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Review
. 2020 Sep 26:2020:9729814.
doi: 10.1155/2020/9729814. eCollection 2020.

Dermatological Manifestations in the Intensive Care Unit: A Practical Approach

Mariona Badia  1 , José Manuel Casanova  2 , Lluís Serviá  1 , Neus Montserrat  1 , Jordi Codina  1 , Javier Trujillano  1
Affiliations
Review

Dermatological Manifestations in the Intensive Care Unit: A Practical Approach

Mariona Badia et al. Crit Care Res Pract. .

Abstract

Dermatological problems are not usually related to intensive medicine because they are considered to have a low impact on the evolution of critical patients. Despite this, dermatological manifestations (DMs) are relatively frequent in critically ill patients. In rare cases, DMs will be the main diagnosis and will require intensive treatment due to acute skin failure. In contrast, DMs can be a reflection of underlying systemic diseases, and their identification may be key to their diagnosis. On other occasions, DMs are lesions that appear in the evolution of critical patients and are due to factors derived from the stay or intensive treatment. Lastly, DMs can accompany patients and must be taken into account in the comprehensive pathology management. Several factors must be considered when addressing DMs: on the one hand, the moment of appearance, morphology, location, and associated treatment and, on the other hand, aetiopathogenesis and classification of the cutaneous lesion. DMs can be classified into 4 groups: life-threatening DMs (uncommon but compromise the patient's life); DMs associated with systemic diseases where skin lesions accompany the pathology that requires admission to the intensive care unit (ICU); DMs secondary to the management of the critical patient that considers the cutaneous manifestations that appear in the evolution mainly of infectious or allergic origin; and DMs previously present in the patient and unrelated to the critical process. This review provides a characterization of DMs in ICU patients to establish a better identification and classification and to understand their interrelation with critical illnesses.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Toxic epidermal necrolysis (TEN): detachment of the top layer of skin of the upper extremity.
Figure 2
Figure 2
Purpura fulminans: haemorrhagic necrosis of the skin in the patient's foot.
Figure 3
Figure 3
Janeway lesions: erythematous macular painless rashes distributed along the tips of the fingers.
Figure 4
Figure 4
Morbilliform rash: maculopapular exanthem on the trunk.
Figure 5
Figure 5
Candida intertrigo: genitocrural intertrigo in the inframammary fold infected by Candida albicans. Note. Satellite lesions.
Figure 6
Figure 6
Secondary syphilis: maculopapular lesions on bottom of the foot.
See this image and copyright information in PMC

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