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Name
Presentation
Caused by
DX
-Darrier’s Sign:
stroke it and
lesion becomes
really red and
gets a wheal
TX
Mastocytosis
-reddish-brown
-elevated
-non-blanchable
-macules
-patches
-topical steroids
-benadryl
Erythema
Multiforme
*Target lesions
(looks like bullseye)
-Inflammatory
-red
-pt feels ill
-infection
-virus
-medication
Drug
ReactionEXANTHAM
(rash)
-red macules
-papules
-generalized form
-new meds
-ampicillin/amox.
Drug
ReactionFIXED
DRUG
ERUPTION
-itch/burn
-DUSKY/REDDISH
COLOR
-well demarcated
-hyperpigmentation
after rash goes
away
-every time take
meds spot comes
back
-penis most
common site
Steven
Johnson’s
Syndrome
(SJS)
-mucus membranes
-hemorrhagic
crusting
-ulcerative
stomatitis
-SEVERE DRUG
INDUCED
REACTIONS
-Treat them as
burn victims
-IV
Toxic
Epidermal
Necrolysis
(TEN)
-Widespread
blistering
-skin is falling offNIKOLSKY’S SIGN
-SJS can progress
into this
-SEVERE DRUG
INDUCED
REACTIONS
-Treat them as
burn victims
-IV
Panniculitis-Erythema
Nodosum
-discrete pink
nodules
-on shin
-bilateral, diffuse
borders
-DEEP, into fat
-young teenage
female
-caused by
hypersensitivity
rxn to infection,
drugs
-treat them
symptomatically
-avoid medication
-must punch
biopsy down into
the FAT
-treat them
symptomatically
Name
Presentation
Caused by
DX
TX
Hypersensiti
vity
Vasculitis-Leukocytocla
stic
Vasculitis
-Palpable purpura
-lower legs then to
hands
-non-blanchable
-caused by
infection/drugs
-full workup, CBC,
CXR
-punch biopsy
-ESR will be high
-direct
florescence
-treat them
symptomatically
Vasculitis--HenochSchonlein
Purpura
-Palpable Purpura
-Lower legs and
buttocks
-children
-non-blanchable
-caused by a virus
-treat them
symptomatically
Eczematous
Dermatitis
-Poorly defined red
patches, plaques
-edema
-moist, crusted,
erosions
-face, neck, wrists
-frequent
washing/bathing
-stress
-hormonal
changes
-topical
antibiotics, wet
dressings
-stress
management
Pityraisis
Alba
-SCALY
-Hypopigmented
elevated
-no borders
-eczema
-asthma
-allergies
-KOH negative
-scrape it
-treat them
symptomatically
Keratosis
Pilaris
-chicken skin
-in hair follicles
-upper arms,
cheeks
-worse in winter
-follucilar plugging
-hydrate skin
-exfoliate
Lichen
Simplex
Chronicus
-Thick
-Like eczema, but
created by habitual
rubbing/scratching
-”localized
neurodermatitis”
-eczema
-topical
antihistamines
Asteatotic
Eczema
-chapping
-below the knee
down
-superficial fissures
-certain pattern,
crackling
-winter months
Nummular
Eczema
-DX of ringworm
common
-”coined shaped
eczema”
-after humid
summer
Name
Presentation
Caused by
DX
TX
Dyshydrotic
Eczema
-blisters on hands
-bilateral, very
symmetrical
-vesicles
-peeling after 1/mo
-hot kitchen
-lots of hand
washing
Contact
Dermatitis
-intense,
inflammatory
-puritic
-papules
-vesicles erupt/drain
serous fluid
-oak, ivy, sumac
-neosporin
-nickel
-nuts/fruits
-delayed
exposure of
hypersensitivity
-frequently get
secondary
bacterial infection
-LINEAR: most
likely caused by a
plant
-BUROW’s
-benadryl
-avoid irritant
-1 injection of
steroids
-PREDINOSE
Stasis
Dermatitis
-legs, dry scaly
-brown staining of
skin
-scratching
-Champagne bottle
appearance
-venous/arterial
insufficiency
-spider veins
-winter months
-compression
stockings
-elevations
-topical steroids
Acute Stasis
Dermatitis
-inflammation
-red, superficial
-itchy plaque
-crusting
-Weeping
-winter months
-compression
stockings
-elevations
-topical steroids
Chronic
-recurrent
inflammation
