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Life-Threatening Skin Rashes (cont.)

What Are Causes of Life-Threatening Skin Rashes?

Patient Comments

Pemphigus vulgaris is an autoimmune skin disease that occurs when the body's immune system is misdirected and produces antibodies directed at a protein vital to the connection of epidermal cells. Toxic epidermal necrolysis and DRESS syndrome are hypersensitivity reactions, most often to drugs. Meningococcemia, Rocky Mountain spotted fever, and necrotizing fasciitis are due to an infection.

  • Pemphigus vulgaris (PV)
    • 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 skin as foreign by producing antibodies to attack the foreign intruder.
    • In PV, the target of these antibodies is a protein named desmoglein 3, which is part of a structure called a desmosome. Desmosomes are responsible for holding epidermal cells together.
    • 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).
  • Toxic epidermal necrolysis (TEN)
  • DRESS syndrome is an acronym for drug rash with eosinophilia and systemic symptoms.
    • This is a severe form of drug eruption that can begin two to six weeks after starting to take the offending drug. Frequent causes are anticonvulsants, namely phenytoin, phenobarbitone, carbamazepine, and lamotrigine. Other drugs incriminated include dapsone, sulphonamides, allopurinol, minocycline, terbina?ne, azathioprine, captopril, nevirapine, abacavir, and sulfasalazine.
  • Toxic shock syndrome (TSS)
    • TSS is caused by an underlying infection with certain strains of Staphylococcus bacteria.
    • Bacterial toxins are released into the bloodstream, producing diffuse organ damage.
    • TSS became a public-health issue in the 1970s with the introduction of super-absorbent tampons. These tampons acted as a foreign body to support bacterial growth of the Staphylococcus bacteria.
    • 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.
  • Meningococcemia is a blood infection (septicemia) caused by Neisseria meningitis. This infection is most common in young adults and may also affect the membrane surrounding the brain and spinal cord. It is acquired through coughing, sneezing, or contaminated surfaces. Vaccination can prevent meningococcemia.
  • Rocky Mountain spotted fever is an infection caused by a small microorganism called a Rickettsia and is transmitted to humans through the bite of a hard shell tick.
  • Necrotizing fasciitis is a bacterial infection most often localized to an extremity and is due to the extremely rapid penetration of the infection into the deeper tissues and the bloodstream.
Medically Reviewed by a Doctor on 5/20/2016

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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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