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  1. Dermatologic diagnoses are associated with longer ICU stays compared to patients with normal skin.

  2. Any systemic infection can have cutaneous manifestations that are often nonspecific.

  3. There are no mucosal lesions with Staphylococcal scalded skin syndrome distinguishing it from Stevens–Johnson syndrome/toxic epidermal necrolysis.

  4. Necrotizing fasciitis is often mistaken for cellulitis. A key feature of necrotizing fasciitis is pain out of proportion to the clinical exam on initial presentation.

  5. Meningococcemia should be considered in any patient with fever and petechial rash.

  6. When suspecting a drug eruption a drug chart with medications and time courses is extremely helpful in identifying the causative medication.


About 10% of ICU patients have a dermatologic diagnosis, which are associated with longer ICU stays compared to patients with normal skin.1 This chapter will focus on skin disorders seen in the ICU setting ranging from common relatively benign disorders to life-threatening diseases. One should not hesitate to consult a hospital dermatologist to assist in the diagnosis, workup, and management of these patients.


Table 47–1Common dermatoses in the ICU setting.
Figure 47–1

Contact dermatitis. Typical geometric shape due to adhesive tape.

Figure 47–2

Miliara crystillina. Clear vesicles on the back.

Skin Infections

Any systemic infection can have ...

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