-ulcers
-higher risk of
secondary infection
-cyanotic red plaque
over medial
malleous
-cobblestoning
-litchenficiation
-winter months
-compression
stockings
-elevations
-topical steroids
Seborrheic
Dermatitis
-Red patch with
yellow scales above
it
-face and scalp
-CRADLE CAP
**OILY**
-winter months
-stress
-fatigue
-scalp, ears,
nasolabial folds
-topical
antifinugals/sham
poos
-Yeast
-control sweating
-BUROW’s
perfect
-ointments work
best
-steroids
-oil on scalp
Name
Scabies
Presentation
-webs of fingers
-very itchy
-writs, hands, BELT
LINE
-Nocturnal Puritis
(nighttime itching)
-red papules,
excoriated,
vesicular lesions,
curved burrows
Caused by
-Eggs and Fecal
pellets of mites
-sexually
transmitted
-PALMS AND
SOLES OF
INFANT
-itching spreads
mites
DX
-drop mineral oil
on lesion, scrape,
put on slide, can
heat if neg at first
TX
-Elimite, one
application, neck
to toes, genitals
-wash all linens
-put pen head
inside burrow,
should enhance it
-roomates must
be tx as well
regardles of sxs
ALL THEY TALK
ABOUT IT
ITCHING
Pediculosis/li
ce
-behind ears, very
itchy and irritating
-close contact,
hats, hairs
Pediculosis
Capitis
-Nits cemented to
hair shaft
-close contact,
hats, hairs
Pediculosis
Pubis/ Crabs
-genitals, anus
Flea Bites
-ankles or lower
legs
-people with pets
Erythema
Migrans/
Lyme
Disease
-bullseye
-small papule
-NO SCALING
**even though there
is central clearing,
there is no scaling**
-deer ticks
Spider Bites/
Necrotic
Arachnidism
-Mild Uticarian
patch then changes
to NECROTIC
-dusky blue
appearance in
center
-solitary spot
-brown recluse
-black widow
-fluoresce under
woods lamp
-OTC shampoos
**Combing of
nits**
-30% have
another STD
-OTC shampoos
**Combing of
nits**
-spray or fogger
-prevention
-fades
-give doxycycline
profolactically
-treat them
symptomatically
Name
Neurofibrom
yosis
Xanthomas
Presentation
Caused by
-many cafe au lat
-Neurofibromas
-groin freckling
**Called CROW’s
Sign**
-nodules on iris
-body defects
-autosomal
dominant
-eyelids
-yellow-orange-pink
plaques
-cholesterol
deposition within
the macrophages
-GO TO EYE
DOCTOR
DX
TX
-crow’s sign looks
like cafe au lait
but with tons of
freckles inside it
-multiple
specialists
-genetic testing
-LABS, HDL, LDL
-laser
-excision
*electrodissication
**
Acanthosis
Nigrans
-Neck and Axillae
-Patches
-thickened
-hyperpigmentation
-”DIRTY SKIN”
-diabetes
-obese
-family HX
-with obesity and
diabetes
-labs: fasting
glucose
-topical cream
-exfoliating
creams
*tertinoin is off
label
prescription**
Dermatitis
Herpetiformis
-pruritic!! Scabbing!!
-vesicular, bullus
-elbow and knees
-glutin sensitivity
-Cilliac disease
Vitiligo
-Depigmenting
-KOBNER’S
PHENOMENON (if
injured patch will
develop)
-macular
-without scaling
-patches
-affects areas of
friction
-unknown
-THYROID
-MJ had it and
used bleach to
get rid of it....
removed all
melanocytes
-punch biopsy
-thyroid
-punch
- dermablend
makeup
- steroids, 2 wk
on, 2 wk off
- sunscreen
- tacrolimus:
gives back
pigment
Necrobiosis
Lipodica
-shins
-round patches
-center turns orange
-waxy
-diabetes
-take fasting
glucose
-steroids
-Legs
-Sharply defined
-purulent base
-ULCER
-IBS, Chron’s
Pyoderma
Gangrenosu
m
-biopsy
-Gluten free diet!!
**because its
vesicular you
want 2 biopsies**
-punch biopsy
immunosuppressi
ve meds
Name
Psoriasis
Presentation
Caused by
DX
-Punch Biopsy
-ASO titer
-KOH to rule out
yeast
TX
-looks like eczema,
but location gives it
away
-elbows and knees
-silvery-white scales
-KOEBNER
PHENOM.
