Other Disorders Flashcards
Pityasis Rosea
multiple broad based papules
begins with a single spot
**thin collarette scaling (Christmas tree pattern)
pityasis rosea
pathognomonic
herald patch (single large lesion)
pityasis rosea treatments
- oral antihistamine
2. topical corticosteroids
acute urticaria
red, itchy welts
multiple erythematous edematous plaques
acute urticaria
imp. symptoms
positive dermatographism (large welt wherever the skin is rubbed)
acute urticaria
treatment
- oral antihistamine
2. ASO titer –> if +, treated with antibiotics
acute acute urticaria treatment
treat with clarinex, hydroxyzine, ASO titer, avoid hot shower
vasculitis
patches of palpable purport
inflammation/damage to blood vessels
vasculitis treatment
- CXR, CBC, CMP, ESR, ANA, UA
- Punch Biopsy
- Topical Corticosteroid
- Slow prednisone taper
bullous pemphigoid
Blisters
severe itching
multiple erythematous fluid filled bulla
bullous pemphigoid imp. symptoms
age is key
found typically in the elderly
bullous pemphigoid treatment
- oral antihistamine
- tapering prednisone
- oral antibacterial
- topical corticosteroids
Rosacea
background erythema
scattered inflammatory papules
central face flushing
no comedones
rosacea imp. symptoms
worse with heat (spicy food, sun)
sun, spicy foods
Rhinophyma (blood rushes to nose and makes nose bigger)
rosacea treatments
- avoid trigger factors
- sulfa based cleanser (Plexion, Cenia)
- Topical antibiotics (metronidazole, sulfa based)
- oral antibiotic (doxy, micocycline)
- mirvaso gel
- Soolantra
folliculitis (Pseudomonas)
follicular erythema
inflammation
no pustules
found chest down
folliculitis (pseudomonas)
get it from a hot tub (everyone in the tub gets it)
folliculitis treatment
- antibiotics (levaquin)
- oral antihistamine
- culture of any pustules to narrow Abx
- dean and disinfect hot tub
pseudofolliculitis barbae
description and treatment
ingrown, inflamed hair
- avoid close shaving
- topical antibiotics (clindamycin)
- laser hair removal
alopecia areata
progressive hair loss
well demarcated
immune system attacking the HAIR
alopecia areata treatment
- TSH lab work up (TSH can stimulate hair growth)
2. topical anthralin or corticosteroid
vitiligo
large, macular patches
hypo-pigmented
immune system attacks the PIGMENT
vitiligo treatment
- sunscreen
- tacrolimus ointment
- thyroid workup
acute paronychia
flourid erythmeia
accumulated exudate to lateral nail fold
“hang nail”
follows trauma
acute paronychia
treatment
- simple I and D, culture
2. Kephlex
hidradentis suppurativa
multiple areas of post inflammatory pigment and scaring
dilated pores with communicated cysts
hidradenitis suppurativa pathognomonic
mostly found in obese patients
lots of skin drainage
double comedones
hidradenitis suppurativa treatment
- minocylcin
2. weight loss
molluscum contagiosum
caused by pox virus
multiple flesh colored umbilicate papules
can be sexually transmitted or found often in small children
molluscum contagiosum treatment
- imquimod cream
2, cryosurgery or topical canthardin (beetle freeze)
these will go away on their own
acanthosis nigricans
velvety brown hyper pigmentation
associated with insulin resistance, obesity, diabetes
“dirty neck”
acanthosis nigricans
- labs (fasting, glucose, Hgb A1C, insulin antibodies) – Screen for diabetes
- Retin A cream for pigment
- weight loss
- diabetes management
why do we use retin A for pigment?
targets keratinization
impetigo
denuded (missing skin from top layer) erythema
honey colored crusting
impetigo is caused by
staph aureus or group A strep
impetigo treatment
- mupirocin (bactrobran) ointment
- oral Kephlex
must rule out MRSA
fifths disease
bright erythema
macular, lacy
just chess reddened
fever, rash on trunk but not hands or feet
fifths disease pathognomonic
erythema infectiosum (slapped cheek)
fifths disease treatment
NSAIDs (fades within 2 weeks)
melasma
macular hyper pigmentation patches on cheeks and forehead
can occur during pregnancy (also birth control, hormone replacement)
chloasma (mask pregnancy)
melasma treatment
- daily sunscreen
2. hydroquinone and retinoid (not while pregnant) – bleaches skin
erythrasma
corynebacterium (NOT yeast)
confluent, mild erythema to groin
erythrasma pathognomonic
woods light (coral red fluorescence)
erythrasma treatment
erythromycin
candidiasis intertrigo
confluent, bright erythema
multiple satellite regions
red and angry, found in folds (anywhere that is moist)
candidiasis intertrigo pathognomonic
yeast infection
diaper dermatitis (warm moist place)
candidiasis intertrigo treatment
- topical “cidal” antifungal
- diflucan
- prevention using absorbent powder (Zeasorb)
impetigo treatment
- mupirocin (bactrobran) ointment
- oral Kephlex
must rule out MRSA
fifths disease
bright erythema
macular, lacy
just chess reddened
fever, rash on trunk but not hands or feet
fifths disease pathognomonic
erythema infectiosum (slapped cheek)
fifths disease treatment
NSAIDs (fades within 2 weeks)
melasma
macular hyper pigmentation patches on cheeks and forehead
can occur during pregnancy (also birth control, hormone replacement)
chloasma (mask pregnancy)
melasma treatment
- daily sunscreen
2. hydroquinone and retinoid (not while pregnant) – bleaches skin
erythrasma
corynebacterium (NOT yeast)
confluent, mild erythema to groin
erythrasma pathognomonic
woods light (coral red fluorescence)
erythrasma treatment
erythromycin
candidiasis intertrigo
confluent, bright erythema
multiple satellite regions
red and angry, found in folds (anywhere that is moist)
candidiasis intertrigo pathognomonic
yeast infection
diaper dermatitis (warm moist place)
candidiasis intertrigo treatment
- topical “cidal” antifungal
- diflucan
- prevention using absorbent powder (Zeasorb)
Seborrheic keratosis
multiple brown spots to back, chest, and abdomen
progressively developed more lesions
seborrheic keratosis
pathognomonic
multiple brown waxy stuck on lesions with sharply demarcated borders
seborrheic keratosis treatment
no treatment unless it becomes enflamed or atypical
cryosurgery (cosmetic)
Actinic Keratosis
dry crusty spot on face, scalp and ears
present for years in sun exposed areas
can develop into squamous cell carcinoma
Actinic Keratosis
pathognomonic
multiple areas of erythema, lesions have yellow or transparent scaling
can develop into carcinoma
Actinic Keratosis
treatment
topical 5-flurouracil cream
dryosurgery to hypertrophic lesions
sunscreen
blood vessel birthmark
port wine stain
responds well to laser therapy
