Dermatologic emergencies. When early recognition can be lifesaving.

Early recognition and treatment of life-threatening dermatoses can reduce morbidity and mortality. Pemphigus vulgaris can usually be brought under control with high doses of corticosteroids. In cases of necrotizing fasciitis, early, extensive debridement of involved tissue is essential, since antibiotic therapy alone has little effect. Patients with toxic epidermal necrolysis and occasionally those with Stevens-Johnson syndrome may need care similar to that required for a major burn. Therapy for toxic shock syndrome includes aggressive fluid replacement and beta lactamase-resistant antistaphylococcal antibiotics. Treatment of urticaria and acquired angioedema includes histamine receptor blockers, prednisone (for intractable cases), and epinephrine (for respiratory compromise); danazol (Danocrine) or stanozolol (Winstrol) may be useful for prophylaxis of hereditary angioedema.