Step2 Derm

>6mm

• Full thickness biopsy, not shave
• Removal, interferon injections for widespread

Sunlight and immunosuppressive drugs such as with organ transplant

• Shave bx
• Mohs micrographic surgery - immediate frozen section with no wide margin
• <5%

• Skin, GI, lung
• In pts with AIDS via sex, not IVDU
• Tx AIDS, intralesional vincristine or interferon, chemo with liposomal doxorubicin

• Premalignant to squamous
• Remove with curettage, cryo, laser, 5FU, or imiquimod

• Moisture
• Avoid irritants including soaps and washcloths
• Topical corticosteroids for flares - oral if severe
• Tacrolimus and pimecrolimus - Tcell inh for tapering off steroids and long term, topical
• Antihistamines- if severe, doxepine
• Antibiotics - cephalexin, mupirocin, repatamulin for secondary imetigo
• UV light

• Local:
• Topical steroids
• Vit A and D (calcipotriene) ointment to taper off roids to prevent atrophy
• Coal tar
• Pimecrolimus and tacrolimus for delicate areas

• Extensive:
• UV
• TNF inh - etanercept, adalimumab, infliximab
• Methotrexate - liver and lung sides

• Pityriasis rosea
• Steroids and UV

• Hypersensitivity rxn to dermal infection of dermatophyte
• AIDs, Parkinson
• Steroids, ketoconazole

• -idiopathic or drugs:
• ACEi,
• penicillamine,
• phenobarbital,
• penicillin

• -Nikolsky sign
• mouth involved
• More fluid loss
• More infections

• -Prednisone
• azathioprine or mycophenolate to wean off
• Rituximab (anti-CD20) or IVIG for refractory

• Prednisone
• Taper with azathioprine, cyclophosphamide or mycophenolate
• Mild: erythromycin, dapsone, nicotinamide

Blistering of sun exposed with involvement of backs of hands and face in pts with HepC, etoh, estrogen, or iron overload

hypersensitivity to abnormal porphyrins when they are exposed to light due to deficiency in uroporphyrin decarboxylase activity

dx with inc uroporphyrins in a 24hr Ur

Correct underlying

• Mupirocin
• Bacitracin
• Repatamulin
• Severe: oral dicoxacillin or cephalexin
• Comm MRSA: Doxy, Clinda, bactrim

• Strep>staph
• Red, hot, lesion on face, bacteremia, leukocytosis, F/C. Can lead to glomerulonephritis if GAS (not rheumatic fever)

• Mild: oral
• Dicloxacillin, cephalexin, cefadroxyl
• Pen all- erythromycin, clarithro, clinda
• MRSA- doxy, clinda, bactrim

• Severe: fever - IV
• Oxacillin, nafcillin, cefazolin
• Penn all - clina, vanc
• MRSA - vanc, linezolid, dapto, tigecycline

• Folliculitis is small
• Furuncle is small abscess
• Carbuncle is collection of furuncles

• KOH prep
• Fungal cx
• Topical antifungal. If hair or nail - terbinafine or itraconazole

• Clotrimazole
• Ketoconazole - antiandrogenic, oral leads to gynecomastia
• Econazole
• Miconazole
• Nystatin - only for yeasts
• Ciclopirox

• Thiazides
• Furosemide
• Sulfonylureas

• Pen
• Sulfa
• Allopurinol
• Phenytoin
• Lamotrigine
• NSAIDs

• Morbilliform rash: no tx, no mucous memb
• Erythema multiforme: widespread, no mucous, prednisone
• Stevens-Johnsons: mucous involved, can lead to resp failure. IVIG
• Toxic epidermal necrolysis: mucous, Nikolsky. IVIG

• Looks like TEN
• Hypotension, Renal, Liver, Delirium

• Mild: Benzoyl peroxide
• Topical clinda or erythro

• Mod: Topical Vit A - tretinoin, adapalene, tazarotene
• Oral abx - minocycline, doxycycline

Severe: oral vit A - isotretinoin (side: hyperlipidemia)