Dermatologic Emergencies

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4. Toxic Epidermal Necrolysis
Generally considered to be a reaction to drugs. A combination of several factors such as genetic background, infection altered CMI (Cell Mediated Immunity) and drugs may lead to epidermal separation in sheets. Nikolsky’s sign is positive.

TEN is associated with constitutional symptoms. Patient has to be managed in intensive care unit with good nursing support.

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Exfoliative dermatitis includes also Seborrhea for which a steroid i.e. Betamethasone Valerate 0.2% is prescribed. However a good scrubbing with bath salts, like skin-friendly Epsom Salt (Magnesium Sulphate) after a shower, will have the same temporary effect, without the nasty side-effects of Steroids. On the scalp Alcohol will prevent excessive dandruff for a day or so.


Why this difference between type 1 and type 2 reactions and why there is difference even in treatment also .

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