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Acne vulgaris
Prevalence Definition Common Demographics Pathogenesis Causes Aggravating Factors Differential Diagnoses Severity Classification Mild Acne Moderate Acne Moderate to Severe Acne Severe Acne Treatment Identification of Acne Severity Considerations Before Treatment Psychosocial Assessment General Measures Mild Acne Moderate Acne Severe Acne Specific Treatments Over-the-Counter Products: Benzoyl Peroxide Clindamycin Role of Antibiotics…
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Actinic Keratosis (Solar Keratosis)
Definition: Actinic keratosis is a precancerous scaly spot found on sun-damaged skin, also known as solar keratosis. Significance: Considered an early form of cutaneous squamous cell carcinoma (keratinocyte cancer). Clinical Presentation Complications Diagnosis Treatment Prevention Outlook Feature Actinic Keratosis Seborrheic Keratosis Nature Precancerous Benign Risk Can progress to SCC Non-cancerous…
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Acute Febrile Neutrophilic Dermatosis (Sweet Syndrome)
Introduction: Demographics: Etiology of Sweet Syndrome Malignancy-Associated Sweet Syndrome: Inflammatory and Autoimmune Disease Associations: Post-Infectious Sweet Syndrome: Drug-Induced Sweet Syndrome: Pregnancy-Related Sweet Syndrome: Triggers: Symptoms: Appearance of Skin Lesions: Constitutional Symptoms: Extracutaneous Manifestations: Diagnosis: Blood Tests: Treatment: Outcome:
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Alopecia
Types of Hair Loss/Alopecia Types of Alopecia Type of Alopecia Pathology Age of Onset Symptoms Risk Factors Differentials Diagnosis Treatment Androgenetic Alopecia Miniaturization of hair follicles influenced by androgens Varies; men in their 20s-30s, women usually post-menopausal Thinning in the crown area in men, diffuse thinning in women Genetics, androgens…
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Alopecia (kids)
Tinea capitis presenting with a solitary circular area of hair loss. Note there is a short stubble of broken hairs and the skin is inflamed. Tinea capitis presenting with a solitary circular area of hair loss. Note there is a short stubble of broken hairs and the skin is…
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Alopecia areata
Alopecia areata is an autoimmune condition causing hair loss, typically presenting as discrete bald patches on the scalp and potentially affecting all hair-bearing areas. Variants of Alopecia Areata Prevalence and Demographics Risk Factors Pathogenesis Clinical Presentation Diagnosis Differential Diagnosis Treatment Prevention Prognosis 4o
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Angular Cheilitis
Risk Factors Diagnosis Treatment General Measures Specific Measures
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Annular Lesions
Comparison of Annular Lesions Diagnosis Clinical presentation Treatment options Tinea corporis Scaly, annular, erythematous plaques or papules on glabrous skin Topical and systemic antifungals Discoid Eczema Less likely to have central clearing (but can occur)More confluent scales Annular psoriasis Silvery scaleNail pittingFamily history of psoriasis Pityriasis rosea Small, fawn-colored, oval…
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Asteatotic eczema (winter itch)
©DermNet NZ www.dermnetnz.org 2022 CLINICAL FEATURES TREATMENT
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Atopic dermatitis (Eczema)
Introduction: Demographics: Causes: Immune System Theory What is Atopy? Disease Manifestation and Triggers Inherited Barrier Defect Consequences of Filaggrin Loss Immune System Imbalance Th2 Cytokines Effects Microbiome Role Factors Contributing to Dry Skin Irritants Infection Role Allergens and Eczema Stress Impact Climate Influence Investigations for Atopic Dermatitis Diagnostic Criteria for…
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Basal Cell Carcinoma (BCC)
Prevalence: Risk Factors Skin Type: Sun Exposure: Personal History: Clinical Presentation Nodular BCC: Differential Diagnoses for Nodular BCC: Superficial BCC: Differential Diagnoses for Superficial BCC: Additional Characteristics Treatment Options
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Bed bug bites
presentation MANAGEMENT Eradication of bed bugs Prevention
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Bowen’s Disease
Overview Risk Factors Differential Diagnosis Treatment
