![Picture](/uploads/2/4/7/7/24774519/8348703.png?169)
INTERTRIGO
Irritant dermatitis
Cause: maceration and friction
Treatment: 1% hydrocortisone cream, bland topical like zinc oxide paste or ointment
Irritant dermatitis
Cause: maceration and friction
Treatment: 1% hydrocortisone cream, bland topical like zinc oxide paste or ointment
![Picture](/uploads/2/4/7/7/24774519/9020038.jpg?187)
CONTACT DERMATITIS
Delayed hypersensitivity reaction. Most common allergens are: nickel, chromium, neomycin and oleoresin.
Treatment: Cold compresses. If severe or involves face systemic glucocorticoids.
Delayed hypersensitivity reaction. Most common allergens are: nickel, chromium, neomycin and oleoresin.
Treatment: Cold compresses. If severe or involves face systemic glucocorticoids.
ACNE
Types:
1. Comedonal: retinoids like adapalene, tretinoin, tazarotene. They work by unblocking clogged pores. (Tazarotene is contraindicated in pregnancy)
2. Inflammatory
- Mild: Benzoyl peroxide - topical clindamycin or erythromycin
- Moderate to Severe: oral antibiotics or isotretinoin
Types:
1. Comedonal: retinoids like adapalene, tretinoin, tazarotene. They work by unblocking clogged pores. (Tazarotene is contraindicated in pregnancy)
2. Inflammatory
- Mild: Benzoyl peroxide - topical clindamycin or erythromycin
- Moderate to Severe: oral antibiotics or isotretinoin
![Picture](/uploads/2/4/7/7/24774519/7199652.png?225)
ROSACEA
No comedones
Telangiectasias
flushing with alcohol, stress
Treatment: tetracyclines, topical metronidazole or sulfacetamide
No comedones
Telangiectasias
flushing with alcohol, stress
Treatment: tetracyclines, topical metronidazole or sulfacetamide
![Picture](/uploads/2/4/7/7/24774519/9535280.png)
HIDRADENITIS
Chronic inflammatory scarring process of apocrine glands. Axillary, vulvar and perianal involvement.
Treatment:
- avoid deodorants (antiperspirants are ok)
- Tetracyclines, erythromycin. topical antibiotic for prophylaxis. surgical excision on severe cases.
Chronic inflammatory scarring process of apocrine glands. Axillary, vulvar and perianal involvement.
Treatment:
- avoid deodorants (antiperspirants are ok)
- Tetracyclines, erythromycin. topical antibiotic for prophylaxis. surgical excision on severe cases.
![Picture](/uploads/2/4/7/7/24774519/9090964.jpg?148)
ORAL HAIRY LEUKOPLAKIA
Seen in AIDS. Due to EBV
Ribbed whiteness along the sides of the tongue
Treatment: does not require treatment.
- Antiviral medications, taken by mouth, are the most common method of treating OHL. These medications are usually taken for one to two weeks or until the OHL patches have disappeared: Acyclovir, valacyclovir, Famciclovir. Topical treatment: tretinoin (Retin A®) 4 times a day or podophyllin resin 2 times a day , two medications that can be applied directly to the OHL patches. Liquid nitrogen (cryotherapy) to the affected area or to remove the patches surgically.
Seen in AIDS. Due to EBV
Ribbed whiteness along the sides of the tongue
Treatment: does not require treatment.
- Antiviral medications, taken by mouth, are the most common method of treating OHL. These medications are usually taken for one to two weeks or until the OHL patches have disappeared: Acyclovir, valacyclovir, Famciclovir. Topical treatment: tretinoin (Retin A®) 4 times a day or podophyllin resin 2 times a day , two medications that can be applied directly to the OHL patches. Liquid nitrogen (cryotherapy) to the affected area or to remove the patches surgically.
![Picture](/uploads/2/4/7/7/24774519/5122141.png?203)
PEUTZ JEGHERS SYNDROME
Multiple intestinal hamartomatous polyps
Multiple intestinal hamartomatous polyps
![Picture](/uploads/2/4/7/7/24774519/2348607.png?111)
MACROGLOSSIA
Associated with MM, primary amyloidosis, lymphoma, hemangioma, acromegaly and down syndrome
Associated with MM, primary amyloidosis, lymphoma, hemangioma, acromegaly and down syndrome
![Picture](/uploads/2/4/7/7/24774519/7790949.jpg)
LICHEN PLANUS (from AAD)
Bumps that are shiny, firm, and reddish purple. Wickham’s striae, tiny white lines running through them. The most common places for these bumps to appear are the wrists, lower back, and ankles. Can appear in legs but darker.
Treatment: Oral antihistamines, topical corticosteroids, tacrolimus ointment, PUVA, retinoic acid.
