diaper dermatitis
tx: fungal, then barrier
what 3 pathologies can cause this?
BLT
Birth Control, Lupus, Tuberculosis
contact dermatitis
DxL: atopic dermatitis
Tx: emollient
AT RISK FOR: MRSA and Eczema Herpeticum
Eczema Herpeticum
Eczema Herpeticum
Seborrheic Dermatitis
CHICKEN VS EGG
(FUNGUS VS INFLAMMATION)
Cradle Cap
Seborrheic Dermatitis in peds
(lightly shampoo and clean w/ toothbrush)
Dyshidrotic Eczema
streoid cream
Venous Stasis Dermatitis
Dx: Bilateral, afebrile, varicosities, erythmatic
Tx: unna boot, elevation, mild steroid
DO NOT GIVE ABX
DO NOT CONFUSE WITH CELLULITIS
lichen planus
Polygona, pruritic, papule, purple
STEROIDS
HAS WICKAMS STRIAE AND KOEBNER PHENOM
Koebner Phenomenon in Lichen Planus
wickams striae in Lichen Planus
DOES NOT EXIST IN LICHENOID DRUG REACTION
Lichen Simplex Chronicus
SCRATCH ITCH CYCLE
induced by stress/emotions
SOAK IN WATER, SEAL IN WITH STEROIDS
Nummular Dermatitis
Trunk and Lower Extremities
Tx: Steroid, and emollient after bathing
DD: Tinea
Nummular Dermatitis
No Image, derm manifestation from gluten sensetivity
Dermatitis Herpetiformis
GI LYMPHOMA
plaque psoriasis
most common, joint locations
MED INDUCED? Lithium/BBlockers
MANY TREATMENTS, TOPICAL and SYSTEMIC STEROIDS
Guttate Psoriasis
FROM STRESS OR
PRIOR INFECTIONS LIKE STREP
Inverse Psoriasis
Not extensor surfaces, no scales
armpit/groin (Intertringous Areas)
Nail Psoriasis
Pitting and oil drop sign
(with psoriasis, lichen planus is in the differential, but there is no nail pitting in lichen planus)
Tx: Physical Maneuvers (whatever that means)
Erythema Multiform Minor
Usually involves the palms, arms, legs, appendages
DD: Herpetic Flair and Mycoplasma
Any with any palm lesions…include Syphillis in DD
Tx: Self limiting
Erythema Multiform Minor
still DD for: mycoplasma and Herpes
Erythema Multiform Major
(major is drug reaction related)
3 Categories:
1) Steven Jonson (SJS)
2) Toxic Epidermal Necrosis (TEN)
3) Combo SJS/TEN
Steven Johnson Syndrome
covers upto 10% BSA
DISCONTINUE THE DRUG, REFER TO BURN UNIT
TEN (Toxic Epidermal Necrosis)
Covers over 30%
Tangent: nurse calls, you he’s red all over, afebrile, thats erythroderma, may be beginning of Erythema Multiform Major (drug rxn)
TEN
(goes to burn unit)
Morbilliform
(3 M’s…Macular, measly, med induced)
REMEMBER: KID WITH MONO, YOU THROUGH STREP SO YOU TX’d WITH Amp/Amox/Penicillin’s and caused a Morbilliform rash
Urticaria (Hives)
can be ACUTE or CHRONIC
reaction to food, drugs, etc.
Sporadic hives is no big deal, but if near face…GIVE A STEROID!! watch for facial swelling, anaphylaxis.
DD: Parasite (R/O w/ CXR, CBC w. diff, Stool)
Fixed Drug Eruption
Rxn to NON-CHRONIC meds
Shows up in same spot.
DD: spider bite
Photosensitivity
(HTN drugs, and Tetracycline can cause this)
Stop the offending medication, or stay out of light
Tangent slide:
what does FLAP stand for in the diagnosis of Srep!
Fever
Lack of cough
Adenopathy
Pharyngeal exudates
Cutaneous Necrosis
drug rxn, self limiting, usually occurs with associated infections
Pityriasis Rosea
LINEAR XMAS TREE DISTRIBUTION and HERALD PATCH to trunk
DD: Seconday Syphillus, Guttate Psoriasis, Tinea Corporis
This is LIKELY VIRAL and gonna last a while
Can give steroids for the itch, and Acyclovir
What are we pointing to?
The herald patch of Pityriasis Rosea
Pityriasis Rosea in a dark skinned person
Pityriasis Rosea
This is why you DD secondary syphillus
No Image:
Since acne is more prevalent in males, and you see heavy female acne, what should you check for?
androgen abnormalities
(excess hair and hair distribution)
Type A/1 Comedome Acne
Tx: Benzol Peroxide
Type B/2 Pustular Acne
Tx: Benzol Peroxide, good to double an antimicrobial with benzol. Each of those meds by themselves are not favorable.
Type 3/C Cystic/Nodular Acne
Consider Acutaine…VERY STRONG
TERATOGENIC, WATCH CHOLESTEROL, TRIGLYCERIDES WILL GO UP
This stage can scar later on
WITH ALL ACNE USED WATER BASED PRODUCTS
Perioral Dermatitis
common in young women, no good slide info on this one
Rosacea
pink papules, telangiectasia (blanching), flushing
light skinned women MOST affected
men more SEVERELY affected including a LARGE NOSE
Tx: Topical Flagyl, PO ABX
DD: Lupus (malar rash), Acne
Staph Folliculitis
red, raised, itchy, may have white pustular center
Hot Tub Folliculitis
pseudomonas - 24hrs after hot tub
Involves only follicles, red, raised, itchy, may be pustular at the center
An staphylococcal inflammed and infected hair follicle that grows large and can drain
Furuncle
Several inflammed & infected follicles coalescing into an ABCESS
Carbuncle
Think BRCA gene in what circumstances?
Male with breast cancer
First degree relatives with breast/ovarian cancer
Jewish Ancestry
Family history of breast cancer under 50