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Bullous pemphigoid
most common form of autoimmune subepidermal blistering disease. occurs in 0.3% of cancer patients treated with checkpoint inhibitors, antibiotics, penicillamine, potassium iodide, frusemide, captopril, gold, penicillin, sulfasalazine, and topical fluorouracil looks like: treatment
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Cercarial dermatitis(swimmer’s itch)
caused by Preventative measures To reduce parasite numbers in the environment: To reduce the risk of cercariae on the skin: Symptomatic measures for itch and rash outcome
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Chilblains
Pathophysiology Epidemiology Risk Factors Clinical Manifestations Association with COVID-19 Diagnosis Management Complications and Prognosis Differential Diagnoses
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Contact Dermatitis
Appearance Diagnosis Treatment
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Dermatitis
Relationship with Eczema: Classification: Dermatitis can be categorized based on various factors: Epidemiology of Dermatitis Clinical Features of Dermatitis Racial Variation in Clinical Features Types of Dermatitis and Their Causes Exogenous Dermatitis: Endogenous Dermatitis: Atopic dermatitis — a common form of dermatitis occurring in children and adults, and often occurring in…
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Dermatitis herpetiform
This extremely itchy condition is a chronic subepidermal vesicular condition in which the herpes simplex-like vesicles erupt at the dermo-epidermal junction. Who Gets Dermatitis Herpetiformis? Pathology Differential Diagnosis of Dermatitis Herpetiformis Disease Differentiating features Dermatitis herpetiformis Pruritic, polymorphic, grouped and symmetrical lesions consisting of erythema, urticarial plaques, papules, vesicles and…
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diagnostic approach
common dermatological problems fall into one of seven categories Common dermatological conditions: AcnePsoriasisAtopic dermatitis (eczema)UrticariaSun-related skin cancerDrug-related eruptionsInfections Bacterial: – impetigo Viral: – warts– herpes simplex, herpes zoster– pityriasis rosea– exanthemata Fungal: – tinea– candidiasis– pityriasis versicolor Acute and chronicPapular: – pediculosis– scabies– insect bites A problem that does not…
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Diagnostic tools
Wood’s light examination of the eye after fluorescein staining. (A low-cost, small ultraviolet light unit called ‘the black light’ is also available.) Simply hold the ultraviolet light unit above the area for investigation in a dark room. Skin conditions that produce fluorescence in Wood’s light Tinea capitis Green/bright yellow (in…
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Dry Skin (Xerosis, Xeroderma, Asteatosis)
Introduction Demographics Causes Clinical Features Complications Diagnosis Treatment Prevention Outlook
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Eczema
Eczema, a chronic inflammatory skin disease, impacts approximately 20% of children and 3% of adults, manifesting as Also referred to as atopic eczema or atopic dermatitis Background: Diagnosis: 4. Diagnostic Features (American Academy of Dermatology): 5. Diagnostic Criteria (Hanifin and Rajka, UK Working Party): Differential Diagnosis: Differential diagnosis of eczema…
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Erythema Multiforme
Erythema Multiforme Prevalence and Demographics: Genetic Predisposition: Causes: Infections (90% of cases): Medications: Associated Conditions: Pathophysiology: Clinical Features: Prodromal Symptoms: Cutaneous Features: Mucosal Features: Complications: Diagnosis: Differential Diagnosis: Treatment: Mild Cases: Other Treatments: Severe Mucosal Disease: Recurrent Disease: Outcome:
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Erythema Nodosum
Definition: Etiology: Epidemiology: Pathophysiology: Histopathology: Clinical Presentation: Associated Symptoms: Diagnosis: Treatment and Management: Prognosis: Pearls and Other Issues:
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Erythrasma
Who gets erythrasma? Cause Clinical features Types of erythrasma Complications Diagnosis Treatment Prevention
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feet infections
