1 / 111

Dermatology in Primary Care

Dermatology in Primary Care. ???. Contact Dermatitis. Poison Ivy, oak and sumac are common causes of skin irritation Irritating substance is the same for each plant – do you know what it is?. Answer. An oily resin called: Urushiol (u-ROO she-ol). Poison Ivy Plant. Poison Oak Plant.

meris
Download Presentation

Dermatology in Primary Care

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Dermatologyin Primary Care

  2. ???

  3. Contact Dermatitis • Poison Ivy, oak and sumac are common causes of skin irritation • Irritating substance is the same for each plant – do you know what it is?

  4. Answer • An oily resin called: • Urushiol (u-ROO she-ol)

  5. Poison Ivy Plant

  6. Poison Oak Plant

  7. Poison Sumac Plant

  8. Diagnosis • Redness • Itching • Swelling • Blisters • Vesicular lesions – many times in a linear pattern

  9. ??? • How long does it take the reaction to develop after exposure? • How long can the reaction last?

  10. True or False • Spreading blister fluid from scratching doesn’t spread the rash.

  11. Treatment • Self-care methods: • Calamine lotion • Hydrocortisone cream 1% • Benadryl 25-50mg q 6 hours prn • Domboro’s or Bluboro’s solution for weeping lesions

  12. Widespread Rash • Oral Prednisone tapering dose over 2-3 weeks

  13. Complications • Scratching the rash with dirty fingernails may cause a secondary bacterial infection.

  14. Prevention • “Leaves of three, let them be” • Identify poison ivy, oak and sumac • Take precautions outdoors • Remove poison ivy • Clean anything that may be contaminated • Wash skin with mild soap and water

  15. Time to Laugh

  16. ???

  17. Tinea Versicolor

  18. Tinea Versicolor • Common fungal infection of the skin • Fungus interferes with the normal pigmentation of the skin resulting in small, discolored patches

  19. Symptoms • Small scaly patches of discolored skin • Patches grow slowly • Patches become more noticeable after sun exposure • Possible mild itching

  20. Symptoms • Most common in warm, humid climates usually affecting: • Back, Chest, Neck, Upper Arms • Patches can be various colors: • White, Pink, Tan, Dark Brown

  21. Causes • Healthy skin may normally have the fungus growing in the hair follicles • Occurs when the fungus becomes overgrown. Factors that trigger growth: • Hot, humid weather • Excessive sweating • Oily skin • Hormonal changes • Immunosuppression

  22. Diagnosis • Examination of skin • If there is doubt can take skin scraping and view under microscope

  23. Treatment • OTC antifungal lotion, cream, or ointment for mild cases • If severe or doesn’t respond to OTC: • Topical: Selsun 2.5% lotion, Loprox cream, or Nizoral cream or shampoo • Oral: Nizoral, Sporanox, or Diflucan

  24. Prevention • Avoid oil or oily products to skin • Avoid wearing tight clothing • Can prescribe a topical or oral treatment taken once or twice a month for chronic cases.

  25. ???

  26. Hives • AKA – Urticaria • Raised, itchy welts (wheals) of various sizes that appear and disappear on skin • One in five people experience • Usually harmless • Can be acute or chronic

  27. Causes • Causes by inflammation in the skin • Triggered when mast cells release histamine into the bloodstream and skin • Allergic reaction to: • Food • Medications • Other allergens • Physical factors • Dermatographism

  28. Diagnosis • Examination of the skin reveals raised, pink to red, warm wheals. • Can be located anywhere on the body. • Classic complaint from patient: “They come and go in different places”.

  29. Risk Factors • Prior history of hives/angioedema • Other allergic reactions • Lupus, lymphoma or thyroid disease • Family history of hives

  30. Acute vs. Chronic • Usually hives are self-limited and can be treated at home • If hives continue for several days or become worse medical evaluation is warranted • Considered chronic if persist 6 weeks or longer

  31. Chronic Hives • If develop chronic hives further evaluation is warranted • Referral for allergy testing • Blood tests – CBC, ESR, TSH, RF, ANA, Hepatitis panel

  32. Treatment • OTC – Benadryl, Chlor-Trimeton, Tavist, Alavert, Claritin, Zyrtec • RX – Clarinex, Allegra, Atarax, Vistaril

  33. Prevention • Avoid known triggers • Keep a food diary

  34. Time to Laugh

  35. ???

  36. ???

  37. ???

  38. Folliculitis/Furuncle • Infection of the hair follicles • Most infections are superficial • Can clear on it’s own in a few days

  39. Diagnosis • Folliculitis • Clusters of small red bumps that develop around hair follicles • Pus-filled blisters that break open and crust over • Itchiness or tenderness

  40. Diagnosis • Furuncle/Boil: • A large swollen bump or mass • Pus-filled blisters that break open and crust over • Usually painful • Possible scars once the infection clears

  41. ??? • What organisms cause folliculitis?

  42. Types of Folliculitis • Pseudomonas (hot tub folliculitis) • Tinea barbae • Pityrosporum • Pseudo folliculitis barbae

  43. Treatment • Warm compresses • Anti-itch creams • Antibiotics – oral or topical • Antifungals – oral or topical • Accutane • I&D

  44. Complications • Cellulitis • Furunculosis (reoccurring boils) • Scarring • Destruction of the hair follicle

  45. Prevention • Avoid constrictive clothing • Shave with care • Maintain hot tubs

  46. Time to Laugh

  47. ???

  48. Pityriasis Rosea • PR occurs most commonly in ages 10-35 • Rash can last from several weeks to several months • Usually no permanent marks • Can occur at anytime of year but most common in the spring and fall

  49. What is this lesion called?

  50. Cause • Unknown • Recent evidence may be a virus – not proven • PR does not seem to spread from person to person • Usually only occurs once in a lifetime

More Related