Bumps that are shiny, firm, and reddish purple. Wickham’s striae, tiny white lines running through them. The most common places for these bumps to appear are the wrists, lower back, and ankles. Can appear in legs but darker.
Treatment: Oral antihistamines, topical corticosteroids, tacrolimus ointment, PUVA, retinoic acid.
![Picture](/uploads/2/4/7/7/24774519/1010670.jpg)
ERYTHRASMA (picture from NEJM)
Polymicrobial (associated with gram positive corynebacterium minutissimum)
Dx: fluoresces bright red with Wood lamp
Tx: oral or topical erythromycin + azole
Polymicrobial (associated with gram positive corynebacterium minutissimum)
Dx: fluoresces bright red with Wood lamp
Tx: oral or topical erythromycin + azole
![Picture](/uploads/2/4/7/7/24774519/1747153_orig.jpg)
POIKILODERMA OF CIVATTE
It is a combination of epidermal atrophy, telangiectasia, hyperpigmentation, and hypopigmentation giving the skin a mottled appearance on the sides of the neck, more commonly in women.
Etiology: is most commonly secondary to photodamaged skin. Photosensitizing chemicals in perfumes or cosmetics. Also implicated low estrogen level. Other causes are topical steroid overuse, dermatomyositis, lupus erythematosus, mycosis fungoides, radiodermatitis.
Rothmund-Thompson syndrome or poikiloderma congenitale is autosomal recessive inheritance ( gene is RECQL4 DNA Helicase). Affects patients have poikiloderma of the face and extensor extremities, photosensitivity, premalignant acral keratoses, alopecia, nail dystrophy, cataracts, hypogonadism, and solid tumors.
It is a combination of epidermal atrophy, telangiectasia, hyperpigmentation, and hypopigmentation giving the skin a mottled appearance on the sides of the neck, more commonly in women.
Etiology: is most commonly secondary to photodamaged skin. Photosensitizing chemicals in perfumes or cosmetics. Also implicated low estrogen level. Other causes are topical steroid overuse, dermatomyositis, lupus erythematosus, mycosis fungoides, radiodermatitis.
Rothmund-Thompson syndrome or poikiloderma congenitale is autosomal recessive inheritance ( gene is RECQL4 DNA Helicase). Affects patients have poikiloderma of the face and extensor extremities, photosensitivity, premalignant acral keratoses, alopecia, nail dystrophy, cataracts, hypogonadism, and solid tumors.
AXILLARY HYPERHIDROSIS
Treatment: topical aluminum chloride solution , it is applied to the dry axilla at night. It precipitates in the eccrine ducts, decreasing sweat secretion. Side effects: irritation
Other treatment options include tap water iontophoresis and botulinum toxin injections.
Transthoracic sympathectomy is reserved for extreme cases.
Treatment: topical aluminum chloride solution , it is applied to the dry axilla at night. It precipitates in the eccrine ducts, decreasing sweat secretion. Side effects: irritation
Other treatment options include tap water iontophoresis and botulinum toxin injections.
Transthoracic sympathectomy is reserved for extreme cases.
![Picture](/uploads/2/4/7/7/24774519/158517_orig.jpg)
ACTINIC KERATOSIS
May evolve to Squamous Cell Carcinoma
Image : Mayo Clinic
May evolve to Squamous Cell Carcinoma
Image : Mayo Clinic
![Picture](/uploads/2/4/7/7/24774519/1633846.jpg?142)
TINEA
Capitis: Griseofulvin (1 choice), or terbinafine or itraconazole
Capitis: Griseofulvin (1 choice), or terbinafine or itraconazole
![Picture](/uploads/2/4/7/7/24774519/2183824.jpg)
CANDIDA
Caracteristic perispheral pustules
Tx: Antufungal cream can be given in conjunction with steroid cream
Burrows solution
Absorbent powder
Caracteristic perispheral pustules
Tx: Antufungal cream can be given in conjunction with steroid cream
Burrows solution
Absorbent powder
![Picture](/uploads/2/4/7/7/24774519/3748256.jpg)
PITYRIASIS VERSICOLOR
![Picture](/uploads/2/4/7/7/24774519/6012687.png?129)
LYME DISEASE
Erythema migrans
Tx Doxycycline
Erythema migrans
Tx Doxycycline
![Picture](/uploads/2/4/7/7/24774519/1411584.jpg)
SPOROTRICHOSIS
![Picture](/uploads/2/4/7/7/24774519/1400114851.jpg)
VENOUS LAKE
Seen in elderly. Easy bleeding, dark blue to violaceous. .
Seen in elderly. Easy bleeding, dark blue to violaceous. .
![Picture](http://www.editmysite.com/editor/images/na.png)