation therapy

    • What is the primary reason for the development of miliaria rubra in patients?

  • Excessive sweating during physical activity
  • Inadequate hydration levels
  • Increased body temperature due to infection
  • Blocked eccrine ducts due to chronic pressure (correct)

    • In which condition does calciphylaxis primarily occur?

    <p>Chronic renal failure</p> Signup and view all the answers

    Which of the following treatments is most effective for miliaria rubra?

    <p>Increased skin ventilation</p> Signup and view all the answers

    What will more aggressive immunosuppression in vasculitis depend on?

    <p>The severity of the disease</p> Signup and view all the answers

    What is the main complication faced by patients suffering from calciphylaxis?

    <p>Difficult-to-treat infections</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with calciphylaxis?

    <p>Persistent cough</p> Signup and view all the answers

    What leads to the ischemia in calciphylaxis?

    <p>Calcification and thrombosis of small arteries</p> Signup and view all the answers

    Why is effective pain control significant in patients with calciphylaxis?

    <p>To manage severe pain from tissue ischemia</p> Signup and view all the answers

    How do calcium and phosphorus levels typically present in patients hospitalized with calciphylaxis?

    <p>Normal calcium and phosphorus levels</p> Signup and view all the answers

    What is a potential surgical option for patients with secondary hyperparathyroidism in calciphylaxis?

    <p>Parathyroidectomy</p> Signup and view all the answers

    What is the typical progression of skin lesions in calciphylaxis?

    <p>From necrotic patches to ulceration</p> Signup and view all the answers

    What does the presence of miliaria rubra indicate in a patient?

    <p>High risk for developing decubitus ulcers</p> Signup and view all the answers

    How long can it take for miliaria rubra to resolve once appropriate skin ventilation is achieved?

    <p>Several weeks</p> Signup and view all the answers

    What is the primary cause of Staph Scalded Skin Syndrome (SSSS)?

    <p>An exfoliative toxin from Staphylococcus aureus</p> Signup and view all the answers

    Which factor can complicate wound healing in patients with calciphylaxis?

    <p>Severe tissue perfusion insufficiency</p> Signup and view all the answers

    What are the primary demographics affected by SSSS?

    <p>Children under age 5 and adults with renal failure or immunosuppression</p> Signup and view all the answers

    What is the typical outcome for children with SSSS?

    <p>They tend to heal quickly without complications</p> Signup and view all the answers

    What mechanisms protect adults from developing SSSS?

    <p>Kidneys filtering toxins and presence of neutralizing antibodies</p> Signup and view all the answers

    Which symptom is commonly associated with the initial stage of SSSS?

    <p>Widespread erythema and flu-like symptoms</p> Signup and view all the answers

    What treatment is primarily administered to patients with SSSS?

    <p>Antibiotics to kill bacteria and prevent toxin production</p> Signup and view all the answers

    What factor contributes to the higher risk of SSSS in young children?

    <p>Less effective immune responses and decreased renal function</p> Signup and view all the answers

    Which complication can arise from SSSS in adults?

    <p>Altered skin barrier function and impaired fluid regulation</p> Signup and view all the answers

    Which type of vasculitis is characterized by a combination of asthma, eosinophilia, and vasculitis?

    <p>Churg-Strauss Syndrome</p> Signup and view all the answers

    What serologic marker is most commonly associated with Wegener’s Granulomatosis?

    <p>c-ANCA</p> Signup and view all the answers

    Which type of vasculitis does not typically present with specific cutaneous manifestations?

    <p>Large Vessel Vasculitis</p> Signup and view all the answers

    Which condition is most associated with significant systemic vasculitis affecting multiple organs?

    <p>Polyarteritis Nodosa</p> Signup and view all the answers

    What is the classic characteristic of Large Vessel Vasculitis when cutaneous symptoms do occur?

    <p>Gangrene</p> Signup and view all the answers

    Which of the following is true regarding the diagnosis of vasculitis?

