Hăisan Anca MD
University of Medicine and Pharmacy “Grigore T. Popa” Iasi
High Risk Dermatological Emergencies
Authors: Diana Carmen Cimpoeşu, Anca Hăisan
The immune system is constantly bombarded with potentially allergic agents in the context of the ongoing evolution of the food, chemical and pharmaceutical industries, but also due to naturally occurring agents. The consequences of these exposures have a variable clinical response, starting from the isolated topical reaction all the way to anaphylactic shock. The evolution and complexity of the clinical symptoms make the difference between an allergic reaction and anaphylaxis, the latter being the emergency situation. Early identification of patients that develop systemic allergic response followed by proper management of the airways and concomitant distributive shock are key aspects to their survival.
Although less frequent in incidence, Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis, both similar pathologies affecting the skin and the mucosa, appear secondary to the administration of different types of drugs in the context of predisposing genetic risk factors and multiple simultaneous pathologies – these represent medical emergencies that can make the diagnosis and treatment more difficult. The fast and complex approach of these patients, treating them as major burns victims, reduces the risk of systemic complications like sepsis, acute renal failure, and multiple organ failure.
Taking into account these pathologies, the Dermatology Specialists have the responsibility of recognizing the severity of the signs and symptoms presented to them in a skin condition and the need to promptly start accurate treatment, thus avoiding the avalanche of clinical manifestations that can culminate in the patients’ demise.