ANSWERS
• - ANSWER Common dermatological conditions in primary care -
pediatric, pregnancy, adult and geriatric
o - ANSWER Christmas tree pattern=pityriasis rosea
o - ANSWER Honey-colored crusts=impetigo
o - ANSWER Erythema migrans= lyme disease
o - ANSWER Ring-shaped pruritic area with some central clearing-tinea
corporis (ringworm)
o - ANSWER Papules and vesicles on a dermatomal pattern= varicella
zoster virus
o - ANSWER Painful nodules in the axilla=hidradenitis suppurativa
o - ANSWER Pinpoint bleeding when scale is removed=psoriasis
o - ANSWER Atopic dermatitis
- ANSWER Chronic inherited skin disorder marked by extremely
pruritic rashes that are located on the hands, flexural folds, and neck
(older child to adult). Rashes are exacerbated by stress and
environmental factors. It is associated with atopic disorders such as
asthma, allergic rhinitis, and multiple allergies
- ANSWER Classic case: infants up to 2 years of age have a larger
area of rash distribution compared to teens and adults. The rashes are
typically found on the cheeks, entire trunk, knees, and elbows. Older
,children and adults have rashes on the hands, neck, and antecubital and
popliteal space (flexural folds). The classic rash starts as multiple small
vesicles that rupture, leaving painful, bright-red, weepy lesions. The
lesions become lichenified from chronic itching and can persist for
months. Fissures form that can be secondarily infected with bacteria
- ANSWER Medications= topical steroids and emollients are 1st line
treatment. Mild disease: hydrocortisone 2.5% (low-potency, group 5).
Moderate disease: triamcinolone acetonide (medium potency, group 4).
Facial skin, skin folds are at higher risk for skin atrophy. Use
hydrocortisone 1% (low potency, group7).
o - ANSWER Tinea versicolor
- ANSWER Superficial skin infection caused by yeasts pityrosporum
- ANSWER Classic case: complains of multiple hypopidmented round
macules on the chest, shoulders, and back that appear after skin
becomes tan from sun exposure; asymptomatic.
- ANSWER Labs potassium hydroxide (KOH) slide: hyphae and spores
(spaghetti and meatballs)
- ANSWER Medications= topical selenium sulfide and topical azole
antifunguals such as ketoconazole (Nizoral), terbinafine (Lamisil) cream
BID x 2 weeks. Spots may take several months to disappear
o - ANSWER Candidiasis
- ANSWER Superficial skin infection from the yeast candida albicans.
- ANSWER Classic case: an obese adult complains of bright-red and shiny
lesions that itch or burn, located on the intertriginous areas ( under the
breast in females, axillae, abdomen, groin, the web spaces between the
toes). The rash may have satellite lesions (small red rashes around the
main rash)
, - ANSWER Thrush= complains of severe sore throat with white adherent
plaques with a red base that are hard to dislodge on the pharynx.
- ANSWER Treatment= nystatin powder and/or cream in skin folds BID.
OTC tropical antifungals are miconazole, clotrimazole.
- ANSWER Keep skin dry and aerated
o - ANSWER Folliculitis
- ANSWER Infection of the hair follicles
- ANSWER Small 1mm round lesions filled with pus with erythema.
- ANSWER Avoid shaving or scrubbing area.
o - ANSWER Lyme disease
- ANSWER Expanding red rash with central clearing that resembles a
target "bulls eye."
- ANSWER Usually appears 7 to 14 days after a deer tick bite range 3-30
days.
- ANSWER Rash feels hot to touch, and has a rough texture.
- ANSWER Common locations belt line, axillary area, behind the knees,
and in the groin area.
- ANSWER Accompanied by flu like sxs
- ANSWER Spontaneously resoles within a few weeks
, - ANSWER Most common in the northeastern regions of the U.S.
- ANSWER Treatment plan doxycycline BID x 10 days (1st line drug for
both adults and children)
- ANSWER Alternative treatment Amoxicillin 500 mg TiD or Ceftin 500mg
Bid x 14 days
- ANSWER Complications= neuropathy, facial palsy, impaired memory
o - ANSWER Rocky mountain spotted fever
- ANSWER Classic symptoms include fever, headache, and rash
- ANSWER Caused by the bite of a dog tick that is infected with parasite
rickettsia.
- ANSWER Treatment is most effected within first 5 days of symptoms.
- ANSWER Doxycycline 100 mg BID for 7-714days is the 1st line
treatment for all age groups
• - ANSWER What treatments work better with which conditions
(ointments, cream, oral medications, etc).
o - ANSWER Alopecia areata, hyperkeratotic/nummular eczema,
lichen
planus, and psoriasis are treated with high potency topical
corticosteroid
class I to III
o - ANSWER Medium potency topical corticosteroids (class IV and V)
are
most often used for the treatment of atopic dermatitis,
seborrheic