Dermatology Flashcards
1
Q
What is included in the atopic disease triad?
A
- Eczema
- Allergic rhinitis
- Asthma
Usually starts in childhood
2
Q
Altered immune reaction in genetically susceptible people when exposed to certain triggers - causes an increase in IgE production
A
Atopic dermatitis (Eczema)
3
Q
Triggers for Atopic dermatitis (Eczema)
A
Heat
Perspiration
Allergens
Contact irritants (wool, nickel, food)
4
Q
Hallmark of atopic dermatitis (eczema)
A
pruritus!
5
Q
Erythematous, ill-defined blisters/papules/plaques that later dries, crusts over and scales
A
Atopic dermatitis (eczema)
6
Q
Atopic dermatitis (eczema) is most commonly found:
A
Flexor Creases
Antecubital fold and popliteal folds
7
Q
Special characteristic of atopic dermatitis (eczema)
A
Dermatographism - localized development of hives when the skin is stroked
8
Q
Sharply defined discoid/coin shaped lesions found on the dorsum of the hands, feet, and extensor surfaces (knees, elbows)
A
Nummular Eczema
Atopic dermatitis
9
Q
Management of atopic dermatitis (eczema)
A
- Topical corticosteroids, antihistamines for itching
2. Topical calcineurin inhibitors (Tacrolimus, Pimecrolimus) are alternatives for steroids
10
Q
Seborrheic dermatitis may be due to a hypersensitivity to:
A
Malassezia furfur
11
Q
Seborrheic dermatitis is most commonly seen in:
A
Adult men
12
Q
Seborrheic dermatitis occurs most common in areas of:
A
High sebaceous gland over secretion - scalp, face, eyebrows, body folds
13
Q
Erythematous plaques with fine white scales seen on infants heads
A
Cradle Cap - Seborrheic Dermatitis
14
Q
Erythematous plaques with fine white scales seen on the scalp, eyelids, beard/mustache, etc.
A
Seborrheic dermatitis
15
Q
Management of seborrheic dermatitis
A
Topical: selenium sulfide, sodium sulfacetamide, ketoconazole (shampoo or cream)
Systemic: oral antifungals - itraconazole, fluconazole, ketoconazole, terbinafine
16
Q
Triggers for dyshidrosis
A
Sweating
Emotional stress
Warm and humid weather
Metals (ex. nickel)
17
Q
Pruritic “tapioca-like” tense vesicles on the soles, palms, and fingers
A
Dyshidrosis
18
Q
Management of dyshidrosis
A
Topical steroids - ointment preferred
Cold compresses
19
Q
Skin thickening in pts with eczema secondary to repetitive rubbing/scratching
A
Lichen simplex chronicus
20
Q
Scaly, well-demarcated, rough hyperkeratotic plaques with exaggerated skin lines
A
Lichen simplex chronicus
21
Q
Management of lichen simplex chronicus
A
Avoid scratching!
Topical steroids (high strength)
Antihistamines
Occlusive dressings
22
Q
Has an increased incidence with Hepatitis C
A
Lichen planus
23
Q
The 5 P’s of lichen Planus
A
Purple, polygonal, planar, pruritic papules
24
Q
Lichen planus most commonly seen on:
A
Flexor surfaces, skin, mouth, scalp, genitals, nails and mucous membranes
25
Koebner's Phenomenon
New lesions at site of trauma
| Seen in psoriasis and lichen planus
26
Fine white lines on the skin lesions or on the oral mucosa - nail dystrophy
Wickham Striae
| Seen in lichen planus
27
Management of lichen planus
Topical corticosteroids
Antihistamines for pruritus
Rash will usually spontaneously resolve in 8-12 mo
28
Urticaria and angioedema are _____ mediated and usually occur immediately after offending drug/trigger is taken
IgE
29
Erythema multiforme is a __________ reaction that is usually delayed and cell mediated
Morbilliform
30
Most common type of drug reaction/skin eruption
Exanthematous / Morbilliform Rash
31
Generalized distribution of "bright-red" macules and papules that coalesce to form plaques - typically begins 2-14 days after medication initiation
Drug eruption
| Exanthematous/Morbilliform Rash
32
2nd most common type of drug eruption
Urticaria
33
3rd most common type of drug eruption
Erythema multiforme
34
Most common type of drug eruption
Exanthematous/morbilliform
35
Most common offending drugs with urticaria
Antibiotics and NSAIDs
36
