ABSTRACT
In the emergency department, intensive care unit, and primary care setting, dermatologic conditions rank as one of the most common disease presentations. It is often a challenge for physicians to differentiate routine skin ailments from more serious, life-threatening conditions that require immediate intervention. This chapter highlights some dermatologic emergencies that plague physicians daily and initially may present with cutaneous manifestations. Septic shock and toxic shock syndrome (TSS) are potentially fatal medical emergencies that manifest with dermatologic signs, making a good understanding of dermatology a crucial step in rapid and early diagnosis of these two emergencies. As part of a clinical continuum, the terms bacteremia, sepsis, and septic shock have for many years been confused due to the inaccurate usage of terminology associated with such infections. In 1991, the American College of Chest Physicians and the Society of Critical Care Medicine convened a Consensus Conference to standardize terminology and provide a framework for physicians to accurately identify the body’s systemic response to infection. These quantiable denitions work on a clinical continuum established by clinical and laboratory ndings. Attempts to improve the accuracy of these 1992 guidelines have met with mixed success. In selected conditions (e.g., pneumonia) other prognostic tools such as the CURB651 have outperformed these guidelines. Modied systemic inammatory response syndrome (SIRS) criteria outperform the original criteria in the perioperative period, presumably due to the inuence of inammatory processes in obscuring an infectious process.2 Nevertheless, we will continue to use these over 20-year-old criteria as our guideline for dening disease states for this chapter (Table 10.1).
