Red Scaly Rash Flashcards
first step in management of red scaly rash
rule out dermatophyte infection w/ KOH test
describe pityriasis rosea, usual pop
acute exanthematous eruption usually in younger ppl 10-35
pityriasis rosea pres
usually asymptomatic, can have flu like sx
starts w/ herald patch (oval patches w/ central clearing), goes away then secondary “christmas tree” eruption
brown, blue shades in darker skin
PR etiology
likely HHV6
PR tx
50% resolves in 5 weeks, most resolve w/o tx
topical steroids and antihistamines can help pruritis
macrolides and acyclovir may have benefit
describe secondary phase of syphilis
prodrome can have malaise, fever, headache, stiff neck, myalgias, arthralgias, runny nose, mental changes
clinical rashes can be variable
rash assoc w/ secondary syphilis
oval papules and plaques on trunk and extremities
lots of variation- can have condyloma lata or perianal papules
characteristic involvement of palms and soles
dx and tx for secondary syphilis
skin biopsy for T pallidum w/ immunostains
can confirm w/ serology, rapid plasma reagin
tx for early infection is IM benzathine peniillin
pres of nummular dermatitis
multi coin shaped eczematous plaques on extremities and trunk
scaly but not central clearing as would be seen in tinea corporis and KOH neg
very pruritic, main complaint
can have weeping and crusts
tx for nummular dermatitis
treat like any eczema- potent topical steroids and emollients
asteatotic dermatitis
aka xerotic eczema
affects lower legs, flanks, arms of elderly
flaking of skin, pruritis
skin cracks and dries like bed of dry lake
approach to red scaly rash
- tinea corporis? do KOH test
- KOH neg? test for psoriasis w/ strep history or maybe biopsy
- PR? teens w/ herald patch, skin line rash (rule out syphilis)
most other causes steroid responsive
