Dermatology

A

• Allergic Contact Dermatitis - Initial Management

  Allergic contact dermatitis is a delayed type IV hypersensitivity reaction that appears hours to days after skin exposure to an allergen. Identify and avoid the trigger, wash away residual exposure, use topical corticosteroids matched to body site and severity, treat extensive disabling disease with an adequate systemic corticosteroid course when appropriate, and distinguish it from irritant dermatitis, cellulitis, and infection.
• Alopecia Areata — Evaluation & Treatment

  Autoimmune non‑scarring hair loss. Treat limited disease with intralesional steroids; consider topical immunotherapy and emerging JAK inhibitors for extensive disease; screen for associated autoimmune disease selectively.

B

• Bullous Pemphigoid - Acute Flare and ED Management

  Bullous pemphigoid is an autoimmune subepidermal blistering disorder of older adults characterized by tense pruritic bullae, often after a prodrome of urticarial plaques. Confirm with lesional histology and perilesional direct immunofluorescence, provide wound and infection care, use high-potency topical corticosteroids when feasible, and escalate to systemic therapy for extensive or disabling disease.
• Bullous Pemphigoid — Diagnosis & Treatment

  Autoimmune subepidermal blistering in older adults; tense pruritic bullae. Diagnose with biopsy and DIF (linear IgG/C3 at BMZ). Treat with potent topical steroids or systemic therapy; manage pruritus and infections.

D

• Dermatographism & Physical Urticarias — Diagnosis & Treatment

  Inducible urticarias (dermatographism, cholinergic, cold, pressure). Identify triggers and use high‑dose second‑generation antihistamines; escalate to omalizumab or cyclosporine for refractory cases; educate on anaphylaxis risk in cold urticaria.
• DRESS Syndrome - Initial Management

  DRESS is a delayed, potentially life-threatening drug hypersensitivity syndrome with rash, fever, hematologic abnormalities, and internal-organ injury. Stop all plausible culprit drugs immediately, assess liver, kidney, lung, heart, and neurologic involvement, trend laboratory abnormalities for weeks, and use systemic corticosteroids for significant organ disease with specialist input.

E

• Eczema Herpeticum - Urgent Management

  Eczema herpeticum is disseminated HSV infection in skin affected by atopic dermatitis and can progress rapidly with fever, pain, ocular disease, and systemic complications. Start systemic acyclovir or valacyclovir immediately when suspected, obtain HSV testing without delaying therapy, assess the eyes, and admit patients with systemic illness, extensive disease, young age, immunocompromise, or inability to take oral medication.
• Erythroderma - Emergency Evaluation

  Erythroderma is generalized erythema and scaling involving most of the body surface and can cause temperature dysregulation, fluid and protein loss, infection, and high-output cardiac stress. Stabilize physiology, stop unnecessary medications, use bland skin care, identify psoriasis, eczema, drug reaction, lymphoma, or other causes, and admit unstable or diagnostically concerning patients.

H

• Herpes Zoster - Antiviral Therapy

  Herpes zoster is reactivation of varicella-zoster virus causing a painful unilateral dermatomal eruption. Start oral antiviral therapy promptly, especially within 72 hours, for older adults, severe pain or rash, ophthalmic or otic involvement, immunocompromise, or ongoing new lesions; urgently escalate disseminated, neurologic, ocular, or visceral disease.
• Hidradenitis Suppurativa - Acute Flare

  An acute hidradenitis suppurativa flare is inflammatory follicular disease, not simply a recurrent boil. Relieve pain, identify fluctuant abscesses that need drainage, avoid repeated wide incision and drainage as definitive therapy, use topical or systemic anti-inflammatory antimicrobial regimens according to severity, and arrange dermatology follow-up for disease-modifying treatment.
• Hirsutism — Evaluation & Treatment

  Assess androgen excess and rule out serious causes; most cases due to PCOS. Treat with combined oral contraceptives and antiandrogens (spironolactone) with reliable contraception; add cosmetic hair removal methods.

I

• Impetigo - ED Treatment

  Impetigo is a superficial bacterial skin infection caused mainly by Staphylococcus aureus and group A streptococci. Limited disease can be treated with topical antibiotics, while numerous lesions, outbreaks, or bullous disease generally require oral therapy that covers both organisms; culture is reserved for unusual, recurrent, or treatment-resistant cases.

L

• Lichen Planus — Cutaneous & Mucosal Management

  Inflammatory condition affecting skin, oral/genital mucosa, nails. Diagnose clinically and with biopsy when uncertain; treat with high‑potency topical steroids; systemic therapy for extensive or erosive disease; screen for hepatitis C.

N

• Nail Disorders — Onycholysis, Paronychia, and Psoriatic Nail

  Common nail disorders require etiology‑specific care: avoid moisture/trauma for paronychia; treat infections; manage psoriatic nail disease with topical/systemic therapy; correct underlying causes of onycholysis.

P

• Pemphigus Vulgaris — Diagnosis & Treatment

  Autoimmune intraepidermal blistering with mucosal involvement. Diagnosis by biopsy showing acantholysis and DIF with intercellular IgG; treat with systemic steroids plus rituximab as first‑line.
• Photosensitivity Disorders — Workup & Counseling

  Differentiate phototoxic vs photoallergic reactions and specific photosensitive diseases (LE, PCT). Workup includes detailed drug/sun exposure history and targeted labs. Emphasize broad‑spectrum sun protection and trigger management.

S

• Scabies - Diagnosis and Treatment

  Scabies causes intense pruritus, often worse at night, with papules and burrows in characteristic locations and household spread. Treat the patient and close contacts at the same time, usually with permethrin 5% cream or oral ivermectin when appropriate, decontaminate recently used clothing and bedding, and use combination therapy with specialist input for crusted scabies.
• Stevens–Johnson Syndrome and TEN — Initial Management

  Stevens-Johnson syndrome and toxic epidermal necrolysis are severe immune-mediated mucocutaneous reactions characterized by painful skin, epidermal necrosis, detachment, and mucosal involvement, most often triggered by medication. Immediate priorities are withdrawal of the culprit drug, burn-center or ICU level supportive care for significant disease, meticulous fluid and wound management, ocular and mucosal assessment, infection surveillance, and early dermatology involvement.

T

• Tinea Capitis - Pediatric Management

  Tinea capitis is dermatophyte infection of the scalp and hair shaft and requires systemic antifungal therapy because topical agents do not penetrate infected hair follicles adequately. Confirm when feasible with fungal testing, select oral griseofulvin or terbinafine according to organism and patient factors, add antifungal shampoo to reduce transmission, and treat inflammatory kerion promptly to reduce scarring risk.
• Tinea Capitis & Tinea Corporis — Diagnosis & Therapy

  Dermatophyte infections: tinea capitis requires systemic therapy; tinea corporis often topical. Diagnose with KOH prep or culture; consider kerion and household transmission.
• Toxic Epidermal Necrolysis — Immediate Drug Withdrawal, Burn‑Unit Care, and Immunomodulators

  Life‑threatening epidermal necrosis usually triggered by medications. Stop culprit drug, admit to burn/ICU, apply SCORTEN for prognosis, and provide meticulous wound, fluid, and infection care. Consider cyclosporine or etanercept in selected cases; IVIG evidence mixed.

V

• Vitiligo — Diagnosis & Repigmentation Therapies

  Autoimmune depigmentation with loss of melanocytes. Combine topical therapies with NB‑UVB; consider systemic JAK inhibitors in select; address psychosocial impact and sun protection.