Q&A STUDY GUIDE GRADED A+
◉Contact Dermatitis. Answer: An inflammation of the skin caused
by having contact with certain chemicals or substances; many of
these substances are used in cosmetology.
It is very pruritic, and usually there is no lichenification. Lesions
evolve into vesicular bullae that easily rupture leaving bright-red
moist areas that are painful
◉Contact dermatitis Treatment:. Answer: • First Line: o Stop
exposure to substance • Topical steroids QD to BID x 1-2 weeks •
Consider referral to allergist for patch testing
◉Scabies. Answer: Pruritic rash located in the interdigital webs of
the hands, axillae, breasts, buttock folds, waist, scrotum, and penis •
Severe generalized itching that is worse at bedtime • Family member
will have same symptoms
o Apply cream to skin from neck to soles of feet. Leave on for at least
8-14 hours then rinse off. Repeat in 1 week o Scabies never go to
scalp! o Treat everyone. Wash sheets and all other items in house in
hot water
--Scabies never go to scalp
,TREAT EVERYONE
◉Pityriasis Rosea: Symptoms. Answer: May be itchy
Herald patch appears 2 weeks before full breakout
Christmas tree pattern
Rash on the hands or soles of the feet
◉Pityriasis Rosea: Treatment. Answer: Resolves on its own in about
4-6 weeks
Test for secondary syphilis with RPR then VDRL as screening • If
positive then do FTA-ABS if this is positive patient has syphilis; treat
appropriately
◉Tinea Corporis (body-think of core): symptoms. Answer: Ring like
itchy rash, slowly enlarges with central clearing
◉Tinea Corporis (body-think of core): Treatment. Answer: Most
respond to topical antifungals, if severe do oral Lamisil
Med ends with azole on exam
,◉Tinea Capitis (scalp-think of baseball cap): symptoms &Treatment.
Answer: Scaly round itchy patches on the scalp. Hair becomes fragile
at the roots and breaks (black dot sign)
Treatment: Oral meds only (Griseofulvin, terbinafine, fluconazole, or
itraconazole)
Obtain baseline LFT and repeat in 2 weeks o Gold standard: §
Griseofulvin QD-BID x 6-12 weeks
Avoid hepatotoxic substances (alcohol, statins, acetaminophen)
Avoid sharing combs, headgear, towels, pillows, and clothes with
others
◉Tinea Cruris (groin):symptoms and treatment. Answer:
Erythematous annular (ring-shaped) rash located in the groin area
which can sometimes extend to buttocks
Usually associated with tinea pedis
Treatment: • Azole topical cream (Lamisil, Lotrimin, Monistat-Derm)
x 7-14 days
◉Tinea Pedis (Hands/Feet- think pedicure):symptoms and
treatment. Answer: Symptoms: • Scaling of the soles • Skin feels wet,
strong odor, vesicles and bullae that rupture • "Two feet and one
hand" disease (dominant hand used for itching the feet becomes
infected)
, Treatment: Azole topical cream (Lamisil, Lotrimin, Monistat-Derm) x
7-14 days
◉Onychomycosis aka tinea unguium (fingernail or toenail fungus):
Symptoms and treatment. Answer: Symptoms: Elderly with yellow-
colored nails
Thickened nails with debris Treatment:
Mild cases fingernails: o Topical Penlac
Toenails: Systemic antifungals either 6 weeks or pulse therapy
(once per week for 3- 4 cycles)
◉Tinea Versicolor: Cause/symptom/treatmetn. Answer: Cause: •
Yeast Pityrosporum orbiculare or P. ovale Symptoms: • Multiple
hypopigmented round macules on chest, shoulders, and/or back
that appear after skin becomes tan from sun exposure
Condition is asymptomatic • KOH slide will show hyphae and spores
("spaghetti and meatballs")
Treatment: • Topical selenium sulfide and topical azole antifungals
(Nizoral) or terbinafine (Lamisil) cream BID x 2 weeks •
Hypopigmented spots may take several months to fill in
◉Herpetic Whitlow (caused by herpes simplex): symptoms and
treatment. Answer: Symptoms: HSV 1 or HSV 2 infection