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Dermatology Basics

Dermatology Basics . David Surprenant, MD. Common Conditions. Cellulitis. Common bacterial infection of the deep dermis and subcutaneous tissue Characterized by: Erythema Pain Warmth Swelling Often have: Fever Chills Malaise Leukocytosis Virtually never occurs bilaterally

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Dermatology Basics

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  1. Dermatology Basics David Surprenant, MD

  2. Common Conditions

  3. Cellulitis • Common bacterial infection of the deep dermis and subcutaneous tissue • Characterized by: • Erythema • Pain • Warmth • Swelling • Often have: • Fever • Chills • Malaise • Leukocytosis • Virtually never occurs bilaterally • If purulence, swab it for culture • Otherwise swab will only grow normal skin flora

  4. Stasis Dermatitis • A type of eczema that occurs in setting of venous insufficiency • Obesity, CHF, DVT, injury, etc. • Pruritus, aching, throbbing, discomfort • Can be unilateral (often bilaterally) • Can be warm to the skin • Will not have other signs of infection, i.e. • Tachycardia • Leukocytosis • Fever

  5. Hidradenitis Suppurativa • Inflammatory disorder • Follicular occlusion -> rupture -> inflammation • Occasionally bacterial superinfection • Onset after puberty • Treatment: • Weight loss & smoking cessation • Antibiotics (primarily for anti-inflammatory) • TNF-alpha inhibitors • Surgery

  6. Ask the patient if this is new or changing

  7. Psoriasis • Chronic inflammatory condition • Think pink/red, scaly plaques • Commonly involved areas: • Occipital scalp • Umbilicus • Elbows • Knees • Treatment: • Topicalsvs systemic medication • Can have deforming psoriatic arthritis

  8. Erythroderma • Erythema & scale >90% BSA • Causes: • Psoriasis • Atopic dermatitis • Drug reactions • Idiopathic • CTCL • Treatment: • Fluid, electrolyte, and thermal regulation • Wet wraps

  9. Pyoderma Gangrenosum • Inflammatory condition • Overactive neutrophils • Non-infectious • Diagnosis of exclusion (biopsy will not be diagnostic) • Surgery & debridement makes this condition worse! • Pathergy • Consider if non-healing wound • Association with inflammatory bowel disease • Treatment: • Immunosuppression

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