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Erythematous Rashes - THE ALGORITHMIC APPROACH

Characterized by diffuse redness of the skin due to
capillary congestion, erythematous
the Nikolsky sign ... the Nikolsky sign ... , the differential ... or Nikolsky sign ... #Differential
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Systemic Lupus Erythematosus ... Malar rash 40% - Fever ... (aPL) 30-45% Differential ... autoantibodies #signs ... #rheumatology
Systemic Lupus Erythematosus (SLE) - Typical Signs/Symptoms
Alopecia, Fever, Malar rash, Photosensitivity, Adenopathies, Lupus pneumonia, Pleurisy, Pancreatitis,
Systemic Lupus Erythematosus ... SLE) - Typical Signs ... Symptoms Alopecia, Fever ... #SLE #Signs #Symptoms ... #diagnosis #rheumatology
Combination of Skin Findings and Arthritis in Pediatrics Patient - Differential Diagnosis
Malar rash: 
 • A
Pediatrics Patient - Differential ... butterfly-like erythematous ... Suggestive of: Rheum Fever ... migrans: • Target sign ... arthritis #skin #differential
STEMI Equivalents on ECG
 • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
J point • De Winter ... symmetrical T-waves ... V2 • Wellens sign ... pain • Wellens sign ... EKG #diagnosis #differential
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
(SLE) General: Fever ... SLE #systemic #erythematosus ... #signs #symptoms ... #diagnosis #rheumatology
Approach to ECGs - Ischemia
MI = Biomarkers + ECG or echo/angiogram findings
Pathologic Q - 1/3 height
Equivalents / Don't Miss Signs ... - hyperacute T waves ... bigger than QRS - deWinter ... T waves - starts ... Interpretation #differential
Fever Patterns - Differential Diagnosis Framework

Continuous Fever:
Temp > 38°C with only 1 degree fluctuation in 24
Fever Patterns - ... Differential Diagnosis ... falls (like a wave ... Brucellosis Faget's Sign ... #Patterns #Differential
Fever in Returning Travelers from Tropical Regions - Frequent Differential Diagnoses
Medical History:
 • Skin exposure to
Fever in Returning ... Regions - Frequent Differential ... without localizing signs ... Returning #Traveler #differential ... diagnosis #tropical #travel
ANTI-MDA5 DERMATOMYOSITIS

Cutaneous manifestations:
• Periorbital heliotrope (blue-purple) rash with edema
• Erythematous rash on the face, or the
chest (in a V-sign ... shoulders (in a shawl sign ... Inverse Gottron’s sign ... Dermatomyositis • Fever ... Dermatomyositis #rheumatology