Management of drug induced exanthematous/morbilliform rash
Oral antihistamines
37
Management of drug induced urticaria / angioedema
Systemic corticosteroids, antihistamines
38
Management of drug induced erythema multiforme
Symptomatic therapy
| Topical steroids, oral antihistamines
39
Associated with Human Herpes Virus 7
Pityriasis Rosea
40
This rash can mimic syphilis, so an RPR should be ordered if the pt is sexually active
Pityriasis Rosea
41
Solitary salmon-colored macule on the trunk, followed by general exanthem 1-2 weeks later
Herald Patch
| Pityriasis Rosea
42
Very pruritic salmon-colored papules with collarette scaling along cleavage lines in a christmas tree pattern
Pityriasis Rosea
43
Management for pityriasis rosea
None needed
PO antihistamines, topical corticosteroids as needed
Can use UVB phototherapy if severe and started early
44
Keratin hyperplasia due to T cell activation leads to greater epidermal thickness and increased epidermis turnover
Psoriasis
45
Raised, dark-red plaques/papules seen with thick silver/white scales
Psoriasis
46
Plaque Psoriasis is most common seen on the:
Extensor surfaces
| Elbows, knees, scalp, nape of neck
47
25% of plaque psoriasis also have:
Nail pitting
| Yellow-brown discoloration until the nail (oil spot)
48
Punctate bleeding with removal of plaque/scale
Auspitz sign
| Seen with psoriasis and actinic keratosis
49
Deep, yellow non-infected pustules that evolve into red macules on palms/soles
Pustular psoriasis
50
Erythematous rash that lacks scales, seen in body folds (groin, gluteal fold, axilla)
Inverse psoriasis
51
Inflammatory arthritis that includes joint stiffness > 30 minutes relieved with activity. May also have "sausage digits"
Psoriatic arthritis
52
Radiograph deformity seen with psoriatic arthritis
Pencil in cup deformity
53
Management for psoriasis
Topical steroids first line
Moderate-severe: phototherapy
Systemic treatment: Methotrexate
54
Most common cause of erythema multiforme
Secondary to herpes simplex infection
55
Multiple target-like lesions that spares the mucosa
Erythema Multiforme Minor
56
Multiple target-like lesions that includes mucosal involvement
Erythema Multiforme Major
57
Treatment of erythema multiforme
Typically resolves after 2 weeks
| Can give topical steroids and antihistamines
58
Most common medications causing SJS and TEN
```
Allopurinol
Sulfonamides
Lamotrigine
NSAIDs
Anticonvulsants
```
59
SJS affects _______% of body surface area
< 10%
60
TEN affects _______% of body surface area
> 30%
61
Prodrome of fever, malaise, myalgias followed by lesions on face and trunk. Bullous and vesicle formation begins days after
SJS/TEN
62
Gentle pressure to the skin causes sloughing
Nikolsky Sign
| Seen in SJS/TEN
63
Main cause of death with SJS/TEN
Sepsis and shock secondary to infection
64
Treatment for SJS/TEN
Admit to hospital, preferably to burn unit
| Supportive care is mainstay
65
Chronic widespread autoimmune blistering skin disease primarily of the ELDERLY
Bullous pemphigoid
66
Bullous pemphigoid will have ________ of Nikolsky sign
Absence
67
Bullous pemphigoid is caused by an ______ autoimmune attack on the epithelial basement membrane
Type II HSN
| IgG
68
Management of bullous pemphigoid
Systemic corticosteroids
Antihistamines
Azathioprine (immunosuppressant)
69
4 main pathophysiologic factors for acne vulgaris:
1. Increased sebum production
2. Clogged sebaceous glands
3. P. acne overgrowth
4. Inflammatory response
70
Small, non inflammatory bumps from clogged pores
Comedones
| Acne vulgaris
71
Treatment for mild acne
Topical retinoids
Benzoyl peroxide
Topical abx (Clindamycin)
OCPs
72
Treatment of rmoderate acne
Oral abx (Doxy, Minocycline, Erythromycin, Clindamycin)
73
Treatment of severe (nodular/cystic) acne
Isotretinoin
74
S/E of isotretinoin
Highly teratogenic
| Hepatitis, increased triglycerides/cholesterol, psych side effects
75
What must be done before prescribing isotretinoin?
