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This chapter describes selected serious generalized skin disorders in adults and discusses their dermatologic diagnosis and treatment. Covered are erythema multiforme, toxic epidermal necrolysis, exfoliative erythroderma, the toxic infectious erythemas, disseminated viral infections, Rocky Mountain spotted fever, disseminated gonococcal infection, purpura fulminans, and pemphigus vulgaris. Staphylococcal scalded skin syndrome and meningococcemia are discussed in the pediatric section, in Chapter 142, “Rashes in Infants and Children.” Disseminated viral infections are discussed in Chapter 154, “Serious Viral Infections” and in Chapter 142.

The disorders erythema multiforme, toxic epidermal necrolysis, exfoliative erythroderma, staphylococcal and streptococcal toxic shock syndrome, and staphylococcal scalded skin syndrome share some features in common. Table 249-1 can help to differentiate these disorders. Management is summarized in Table 249-2.

TABLE 249-1Comparison of Inflammatory and Infectious Generalized Skin Disorders
TABLE 249-2Management of Serious Generalized Skin Disorders

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