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Life-Threatening Skin Rashes (cont.)

Life-Threatening Skin Rashes Causes

Patient Comments

Serious rashes are usually caused by allergic reactions, disorders of the immune system, or by poisonous byproducts of an infection. Blisters in these disorders are usually caused when the proteins that connect layers of skin are attacked. Because the proteins holding them together aren't working, the layers of skin come apart, and fluid fills the space between them, thus forming the blister.

  • Pemphigus vulgaris
    • PV is a disorder of the immune system (an autoimmune disorder). As in all autoimmune disorders, the body's natural immune system mistakenly identifies proteins within the body as foreign and begins the natural response to get rid of these foreign proteins producing antibodies to attack the foreign intruder.
    • In PV, the targets of these antibodies are anchoring proteins within the skin.
    • Certain medications have been linked with the development of PV, including D-penicillamine (Cuprimine, Depen), captopril (Capoten), enalapril (Vasotec), penicillin, interleukin 2, nifedipine (Adalat CC, Procardia, Procardia XL), and rifampicin (Rifadin).
  • Stevens-Johnson syndrome (SJS)
  • Toxic epidermal necrolysis (TEN)
    • TEN is thought to be a severe form of SJS.
    • Causes are similar but include penicillin-type antibiotics, radiation therapy, collagen vascular disease, and recent bone marrow transplantation or blood transfusions.
    • HIV-infected individuals are at higher risk for the development of both SJS and TEN, with a combined incidence of 1/1000 person-years.
  • Toxic shock syndrome (TSS)
    • TSS is caused by an underlying infection with specific Staphylococcus bacteria.
    • Certain strains of bacteria produce poisons that are released into the bloodstream and cause disease throughout the body.
    • TSS became a public health issue in the 1970s with the introduction of super-absorbent tampons. These tampons caused menstruating women to be more easily infected with the staphylococcal infections that led to TSS.
    • Other infections that may lead to TSS include superficial skin infections, surgical wound infections, infections after delivering a baby, or infected nasal packings after nasal surgery or nosebleeds.
  • Staphylococcal scalded skin syndrome (SSSS)
    • A disease of children, SSSS is similar to TSS.
    • It is caused by infection with a different type of Staphylococcus bacteria (often referred to as "staph" infections) than TSS.
    • These bacteria also produce a poison that is released into the bloodstream and causes the typical rash seen in SSSS.
    • The underlying infection in children is a minor skin infection that often goes unnoticed.
Medically Reviewed by a Doctor on 11/4/2014
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Read What Your Physician is Reading on Medscape

Toxic Epidermal Necrolysis »

Described in 1956 by Alan Lyell, toxic epidermal necrolysis (TEN) is a life-threatening skin disorder that is commonly drug-induced.

Read More on Medscape Reference »

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