Highly teratogenic
Obtain at least 2 pregnancy tests prior to initiation and monthly
Must be on 2 forms of contraception
76
Symptoms due to increased capillary permeability and increased vasomotor instability with lesion formation
Rosacea
77
Triggers for Rosacea
```
EtOH
Hot/cold temperature
Hot drinks
Hot baths
Spicy foods
```
78
Acne-like rash, erythema, facial flushing, telangiectasia
Rosacea
79
Absence of comedones distinguishes it from acne
Rosaceae
80
Treatment for rosacea
Metronidazole first line
Topical abx
Can do oral abx if severe
81
Lifestyle modifications for rosacea
Sunscreen, avoid toners, camphor and triggers
82
Most commonly seen in fair-skinned elderly with prolonged sun exposure
Actinic keratosis
| Seborrheic keratosis
83
Premalignant condition to squamous cell carcinoma
Actinic keratosis
84
Most common premalignant skin condition
Actinic keratosis
85
Dry, rough, scaly "sandpaper" skin lesion or erythematous, hyperkaratotic
Actinic keratosis
86
May present with a projection (horn) on the skin
Actinic keratosis
87
Diagnosis of actinic keratosis
Punch or shave biopsy
88
Management of actinic keratosis
Observation, surgical
| Topical 5-fluorouracil, imiquimod
89
Most common benign skin tumor
Seborrheic keratosis
90
Small papule/plaque velvety warty lesions with a greasy/stuck on appearance
Seborrheic keratosis
91
Intense itching, especially in the occipital area, papular urticaria may been seen
Lice
92
White oval-shaped egg capsules at the base of the hair shafts
Nits
| Lice
93
Management of lice
Permethrin topical drug of choice
Safe in children > 2 y/o
If lice in hair: permethrin shampoo (leave on 10 min)
If pubis/body: permethrin lotion at least 8-10 hours
94
Second line management of lice and S/E
Lindane
Neurotoxic - headaches, seizures
Do not use after showering
95
Instructions for mom with children with lice
Bedding/clothing should be laundered in hot water with detergents and dried in hot drier for 20 minutes.
Toys that cannot be washed should be placed in airtight plastic bags x 14 days
96
Scabies cannot survive off the human body for _____ days
> 4
97
Intensely pruritic papules, vesicles and linear burrows
Scabies
98
Commonly found in the intertriginous zones including web spaces between fingers/toes and scalp
Scabies
99
Increased intensity of rash at night
Scabies
100
Diagnosis of scabies
Clinical diagnosis
| Can scrape burrows with mineral oil to identify mites or eggs under microscopy
101
Treatment of scabies
Permethrin topical
Apply topically from neck to soles of feet for 8-14 hours before showering
Repeat application after 1 week is recommended
102
Second line tx for scabies
Linedane (cheaper)
Do not use after bath/shower
May cause seizures
Teratogenic, not used in breastfeeding women or children < 2 y/o
103
Instructions for scabies
All clothing, bedding, should be placed in plastic bag at least 72 hours then washed and dried using heat
104
Spider bite with local burning and erythema, will have an erythematous margin around the ischemic center, or a "red halo"
Brown Recluse spider bites
105
Spider bite after 24-72 hours that will have hemorrhagic bullae that undergoes eschar formation
Brown recluse spider bite
106
Management of brown recluse spider bite
1. Local wound care - clean area with soap and water, apply cold packs to bite site
2. Pain control - NSAIDs, opiates
3. Dermal necrosis - debridement
107
Spider bite that may cause muscle pain, spasms and rigidity. Muscle pain most commonly affects the extremities, back and abdomen
Black widow spider bites
108
Classic appearance is a blanched circular patch with a surrounding red perimeter and central punctum (target lesion)
Black widow spider bitet
109
Management of black widow spider bite
1. Wound care and pain control
2. Opioids +/- muscle relaxants if severe
3. Antivenom used if not responsive to other medications
110
Major risk factor for basal cell carcinoma
Exposure to UV light
