32. Generalized bullous & maculopapular lesions occur with affection of oral mm in all cases in the form of extensive bullae formation followed by erosions.
33. New crops of lesions develop over a period of 3-4 wks.
34. Many organs may be affected: severe catarrhal or purulent conjunctivitis, genital mucosa, pneumonitis & renal affection.
43. Major cases may require systemic steroids: 30-60 mg prednisone daily.
44. Acyclovir may be used as a prophylactic measure to prevent recurrence after herpes simplex.
45.
46. It has been called Lyell’s syndrome which includes also cases of SSS syndrome.
47.
48. Erythema, which may be morbilliform or diffuse, occurs with +veNikolsky sign followed by large flaccid bullae & detachment of large areas of necrotic epidermis leaving large, raw, painful areas.
49. Mucous membranes may be extensively involved. Ocular conjunctiva is involved in 85% of pts.
93. Urticarias Potential Provoking Factors (Cont.) 3. Inhalants: e.g. pollen grains, house dust, feathers. 4. Infections e.g. focal sepsis in tonsils, teeth or sinuses, or urinary tract infections. Recently, Helicobacter pylori has been suggested.
140. Oral challenge may reveal food additives as a cause of chronic urticaria.
141.
142.
143.
144.
145.
146. Management of chronic ordinary urticaria Pharmacological therapy SECOND LINE Special indications Corticosteroids (for severe ordinary or delayed pressure urticaria) Short term use only Epinephrine (severe throat angioedema or anaphylaxis only) Others (as determined by history & investigations)
147. Management of chronic ordinary urticaria Pharmacological therapy THIRD LINE Specialist use only Immunotherapy (severe refractory autoimmune urticaria only)