-Abnormal Tlymphocyte
-abnormal skin
growth
Plaque
Psoriasis
-scalp, ankles,
knees
-symmetrical
-silvery scales
-AUSPITZ SIGN pin
point bleeding when
remove scale
-most common
-obese
-smoking
Guttate
Psoriasis
-RAINDROP
-small plaques
-recent strep
infection
-occurs suddenly
-ASO titer: looks
for strep
-UVB
phototherapy
-if ASO levels
high treat with
antibiotics
Inverse
Psoriasis
-along skin folds
-red, inflamed
-NO SCALING
-yeast infection
-hard to DX
-punch biopsy
-steroid, low to
mid potency
Erythrodermi
c Psoriasis
-inflammatory
-redness
-fever, pain
-severe sunburn
-triggered by
drugs
-uncommon
-severe
PalmarPlantar
Pustulosis
-palms and soles
-pustules
-nails involved
-red-based pustule
-brown scale
-smoking
-sterile puss
-topical steroid
creams
Nail and
Joint
Psoriasis
-pitting of nails
- oil drop sign
- asymmetrical
oligoarticular
- sausage fingers
-Labs normal
-gentile buffing of
nails
-steroids at nail
bed
-NO good
treatment
-mild: 2%
-Mod: 2-10%
-Severe: 10% +
-topical:
Corticosteroids
(tachyphlaxis-immune to
steroid)
Vitamin D
Tazorotene
-Phototherapy:
3XWk
-Systemic:
Tazorotene
(CATEGORY X)
Name
Pemphigus
Vulgaris
Presentation
Caused by
-blistering
(BULLAE, large)
-nikolsky’s sign -pressure on intact
skin, blister laterally
forms
-autoimmune
-60 y/o
-Ashkenazi Jews
-blisters-superficial
-crusted patches
-erosion
-face, scalp
-autoimmune
-middle-older age
-looks like
serrboheric
dermatitis
-sun and heat
exaserbate
Bullous
Pemphigoid
-skin folds common
areas
-hive-->plaques->bullae
-pruritis severe
-no nikolskys sign
-autoimmune
-IgG
Lupus
-superficial
-on face
-red
-Butterfly Rash
-autoimmune
-connective tissue
disease
Dermatomyo
sitis
-Grotton’s Papules
(on the knuckle no
rash)
-autoimmune
connective tissue
disorder
Scleroderma
-Symmetric FIbrous
Thickening of skin
Morphea
Pemphigus
Foliaceus
Acne
Vulgaris
DX
-punch biopsy
imunoflorescene
TX
-oral steroids
**always do 2 bc
its a blister**
-punch biopsy
-take Dpencillamine or
captopril
-early dx: topical
steroids
-late dx: oral
steroids
-steroids
-antihistamines
-atibiotics
-biopsy
-BLOOD TEST
-HX tells you
-topical steroids
-hypersensitive
pts
-Raynauds
-organs become
fibrotic, pt dies
-Penicillimine
-sclerotic dermal
plaques
-looks like bruise
that lasts forever
-shiny
-central
hypopigmentation
-idiopathic
-localized
scleroderma
-young women
-ANA +
-CBC: shows
eosinophilia
-dovinex
-comedones
-papules
-stress, young
women with
hormonal
changes
-bacteria
-Biopsy
-topical antibiotics
-Topical cream
(benzyole perox)
-Severe:
ACUTANE
(Isotretinoin)
Name
Presentation
Caused by
DX
TX
Rosacea
-clusters of papules
and pustules
-telangiectasias
-bulbous nose
-genetic
-treated like acne,
called adult acne
-topical skin
cream
-oral antibiotics
Perioral or
Periorbital
Dermatitis
-pinpoint papules
-scaling
erythematous base
-females more
common
-NO STEROIDS
-oral abx
Hidradentitis
Suppurativa
-DOUBLE
COMODONE
-sinus tracts
-groin
-obese
-weight loss
Furnucle
-ABCESS OR BOIL
-firm red papule
-nodulizes
Carbuncle
-infected follicles
-Firm red lesion
-drains through
multiple openings
Erysipelas
-IND
-Warm compress
-IND
-pts are very
sickly
-cannot IND
-ABX
-SUPERFICIAL
CELLULITIS WITH
LYMPHATIC
INVOLVEMENT
-due to surgery or
trauma
-face and legs
-GAS, S. Aureus
-ABX
Cellulitis
-Bordered red mass
-pain, redness
-GAS, Staph
Aureus
-ABX
Lymphangitis
-RED STREAK
-GAS
-IV ABX
Impetigo
-Honey Colored
Crust
-face, ezcema
erythematous base
-GAS, Staph
Aureus
-Highly
contageous
-ABX
-warm water
soaks
Folliculitis
-superficial
inflammation of hair
follicles
-papules and
pustules in hair
-butt and thigh
-hot tub dermatitis
-wash with abx
soap
-may have to give
oral ABX
Name
Presentation
Caused by
DX
TX
Name
Presentation
Caused by
DX
TX