111
Pearly papule with a telangiectatic vessel that typically occurs on face
Basal cell carcinoma
112
Diagnosis of basal cell carcinoma
Shave biopsy
113
Basal cell carcinoma where papule ulcerates
Rodent ulcer
114
Treatment of basal cell carcinoma
Rarely metastasize
| Removal
115
Connective tissue cancer caused by Human Herpes Virus 8
Kaposi Sarcoma
116
Cancer most commonly seen in immunosuppressed pts or HIV
Kaposi Sarcoma
117
Macular, papular, nodular, plaque like brown/pink/red violaceous lesions
Kaposi Sarcoma
118
Management of Kaposi Sarcoma
HAART therapy
| Radiation therapy for local dz
119
Most dangerous form of skin cancer, as it has high risk for metastasis
Melanoma
120
ABCDE rule of melanomas
```
Asymmetry
Border irregularity
Color variation
Diameter > 6 mm
Evolving shape, size, or color
```
121
Diagnosis of melanoma
Excisional biopsy with 1-3 mm of the surrounding skin and part of subcutaneous fat
122
Treatment of melanoma
Surgical removal
| Adjunctive tx with interferon alpha can prolong survival in high risk groups
123
Non-scarring immune-mediated hair loss targeting the anagen hair follicles
Alopecia Areata
124
Alopecia areata is commonly associated with other _________ disorders
Autoimmune
| Thyroid, Addison's disease
125
Smooth discrete circular patches of complete hair loss that develops over a period of weeks
Alopecia Areata
126
Short hairs broken off a few mm from the scalp at the margins of the patches with tapering near the proximal hair shaft
Exclamation point hairs
| Alopecia Areata
127
Management of alopecia areata
Local - intralesional corticosteroids
| Extensive - topical corticosteroids
128
Progressive loss of the terminal hairs on the scalp in a characteristic distribution
Androgenetic alopecia
129
___________ is the key androgen leading to androgenetic alopecia
Dihydrotestosterone
130
Treatment of androgenetic alopecia
1. Minoxidil (best if used early)
2. Oral Finasteride
S/E: decreased libido, sexual or ejaculatory dysfunction
131
Nail infection by various fungi, occurs most commonly on the great toes
Onychomycosis
132
Management of onychomycosis
Itraconazole and terbinafine
| However, associated with hepatotoxicity and drug interactions
133
Infection of the nail margin
Paronychia
134
Paronychia most commonly occurs after __________
Skin trauma
| Biting nails, cuticle damage
135
Most common organism in paronychia
Staph aureus
GABHS
Candida if slow growing
136
Closed-space infection of the fingertip pulp - progression of a paronychia
Felon
137
Management of paronychia
Warm soaks
Antibiotics (Cephalexin)
Incision and drainage if needed
138
HPV infects keratinized skin, causing excessive proliferation and retention of the stratum corneum causing papula formation
Condyloma acuminatum
139
Genital warts
Condyloma acuminatum
140
Tiny, painless, papules evolve into soft, fleshy, cauliflower-like lesions
Condyloma acuminatum
141
Management of condyloma acuminatum
Most warts resolve spontaneously within 2 years if immunocompetent
Chemical, salicylic acid, cryotherapy, laser and podophyllin
142
Exanthem with prodrome of high fever for 3-5 days, which resolves before onset of a rose pink, maculopapular blanchable rash on the trunk/back progressing to the face
Roseola Infantum
| Sixth disease
143
Only childhood exanthem that starts on the trunk
Roseola infantum
| Sixth disease
144
Management of roseola infantum (sixth disease)
Supportive
Anti Inflammatories
Antipyretics (to prevent febrile seizures)
145
Oral exanthem with vesicular lesions with erythematous halos in the oral cavity leading to vesicular, macular or maculopapular lesions on the distal extremities (often includes palms and soles)
Hand Foot & Mouth Disease
| Coxsackie A Virus
146
Management of hand foot and mouth disease
Supportive
Antipyretics
Topical lidocaine
147
Rashes that affect palms/soles
HF and M
RMSF
Syphilis (secondary)
Janeway lesions (endocarditis)
148
What causes mumps?
