Derm-(28Jul) Psoriasiform Disorders

Psoriasis
– waves of recurrent fever & pustule: pathognomonic
– psoriasis-pitting
Pityriasis
– salmon-color (pink-orange), waxy plague
– start in the head & neck
– alternating horizontal & vertical
– with follicular plague, hyperkeratotoc
– resolved within 3years
– not give systemic -> no need regular lab test
– give emollient, vit D3 (calcitriol)
– severe give oral retinoid (isotretinoin)
– need to do lab first
– teratogenic
– methotrexate
– 2nd line: high-potency corticosteroids
– phototherapy
Diff diag
– psoriasis
– nail pitting, auspitz, dermacated plague with slivery white skin
– Seborrhic dermatitis
– intra dermal microabcesses (Monro)
Pityriasis rosea
– pink salmon patch, gradually fading but will pigmented, christmas tree
pattern
– (-)Auspitz sign
– self-limiting 6-8 wk
– even with treatment there will still be new lesion
– no long-term effect
– usually young adult-teenager
– look like viral examthems (herpes)
– usually @trunk (rare in the neck)
– no need blood test
Diff diag
– tinea corporis
– fungal infection
– (+)KOH examination
– scale usually at the edge/periphery
– Guttate
– small drop-like lesion
– scale on top, with auspitz sign
– Nummular dermatitis

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Derm-(4Aug) M5. Bacterial infection of the skin

– usually 2nd infection
no bleeding if remove crust (Neg Auspitz)
– Cep > erythromycin
– 0.9 NaCl solution soak in gauze -> leave 2-3 mins -> remove & wash
with water
– Burrow’s solution only reserved for derm doc
– crowded area
alopecia -> impaired hair growth
…
Nasal decompression
– cotton bud soak saline -> iodine -> topical ABO
– 2-3 times a day
very red, face&scalp,
– systemic ABO naja
(Left) beginning area then spread (right)

follow laceration
*febrile, exfoliate in sheets, (+)Nikolsky sign
SSS -> TEN
tampons, multiorgan,
Corynebacterium, @sole of feet, moist
web between 4-5th toe, corynebacterium minutissimum

macerated area
wood light เจอ coral red, gram stain
erythromycin

non-contagious, KOH see corynebacterium

oatmeal leave on 2-5 mins
topical steroid+ABO

migratory,
…
Tx: ABO
*Lymphadenitis, (+)Ag test
*Farcy bud nodule

Tetracycline is DOC
Oraya - insect bite lesion
Nodular - elbow & knee
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