1.

Contact Dermatitis

Allergic:

Allergic Contact Dermatitis is dermatitis or irritation of the skin caused by an allergic reaction
towards a certain substance, the reaction is delayed and require a desensitization phase before
the reaction could occur, the reaction may not occur for the first exposure but may occur after
the second or third exposure. It is very common in all age groups. It is immune modulated, and
laboratory testing reveals IgE antibodies and elevated histamine levels. Proliferation of TH1 and
TH2 cells may also be observed, TH1 is directly correlated with the release of interferon gamma,
while TH2 secrete IL4, these two substances causes an urticarial responses.

Diagnosis of Allergic Contact Dermatitis can be done with 2 test which is indicated with the
suspicion of allergic reaction, the patch test and the skin prick test. This diagnosis is crucial in the
treatment as it allows the allergenic culprit to be identified and subsequently avoided.

Treatment includes topical corticosteroids for great outbursts, antihistamines for smaller
outburst, and gentle cleansing of the area with either no soap or gentle cleansers.

Irritant:

Irritant Contact Dermatitis is caused by a sufficient amount of contact with an irritating

substance. Known as occupational dermatitis or housewives dermatitis, take a guess to what
demographic that is prone to getting this type of dermatitis. The clinical features may be
identical to that of Allergies. Irritants requires sufficient contact in order to proc a reaction, but
bioaccumulation may confuse physicians with an allergic reaction.

2. Skin disease classification

 Infection
o Fungal
 Tinea
 Candidiasis
o Bacterial
 Impetigo contagiosa
 Lupus Vulgaris
 Anthrax
 TBC
 Sarcoidosis
 Hansen’s disease
o Protozoal
 Lyme Disease
 Leishmaniasis
o Viral
 Herpes Simplex
 Herpes Zoster
 Varicella
 HPV warts
 Verruca vulgaris
 Condyloma acuminatum
 Molluscum Contagiosum
 Infestations
o Sarcoptes Scabiei (Scabies)
 Normal Scabies
 Crusted Scabies
o Pediculosis
 Capitis
 Pubis
 Corporis
o Onchocerciasis
 Bug Bites
o Cimex spp
o Hymenoptera spp
o Diptera spp.
o Mites
o Ticks
 Immune Mediated
o Dermatitis
 Atopic
 Seborrhoeic Dermatitis
 Herpetiformis
 Contact
 Irritant
 Allergic
o Psoriasis
o Lichen Planus
o Lichen simplex
o Erythema
 Multiforme
 Nodosuum
o Lupus
o Drug Eruption
 Acne
o Acne
o Rosacea
 Benign Growths
o Epidermal Tumor
o Melanocytic naevi
o Angioma
o Dermatofibroma
o Leiomyoma
o Lipoma
o Cyst
 Malignancy
o Melanoma
o Non-melanoma skin cancer
o Lymphoma of skin
3. Skin testing

Patch testing: Patch tests are used to help diagnose skin allergies. Identified allergens
(substances that a person may be allergic to) are applied to the skin on the back with
adhesive patches and left for a period of time. The skin is then examined for any reaction.

Skin biopsy: Skin biopsies are performed to diagnose skin cancer or benign skin disorders.
During a skin biopsy, skin is removed (after a local anesthetic is applied) and is taken to a
laboratory for analysis. Skin may be removed with a scalpel, Gillette blue blade, or a
cylindrical punch biopsy tool. Stitches may be used to close the wound.

Culture: A culture is a test that is done to identify the microorganism (bacteria, fungus, or
virus) that is causing an infection. Skin (surface scrapings, biopsies, contents of pus bumps
and blisters), hair, or nails may be cultured to detect bacteria, fungi, or viruses.

Wood light: (black light) can help clinicians diagnose and define the extent of lesions (eg,
borders of pigmented lesions before excision). It can help distinguish hypopigmentation
from depigmentation (depigmentation of vitiligo fluoresces ivory-white and hypopigmented
lesions do not). Erythrasma fluoresces a characteristic bright orange-red. Tinea capitis
caused by Microsporum canis and M. audouinii fluoresces a light, bright green. (Note: Most
tinea capitis in the US is caused by Trichophyton species, which do not fluoresce.) The
earliest clue to cutaneous Pseudomonas infection (eg, in burns) may be green fluorescence.

Tzanck testing: can be used to diagnose viral disease, such as herpes simplex and herpes
zoster, and is done when active intact vesicles are present. Tzanck testing cannot distinguish
between herpes simplex and herpes zoster infections. An intact blister is the preferred lesion
for examination. The blister roof is removed with a sharp blade, and the base of the
unroofed vesicle is scraped with a scalpel blade. The scrapings are transferred to a slide and
stained with Wright stain or Giemsa stain. Multinucleated giant cells are a sign of herpes
infection.

4. Principles of Dermatotherapy

Principles of Topical Therapy at a Glance

The efficacy of a topically applied drug depends on its inherent potency and on its ability to
penetrate skin.

Some factors that affect penetration include: concentration of medication, thickness and
integrity of the stratum corneum, frequency of application, occlusiveness of the vehicle, and
compliance.

Topical formulations are meant to enhance the beneficial effects of the medication.

Either the vehicle or its active ingredient(s) may cause local toxicity.

Topical medications may induce systemic toxicity.

Sensible topical drug therapy involves not only the selection of an appropriate agent, but
also a thoughtful consideration of the areas of the body affected, the state of the diseased
skin, the concentration of the drug, the type of vehicle (e.g., ointment, cream, lotion), the
method of application, and a defined duration of use that both maximizes efficacy and
minimizes adverse side effects.
5. Oral Steroids

6. Topical Steroid Potency

7. Vehikulum

Cream

Due to their water content, creams are easily absorbed in the skin. This can make them ideal
for widespread treatment areas. At the same time, the oil content is desirable if you have
dry skin, rashes, or skin lesions because the product stays on the surface of your skin for
protection against moisture loss.

As daily moisturizers, creams are typically sold in jars. Treatment creams, such as
hydrocortisone for bug bites and rashes, may come in tubes for more precise application.

Ointment

Of all skin products, ointments contain the highest oil content. Their purpose is to have an
occlusive effect, which means they stay on top of the skin, rather than being absorbed right
away. This offers more protection against moisture loss and elements like dry air. Common
ingredients found in ointments include mineral oil and petroleum.

Topical medications, such as antibiotics for infections or corticosteroids for psoriasis, may be
ideal in ointment form because they don’t evaporate off the skin, ensuring maximum
product absorption. Extremely dry skin may also benefit from moisturizers in ointment form
due to the same benefits.