Paramyxovirus
149
Low grade fever, myalgias, headache, parotid gland pain and swelling
Mumps
150
Management of mumps
Supportive
Anti-inflammatories
Symptoms usually last 7-10 days
151
Complications of mumps
Orchitis in males
| Acute pancreatitis in children
152
URI prodrome with high fever and 3 C's - cough, conjunctivitis, and coryza (stuffy nose)
Rubeola (Measles)
153
Small red spots in buccal mucosa with pale blue/white center
Koplik Spots
| Rubeola (Measles)
154
Morbilliform (maculopapular) brick-red rash on face beginning at hairline, moving to extremities that darkens and coalesces
Rubeola (Measles)
155
Rash usually lasts 7 days, fading from top to bottom. Fever often concurrent with rash
Rubeola (Measles)
156
Low grade fever, cough, anorexia, lymphadenopathy (posterior, cervical, posterior auricular). Pink, light-red spotted maculopapular rash on face and extremities
Rubella (German Measles)
157
3 day rash
Rubella (German Measles)
158
Small red macules or petechiae on soft palate
Forchheimer Spots
| Rubella (German Measles)
159
Compared to rubeola, spreads more rapidly and does not darken or coalesce
Rubella (German Measles)
160
Diagnosis of rubella (german measles)
Clinical
| Rubella-specific IgM antibody via enzyme immunoassay
161
Management of Rubella
Anti-inflammatories
| Supportive
162
Rubella (german measles) is teratogenic, especially:
In the first trimester
| Can lead to sensorineural deafness, TTP (blueberry muffin rash), mental retardation, heart defects
163
Erythema infectiosum (fifth disease) is caused by:
Parvovirus B19
164
Stuff nose, fever followed by a slapped cheek rash on face with circumoral pallor
Erythema infectiosum (fifth disease)
165
Lacy reticular rash on the extremities (especially upper) that spares the palms and soles
Erythema infectiosum (fifth disease)
166
Diagnosis for erythema infectiosum (fifth disease)
Serologies
167
Management of erythema infectiosum (fifth disease)
Supportive
| Anti-inflammatories
168
Have to be aware of erythema infectiosum (fifth disease), because it may cause aplastic crisis in pts with:
Sickle cell disease OR
| G6PD deficiency
169
Clusters of vesicles on an erythematous base, dew drops on a rose petal in different stages (macules, papules, vesicles, pustules, and crusted lesions). Usually pruritic.
Varicella (chicken pox)
170
Management of varicella (chicken pox)
Symptomatic treatment
171
Molluscum contagiosum is due to:
Poxviridae family (benign viral infxn)
172
Single or multiple dome-shaped, flesh-colored to pearly-white, waxy papules with central umbilication
Molluscum contagiosum
173
Treatment for molluscum contagiosum
No treatment needed in most cases
| May do: curettage, cryotherapy, imiquimod, topical retinoids if severe
174
HPV infects keratinized skin, causing excessive proliferation and retention of the stratum corneum - papule formation
Verrucae (warts)
175
Firm, hyperkeratotic papules between 1-10 mm with red-brown punctuations. Thrombosed capillaries are pathognomonic
Common and plantar warts (verrucae)
176
Numerous, small, discrete, flesh-colored papules measuring 1-5 mm in diameter. Flat
Flat warts (verrucae)
177
Management of verrucae (warts)
Most resolve spontaneously within 2 years if immunocompetent
May use OTC salicylic acid and plasters
Can do cryotherapy (liquid nitrogen), etc.
178
Most common etiologies of erysipelas/cellulitis
Streptococci (GABHS)
| Staph aureus
179
Infection of the skin that presents with erythema, edema, warmth and tenderness
Cellulitis / Erysipelas
180
______ involves deeper dermis and subcutaneous fat
Cellulitis
181
_______ involves only upper dermis
Erysipelas
182
Raised with clear line of demarcation between infected and uninfected tissue
Erysipelas
183
Treatment for cellulitis
1. elevate area and keep skin hydrated
2. those with drainage should be treated for MRSA (clindamycin, TMP/SMX or doxy)
3. Those without drainage should be treated for MSSA (clindamycin, cephalexin, dicloxacillin)
184
Treatment for erysipelas
Those with mild infxn can be treated with penicillin, macrolide, cephalexin or clindamycin
Improvement should be noted after 3 days of treatment
185
Highly contagious superficial vesiculopustular skin infection that typically occurs at site of superficial skin trauma
Impetigo
186
Impetigo occurs primarily on exposed surfaces of the:
Face and extremities
187
Risk factors for impetigo
Warm
Humid conditions
Poor personal hygiene
188
Vesicles, pustules that have a characteristic honey colored crust
Nonbullous impetigo
189
Most common causes of impetigo
Staph aureus
190
Vesicles form large bullae (rapidly), which rupture and leave thin "varnish-like crusts", fever and diarrhea also
Bullous impetigo
191
Management of impetigo
1. Mupirocin (Bactroban) topical drug of choice TID x 10 days
2. Wash area gently with soap and water
192