Wearing boots for extended periods, especially in environments where the feet remain wet, warm, and confined, can lead to various infections and foot conditions. Here ar Trench foot
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Female Pattern Hair Loss (FPHL)
Causes Normal Hair Growth Cycle Hair Shedding and Miniaturisation Clinical Presentation: Diagnostic Approach: Treatment Options Overview: Medications: Other Treatments: Key Considerations: Factors Influencing Prognosis: Complications of Androgenetic Alopecia While AGA itself is mainly a cosmetic concern, it can be associated with various complications and linked conditions: Physical Complications: Psychological and…
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Flea bites
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Flexural Eczema
Definition: Atopic dermatitis that develops in flexural areas (backs of knees, inner elbows, wrists). Location: Eczema refers to skin conditions causing itchy, inflamed, cracked, and sore patches.Flexural eczema occurs where skin bends or folds (e.g., joints, skin creases).Common areas: inner elbows, behind knees, wrists, ankles. Affected Population: Common in late…
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Folliculitis
Causes
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Generalised pruritus
CAUSES: History Key examination Key investigations to consider Treatment
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Golfer’s vasculitis (summer leg rash)
Brachioradialis pruritus ‘golfer’s itch’
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Grover disease
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Ichthyosis vulgaris
excessive dry, scaly skin It is the most common form of the inherited ichthyoses
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Idiopathic Guttate Hypomelanosis
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Impetigo
Epidemiology Pathophysiology Causes Predisposing Factors Types of Impetigo Bullous Impetigo Non-Bullous Impetigo Primary Impetigo Secondary Impetigo Symptoms Signs Streptococcal Impetigo Staphylococcal Impetigo Complications Differential Diagnosis Common Uncommon Course Management Topical Therapy Systemic Agents Cephalexin (Keflex) Dicloxacillin Staphylococcus Suspected (especially MRSA) Prevention
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Infantile acne
Infantile acne usually starts after the age of 3 months, with comedones, papules and pustules on the cheeks and chin. For a diagnosis of acne, comedones must be present. See here for a photo of infantile acne. Milia, miliaria and neonatal cephalic pustulosis are commonly misdiagnosed as infantile acne. Most cases are mild and resolve by the age…
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Itchy anus
Itchy anus is a common complaint characterized by intense itching in the perianal area between the buttocks. It can result from infestations, skin infections, inflammatory skin conditions, or rarely, skin tumors. When there is no obvious cause, it is referred to as pruritus ani. Demographics Itchy anus affects up to…
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Keloid and hypertrophic scar
Hypertrophic scars Keloid scars Common in all races and ages. Less common; more frequent in Fitzpatrick skin types III to VI.Self-reported in 16% of Black individuals.More likely in Chinese than Indian or Malaysian origin.Least affected: White-skinned individuals and albinos.Genetic association with certain HLA haplotypes and blood group A.Associated conditions include…
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Keratosis Pilaris (chicken skin)
. Cause: Clinical Features complications: Treatment:
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Lichen planus
Causes: characterised by MANAGEMENT
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Lichen simplex
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Malassezia folliculitis / pityrosporum folliculitis
Definition: Associated Conditions: Who Gets Malassezia Folliculitis? Clinical Features: Diagnosis: Differential Diagnosis: Treatment: Prevention:
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Male pattern hair loss (androgenetic alopecia, balding)
Cause: DHT Effects: 5-Alpha Reductase: Genetics: Genetic Testing: Women with Male Pattern Hair Loss (MPHL) Characteristics: Female Pattern Hair Loss Prevalence: Prevalence of Male Pattern Baldness General Prevalence: Specific Statistics: Pathophysiology Role of Androgens: Normal Hair Growth Cycle Anagen Phase (Growth Phase): Catagen Phase (Transition Phase): Telogen Phase (Resting Phase):…