    <p>Pathologic confirmation of vascular inflammation is essential.</p> Signup and view all the answers

    What is one of the classic types of Medium Vessel Vasculitis?

    <p>Kawasaki’s Disease</p> Signup and view all the answers

    In terms of cutaneous involvement, which form of vasculitis may be relatively simple to diagnose?

    <p>Leukocytoclastic Vasculitis</p> Signup and view all the answers

    What characterizes the primary cutaneous manifestation of leukocytoclastic vasculitis (LCV)?

    <p>Palpable purpura that does not fade with pressure</p> Signup and view all the answers

    In the context of small vessel vasculitis (SVV), what is a common diagnostic challenge?

    <p>Finding a causative antigen in 50% of cases</p> Signup and view all the answers

    Which of the following is NOT a goal after confirming small vessel vasculitis by biopsy?

    <p>To determine the efficacy of antibiotics</p> Signup and view all the answers

    What is a characteristic of microscopic polyarteritis (MPA)?

    <p>Significant systemic symptoms such as fever and malaise</p> Signup and view all the answers

    Which of the following best describes the term 'idiopathic LCV'?

    <p>LCV without a discoverable causative antigen</p> Signup and view all the answers

    Which of the following conditions is used to evaluate potential underlying causes of leukocytoclastic vasculitis?

    <p>Chronic endocarditis</p> Signup and view all the answers

    What is the significance of the review of systems in vasculitis evaluation?

    <p>It can reveal symptoms related to vasculitis in other organs.</p> Signup and view all the answers

    What type of vasculitis primarily affects capillaries, arterioles, and venules?

    <p>Small vessel vasculitides</p> Signup and view all the answers

    Study Notes

    Staph Scalded Skin Syndrome (SSSS)

    • Primarily affects children under 5, but can occur in adults with renal failure or immunosuppression.
    • Characterised by fever, malaise, and widespread erythema (skin redness) followed by flaccid blisters that rupture.
    • Skin that doesn't blister sloughs off.
    • Healing is typically quick, without scarring, in children.
    • Adults have a higher risk of complications due to underlying medical conditions.
    • Caused by exfoliative toxin produced by Staphylococcus aureus.
    • This toxin cleaves desmoglein 1, causing detachment of superficial epidermis (stratum corneum).
    • Adults are generally protected due to renal filtration of the toxin and presence of neutralizing antibodies.

    Treatment and Prognosis

    • Treatment focuses on antibiotic therapy to stop toxin production.
    • Moist dressings and emollients to aid healing.
    • Good hygiene is crucial to prevent infection.
    • Adults with SSSS have a poor prognosis often due to underlying health conditions, fluid imbalances, and increased infection risk.

    Vasculitis

    • A broad term referring to inflammation of blood vessels.
    • Classification is based on the size of the blood vessels affected (small, medium, or large).
    • Diagnosis can be challenging due to its diverse presentation and potential involvement of multiple organ systems.
    • Small vessel vasculitis (SVV) can present with palpable purpura (small, purplish skin lesions).
    • Other types of SVV include microscopic polyangiitis, Wegener's granulomatosis, and Churg-Strauss syndrome.

    Calciphylaxis

    • An uncommon but serious complication, primarily in chronic renal failure patients.
    • Characterized by painful, violaceous patches, necorisis, and the development of eschars.
    • Usually occurs on the legs, but can also involve the trunk and proximal extremities.
    • A worse prognosis is associated with involvement of the trunk or proximal extremities.

    Miliaria Rubra

    • A common condition caused by trapped sweat in eccrine ducts, often due to prolonged bed rest or immobility.
    • Presents as slightly itchy papules on skin.
    • No treatment is typically needed, but improved mobility and skin ventilation allows for resolution.

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    Description

    This quiz covers the essential aspects of Staph Scalded Skin Syndrome (SSSS), focusing on causes, symptoms, and treatment. It highlights the differences in presentation between children and adults, as well as the importance of hygiene and timely antibiotic therapy. Test your knowledge on this critical skin condition and its impact.

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