Management of impetigo if extensive disease or systemic symptoms (fever)
Systemic abx - cephalexin
| Dicloxacillin, clindamycin, ertyrhomycin, azithromycin
193
Velvety hyperpigmented lesions found on neck and axilla that is usually associated with insulin resistance
Acanthosis Nigricans
194
Management of acanthosis nigricans
Screen for diabetes
Treat underlying cause
Topical retinoids, vitamin D analogs, and hydroquinone can be used for cosmetic purposes
195
Chronic abscess of apocrine sweat glands or sebaceous cysts with tract formation. Red tender inflammatory nodules/abscesses
Hidradenitis suppurativa
196
Most common areas of hidradenitis suppurativa
Axilla, groin, under breasts or anogenital areas
197
Management of hidradenitis suppurativa
1. Mild: topical clindamycin
2. Deep, recurrent infxns: punch debridement
3. Painful abscess - I and D
4. surgical excision
5. watch obesity (common cause)
198
Subcutaneous benign tumor of adipose tissue. Soft, symmetric, painless, easily mobile, palpable mass in the subcutaneous tissue
Lipoma
199
Mobile masses of fibrous tissue and keratinous (cottage cheese like) substance
Sebaceous cyst
200
Management of sebaceous cyst
No tx needed
Abx and I and D if becomes infected
Cosmetic removal
201
Hypermelanosis (hyperpigmentation) of sun exposed areas of the skin
Melasma
202
Melasma usually seen on:
Face and neck
203
Diagnosis of melasma
Wood's Lamp - appearance unchanged under black light
204
Management of melasma
```
SUNSCREEN
Topical bleachers (hydroquinone, topical retinoids, azelaic acid)
```
205
Tender abscess with drainage on or near the gluteal cleft near the midline of the coccyx or sacrum with small midline pits
Pilonidal disease
206
Management of pilonidal disease
I and D
| May surgical remove tracts if recurrent
207
Skin intact, superficial, nonblanchable redness that does not dissipate after pressure is relieved
Stage I pressure ulcer
208
Epidermal damage extending into dermis. Shallow ulcer that resembles a blister or abrasion
Stage II pressure ulcer
209
Full thickness of the skin and may extend into the subcutaneous layer
Stage III pressure ulcer
210
Deepest, extends beyond the fascia into the muscle, tendon or bone
Stage IV pressure ulcer
211
Purple area of discolored skin
Suspected deep tissue injury
212
Ulcer covered with slough or eschar, making depth undetermined
Unstageable pressure ulcer
213
Management of pressure ulcers
1. Optimize nutritional status, offer pain control
2. Wet to dry dressings, hydrogels
3. May need surgical debridement for stages III and IV
214
Type I HSN (IgE) or complement-mediated edematous reaction of the dermis and/or SQ tissues
Urticaria
215
Mast cells release histamine causing vasodilation of venules and edema of dermis and SQ tissue
Urticaria
216
Blanchable, edematous pink papules, wheals or plaques (oval, linear or irregular)
Urticaria
217
Localized urticaria where the skin is rubbed (urticaria pigmentosa)
Darier's sign
218
Management of urticaria
Oral antihistamines treatment of choice
219
Autoimmune destruction of melanocytes leading to skin depigmentation
Vitiligo
220
Irregular discrete macules and patches of total depigmentation. Commonly involves the dorsum of the hands, axilla, face, fingers, body folds and genitalia
Vitiligo
221
Management of vitiligo
1. Localized: topical corticosteroids
| 2. Disseminated: systemic phototherapy
222
Superficial hair follicle infection with singular or clusters of small papules or pustules with surrounding erythema
Folliculitis
223
Most common organism for folliculitis
Staph aureus
224
Treatment for folliculitis
1. Topical Mupirocin, clindamycin, erythromycin
225
Annual, scaling lesions and broken hair shafts. Inflamed plaques with multipel pustules with scarring and alopecia
```
Tinea capitis (fungal)
Ringworm
```
226
Treatment for tinea capitis
PO griseofulvin
| Terbinafine, itraconazole
227
Pruritic, scaly eruption rash between toes
Tinea pedis (athlete's foot)
228
Management for tinea pedis
Topical antifungals
| PO griseofulvin if uneffective
229
Diffusely red rash on the groin or on the scrotum
Tinea cruris (jock itch)
230
Management of tinea cruris
Topical antifungal
| PO griseofulvin in ineffective
231
Erythematous plaques (circular rash with clear center and defined borders), scaling, cracking and vesicles
Tinea corporis
232
Management of tinea corporis
Topical antifungal
| PO griseofulvin if ineffective
233
Diagnosis of fungal infections
KOH smear
| Wood's lamp
234
Overgrowth of the yeast Malassezia furfur
Tinea versicolor
235
Diagnosis of tinea versicolor
KOH prep from skin scraping - spaghetti and meatball appearance
Wood's lamp - yellow green fluorescence
236
Management of tinea versicolor
Topical antifungals - selenium sulfide, sodium sulfacetamide, zinc pyrithione, azoles
PO itraconazole or fluconazole if widespread