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Medications in Dermatology
Corticosteroids Generic name Formulation Group I Mild Desonide 0.5% Lotion Hydrocortisone 0.5%, 1% Cream, ointment Group II Moderately potent Betamethasone valerate 0.02% Cream Betamethasone valerate 0.05% Cream, ointment Clobetasone butyrate 0.05% Cream Triamcinolone acetonide 0.02%, 0.05% Cream, ointment Group III Potent Betamethasone valerate 0.1% Cream, ointment Betamethasone dipropionate 0.05% Cream,…
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Melanoma
Skin Neoplasia Naevi and Melanoma Naevi = hamartoma of the skin. With respect to melanocytes, a benign neoplasm Melanocytic Naevi Dysplastic melanocytic naevi (Atypical Mole Syndrome): Halo naevi: Blue naevus Melanoma Risk Factors: VERY HIGH RISK: Less strong factors include Extrinsic Risk Factors for Melanoma Solar UV radiation [8,11,12] ● Intermittent…
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Molluscum contagiosum
Overview Age and Prevalence Spread Complications Treatment Physical Treatments Medical Treatments Prevention
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Necrotizing Fasciitis
Overview: Causative Organisms: Monomicrobial pathogens: Polymicrobial pathogens: Risk Factors: Clinical Assessment: History: Examination: Investigations: Laboratory: Imaging: Other: Management: Resuscitation: Specific Therapy: Empiric Antibiotics: Other Therapies: Supportive Care and Monitoring: Consults: Disposition: Prognosis:
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Neonatal Rashes
Erythema toxicum Milia neonatal pustular melanosis Acropustulosis of infancy
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Nummular/discoid eczema
scattered, well-defined, coin-shaped and coin-sized plaques of eczema. Discoid eczema is also called nummular dermatitis The eruption can be precipitated by: Differentials : annular skin eruptions including Management
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Onychomycosis
Onychomycosis, also known as tinea unguium, is a fungal infection of the nails. Accounts for over 50% of all nail diseases, with an estimated 5.5% prevalence. Toenails, fingernails, or both. Differential diagnosis of onychomycosis Differential diagnosis Clinical features Nail psoriasis Shares many common clinical and histopathological features with onychomycosisFingernails are…
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Oral Antifungals
Azoles 2. Terbinafine 3. Griseofulvin Monitoring and Considerations
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Periorificial dermatitis
Periorificial dermatitis (POD) is a chronic inflammatory skin condition, characterized by eruptions around the body’s orifices. Here’s a breakdown of what it is, who it affects, its causes, clinical features, complications, diagnosis, differential diagnosis, treatment, and outcome: What is Periorificial Dermatitis? Who Gets Periorificial Dermatitis? Causes Clinical Features Complications Diagnosis…
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Periorificial Dermatitis (POD)
Definition and Characteristics: Prevalence and Demographics: Etiology and Risk Factors: Clinical Presentation: Complications: Diagnosis: Differential Diagnosis: Treatment Approaches: Outcome and Prognosis: This comprehensive summary provides an in-depth look into the nature, prevalence, etiology, clinical presentation, complications, diagnosis, differential diagnosis, treatment approaches, and outcomes associated with Periorificial Dermatitis.
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Photodermatitis
Who gets photosensitivity? Classification of photosensitivity Causes Clinical features Complications Diagnosis Treatment Prevention Outlook
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Pitted Keratolysis
Pitted keratolysis, also known as keratolysis plantare sulcatum or ringed keratolysis. is a Superficial bacterial skin infection. Characterized by crater-like pits on the skin and often accompanied by a malodorous smell. Primarily affects pressure-bearing areas on the soles of the feet; rare occurrences on the palms. Prevalence and Risk Groups…
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Pityriasis alba
Treatment No treatment is necessary for asymptomatic pityriasis alba.
