TIKI TAKA DERMATOLOGY

((CELLULITIS))

. Generalized swelling which is erythematous "linear streaks", warm, tender but less well
demarcated than Erysipelas.

((Tinea Corporis))

. Ring shaped scaly patches with central clearin & scaly borders.

. Dx: KOH -----> Hyphae. . Tx: Local Terbinafine or systemic Griseofluvin.

((Tinea Versicolor))

. Pale velvety pink or whitish hypopigmented macules that DON'T TAN !

. SCALE ON SCRAPING.

. Dx: KOH preparation ----> Spaghetti & meat ball appearance.

. Tx: Selenium sulfide.

((NECROTIZING FASCIITIS))

. Severe pain & swelling.

. H/O of recent trauma.

. High fever > 39 c.

. Edematous limb with PURPLISH DISCOLORATION of the injured area "denoting start of
gangrene!".

. Surgical debridement of all necrotic tissue.

. Empiric IV Antibiotics e.g AMPICILLIN + SULBACTAM + CLINDAMYCIN.

. Bullae & seroanguinous discharge.

((PRIMARY BILIARY CIRRHOSIS))

. Pruritis, jaundice, steatorrhea, HSM, ++ ALP, ++ Bilirubin.

. +ve Anti-mitochondrial Antibodies.

. Immune mediated destruction of intra hepatic bile ducts ---> Bile stasis & cirrhosis.
. Cutaneous association ---> XANTHELASMA

."Yellowish, soft plaques on the medial aspects of the eyelids bilaterally".

((CHALAZION))

. Painful swelling that progress to a nodular rubbery lesion.

. due to MEIBOMIAN gland obstruction.

. Recurrent chalazion may be due to meibomian gland carcinoma !

. U can't differentiate bet. PERSISTENT CHALAZION & BASAL CELL CARCINOMA except
through HISTOPATHOLOGICAL exam.

((MOLLUSCUM CONTAGIOSUM is caused by POX VIRUS))

((MELANOMA -----------> Excisional biopsy " FULL THICKNESS”))

((ANGIO-EDEMA))

. H/O of ICU pt on ACEIs e.g ENALAPRIL.

. Edema in the face, mouth, lips.

. Laryngeal edema may occur causing airway obstruction.

. occurs due to BRADYKININ release.

. it may occur at any time not just at the start of drug intake.

. Dx----> Low levels of C2 & C4.

. Tx----> STOP ACEIs + FRESH FROZEN PLASMA + Secure the airway.

((HERIDITARY angioedema))

. C1 esterase inhibitor defeciency.

((Drug induced PHOTOTOXICITY))

. The most common drug is DOXYCYCLINE (TETRACYCLINE).

. Manifest as exaggerated sunburn reactions with erythema ,edema & vesicles over sun-
exposed areas.

((WARFARIN induced skin necrosis))

. Common sites: Breasts, buttocks, thighs & abdomen.

. Initial complaint is pain followed by bullae formation & skin necrosis.

. Occurs within weeks after starting therapy.

. Tx: Discontinue WARFARIN & Give Vit. K & maintain anticoagulation using Heparin.

((ROSACEA))

. 30 - 60 ys old pt.

. TELANGECTASIA over the cheeks, nose & chin.

. Flushing of these area is precipitated by hot drinks,heat,emotion.

. Tx: initial ttt is METRONIDAZOLE.

((Vitiligo (Leukoderma)))

. Young 20-30 ys.

. Pale whitish macules with hyperpigmented borders.

. Around body orifices.

. Auto-immine destruction of melanocytes.

((STEVENS JOHNS $YNDROME))

. Immune complex mediated hypersensitivity.

. H/O of SULFONAMIDES, NSAIDs & PHENYTOIN intake.

. Characteristic "TARGET" appearance.

. Fever, conjunctivitis, ++HR, --BP, altered consciousness, coma, convulsions may occur.

((RUBELLA))

. Middle aged female.

. Maculo-papular rash starting on the face & extends to involve the trunk & extremeties (Not
involving the palms & soles).

. Tender lymphadenopathy (Post. auricular & post. cervical LNs).

((Secondary $yhphilis))

. Maculopapular rash (involving the palms & soles).

. The papules may coalese to form CONDYLOMA LATA in severe cases!

((NICKEL jewelry can cause allergic contact dermatitis (Type 4 hypersensitivity)))

((Drug induced type 1 hypersensitivity reaction))

. IMMEDIATE ONSET.

. Mediated by IgE & Mast cells.

. Urticaria & pruritis without systemic symptoms.

. Tx: ANTI-HISTAMINICS & dis-continue the offending drug !

((The most concerning sign for malignancy in melanoma is ZONES OF DIFFERENT SKIN
COLORS))

((SQUAMOUS CELL CARCINOMA))

. isolated solitary ulcer.

. in the Vermilion area of the lip.

. H/O of sun exposure (FARMER).

. Histologically: INVASIVE CORDS OF SQUAMOUS CELLS WITH KERATIN PEARLS.

((BASAL CELL CARCINOMA))

. INVASIVE CLUSTERS OF SPINDLE CELLS SURROUNDED BY PALISADED BASAL CELLS.

((CHERRY HEMANGIOMA))

. Small vascular bright red papular lesion.

. 30-40 ys & ++ in no with age "Senile hemangioms".

. Don't regress spontaneously.

. Sharply circumscribed areas of congested capillaries.

. Erythematous papule with a central scaling.

. Sand paper like texture.

. H/O of chronic sun exposure.

. Pre-cancerous ----> may convert to squamous cell carcinoma.

((Molluscum Contagiosum (Pox virus)))

. Firm, flesh colored, dome-shaped, umbilicated papules.

. Transmitted through sexual contact.

. Due to CELLULAR immunodefeciency.

. Associated with HIV.

((SHINGLES (HZV) may develop due to "INFLIXIMAB" therapy causing immunodeficiency))

((Allergic contact dermatitis))

. Type 4 hypersensitivity reaction.

. Prurutic erythematous rash with vesicles.

. Bilateral distribution.

. H/O of cutting woods (Poison Sumac).

. Vesicular fluid is sterile and grows coagulase -ve staphylococci (S. Epidermidis).

. May be 2ry infected staph or strept !

((ACANTHOSIS NIGRICANS))

. Symmetrical, hyperpigmented, velvety plaques in the axilla, groin & neck !

. Ass. with INSULIN RESISTANCE in YOUNG pts e.g. DM & PCO.

. Ass. with GIT malignancy in OLD pts.