Abstract
A 5-year-old treated with sulfamethoxazole/trimethoprim for uroprophylaxis is in the ICU and is scheduled for a central line; he has extensive erosive bullae over most of his body, in particular on the face and mucosal areas. Specific concerns about perioperative care and the anesthetic plan are discussed. Additional questions review skin physiology as it pertains to anesthesia, considerations for epidermolysis bullosa, and finally, a patient with Ehler’s-Danlos syndrome scheduled for spinal fusion.
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Natacha Levi N, Bastuji-Garin S, Mockenhaupt M, Roujeau J, Flahault A, Kelly J, et al. Medications as risk factors of Stevens-Johnson syndrome and toxic epidermal necrolysis in children: a pooled analysis. Pediatrics. 2009;123:e297–304.
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Annotated
Zieg J. Integumentary system. In: Holzman R, Mancuso T, Polaner D, editors. A practical approach to pediatric anesthesia. 2nd ed. Philadelphia: Wolters Kluwer; 2015. p. 614–28.
Broad review of specific anesthesia considerations in a variety of skin disorders.
Further Reading
Mockenhaupt M. The current understanding of Stevens–Johnson syndrome and toxic epidermal necrolysis. Expert Rev Clin Immunol. 2011;7(6):803–15. https://doi.org/10.1586/eci.11.66.
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Holzman, R.S. (2021). Skin Disorders. In: Pediatric Anesthesiology Review. Springer, Cham. https://doi.org/10.1007/978-3-030-60656-5_41
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DOI: https://doi.org/10.1007/978-3-030-60656-5_41
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