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Pityriasis rosea
Possible Causes: Stages of Development: Treatment: General Measures: Specific Measures: Notes:
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Pompholyx
It is not related to occlusion of sweat glands as was first thought when the disease was recognised over 100 years ago, but there are some factors associated with the disorder, including: DDx Mx
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Prurigo nodularis / Nodular prurigo
DDx Mx
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Pruritus ani
Typical Patient Profile: Aetiology Idiopathic Causes: Benign Aetiology: Faecal Soiling, Diet, and the Itch-Scratch Cycle Causes of Faecal Soiling: Contributing Factors: Anorectal Conditions Common Conditions: Serious Conditions: Skin Disorders Contact Dermatitis: Therapeutic Agents: Infections Fungal Infections: Bacterial Infections: Parasitic Infections: Investigations Initial Review: Tests: Management Normalisation of Bowel Motions: Cleaning…
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Pruritus in the Elderly
Skin Changes in the Elderly: Factors in Skin Ageing: Differential Diagnosis: Common dermatological causes of pruritus Xerosis This is the most common cause of pruritus in the absence of an identifiable skin lesion. It is characterised by dry, scaly skin, usually in the lower extremities. Atopic dermatitis Atopic dermatitis is…
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Psoriasis
Types of psoriasis Differential diagnosis Infantile Seborrhoeic dermatitis, atopic dermatitis Plaque (commonest) Seborrhoeic dermatitis, discoid eczema, solar keratoses, Bowen disease Guttate Pityriasis rosea, secondary syphilis, drug eruption Flexural Tinea, candida intertrigo, seborrhoeic dermatitis Scalp (sebopsoriasis) Seborrhoeic dermatitis, tinea capitis Nail Tinea, idiopathic onycholysis Pustular (palmoplantar) Tinea, infected eczema Exfoliative Severe…
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Pyogenic granuloma
Introduction Demographics Causes Clinical Features Dermoscopy Features Complications Diagnosis Differential Diagnoses Treatment Outcome
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Rashes (kids)
LESION DESCRIPTION PATHOGENS ORINFECTION a)Maculopapular rash macules – red/pink discrete flat areas, blanch on pressure papules – solid,raised hemispherical lesions, tiny, blanch on pressure VRS – Measles, rubella, roseola, erythema infectiosum, EBV, echovirus, HBV, HIV BACT – Erythema marginatum, scarlet fever, erysipelas, 2° syphilis, leptospirosis, Lyme dzs, RICK – Rocky…
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Red Rashes on Face
Background Assessment and Diagnosis Common Causes and Clinical Features Causes of red rashes on the face Diagnosis Morphology Distribution Clinical clues Diagnostic tests Atopic dermatitis (eczema) Erythema, scale, excoriations, xerosisLichenificationIll-defined plaquesHoney-coloured crusts if secondarily infected Anywhere on face, neck, scalp Variants: – NeckLips (eg licker’s eczema)– Eyelids (eg Dennie–Morgan folds)–…
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Rhinophyma
Cause of Rhinophyma: Other Forms of Phymatous Rosacea: Severity Classification: Demographics: Treatment Options: Complications:
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Rosacea
Background Clinical Features Demographics Pathophysiology Subtypes and Clinical Manifestations Cutaneous Features: Differential Diagnosis Complications Diagnostic criteria Major criteria (must occur in centrofacial distribution) Minor features In cases where there is diagnostic uncertainty, skin biopsy may be considered. Treatment Systemic Treatment Maintenance Therapy (if rosacea recurs within a month): Topical Treatment Apply for 6…
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Scabies
Differential diagnoses of classical scabies Insect bites Infections Dermatitis Immune-mediated Mosquitos Folliculitis Eczema Papular urticarial Midges Impetigo Contact dermatitis Bullous pemphigoid Fleas Tinea Pityriasis rosea Bedbugs Viral exanthems Diagnosis: Differential Diagnoses: Insect bites Infections Dermatitis Immune-mediated Mosquitos Folliculitis Eczema Papular urticarial Midges Impetigo Contact dermatitis Bullous…
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scalp rashes
The most common scalp symptoms are: Itch, Soreness, Scale/flaking, Pustules/sores Pityriasis amiantacea Very thick asbestos-like scaleScale is very adherent to hair shaftsSubsequent diagnosis usually seborrhoeic dermatitis or psoriasisPityriasis amiantacea Tinea capitis Irregular scaly plaques with moth-eaten hair lossMay have inflammatory, abscess-like kerionHairs are easy to extractPositive microscopy and culture of scrapings and extracted hairSometimes, fluorescence on Wood light examination Psoriasis Any age, most >…
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Scarlet Fever
Pathophysiology Epidemiology Symptoms Signs Labs Differential Diagnosis
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Seborrhoeic Keratosis
Definition Synonyms Prevalence Causes Clinical Features Variants of Seborrhoeic Keratoses Complications Diagnosis Histopathology Treatment Prevention Outlook
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skin bumps
Keratosis pilaris
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Squamous Cell Carcinoma (SCC)
Risk Factors Types of SCC Clinical Presentation Prognostic Factors Surgical Margins and Incomplete Excision Rate Recommended Surgical Margins Based on Risk Level Considerations in Determining Surgical Margin Referral to a Specialist (Dermatologist or Plastic Surgeon) High-Risk SCC Features and Multidisciplinary Referral Alternative Treatment Modalities Management of Incompletely Excised Lesions Follow-up…
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Stevens-Johnson Syndrome (SJS) / Toxic Epidermal Necrolysis (TEN)
Demographics Causes Clinical Features Complications Diagnosis Differential Diagnoses Treatment Prevention Outlook Related
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Superficial fungal infection diagnosis and treatments
Tinea Type Risk Factors Treatment Complications Tinea Capitis (Scalp Ringworm) Young childrenpoor hygienecontact with infected petsharing combs/hats Oral antifungals (e.g., griseofulvinterbinafineitraconazole) Permanent hair loss, secondary bacterial infection, kerion formation Tinea Corporis (Body Ringworm) Contact with infected individuals or animalswarm and humid climatescompromised immunity Topical antifungals (e.g., clotrimazole, miconazole) for mild…
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Telogen Effluvium
Contrast with Anagen Effluvium Population Affected by Telogen Effluvium Causes and Triggers Clinical Features and Presentation Chronic Telogen Effluvium Characteristics Diagnostic Approach Differential Diagnosis Considerations Management Strategies Prognosis and Outcome
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Terminology Of Skin Lesions
Primary lesions Macule Circumscribed area of altered skin colour (Latin for stain) without elevation <1 cm diameter Patch Macule of >1 cm diameter Papule Palpable mass on skin surface <1 cm diameter Plaque A flat-topped palpable mass >1 cm diameter. Nodule A circumscribed, solid palpable mass >1 cm diameter Wheal…
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Tinea cruris
TREATMENT
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Tinea incognito
Tinea incognito (often mislabeled as “tinea incognita”) is a fungal infection modified and exacerbated by the inappropriate use of topical steroids, leading to an altered clinical appearance. The clinical features may become masked with attenuated scale and erythema, as well as a less well-defined border The infection may also be…
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Tinea Pedis
Tinea pedis, commonly known as athlete’s foot, is a fungal infection of the foot caused by dermatophytes. Causes Risk Factors Clinical Features Diagnosis Differential Diagnoses Treatment Non-Pharmacological Pharmacological Topical Antifungals Oral Antifungals Prevention
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Topical Steroids
click on heading to sort Potency Product-Name Active-Ingredient Formulation Pack Size Age Preg Cat Dosing Sched PBS Max Q & Repeats Very potent Diprosone OV3 Betamethasone dipropionate 0.05% (in optimised vehicle) Ointment 30 g 12 years+ B3 1-2 times daily S4 Not PBS Listed n/a Potent Betnovate Betamethasone valerate…
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Urticaria
Clinical Recommendations Urticaria Characteristics Etiology and Pathophysiology Aggravating Factors Classification CLASSIFICATION ACCORDING TO SITE Clinical History and Examinaiton Possible Etiologies: CLINICAL CLUE POSSIBLE ETIOLOGY Abdominal pain, dizziness, hypotension, large erythematous patches, shortness of breath, stridor, tachycardia Anaphylaxis Dermatographism, physical stimuli Physical urticaria Food ingestion temporally related to symptoms Food allergy…
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Vitiligo
Overview Epidemiology Race Sex Onset Inheritance Associated Autoimmune Disorders Treatment Specific Measures
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warts
Etiology Epidemiology Prognosis Treatment / Management