Therapeutic Strategies in Dermatology

Pediculosis (Lice): Initial Evaluation

…nd down the hair shaft), seborrheic dermatitis (loose, greasy scale that is very loosely adherent to hair, if at all), and a superficial fungal infection of the hair shaft. It is important to note that the primary mode of transmission of hair lice is…

Therapeutic Strategies in Dermatology

Lichen Planus: Initial Evaluation

…papules, often with a white-to-lavender reticulate overlying scale (Wickham’s striae). Patients report intense pruritus and sometimes koebnerization (development of lesions at areas of trauma/ injury). Presentation is almost always bilateral a…

Therapeutic Strategies in Dermatology

Psoriasis: Principles of Psoriasis Management

…stone of psoriasis therapy. Keratolytics. These agents remove scale, soften plaques, and enhance penetration of other therapies. They are most effective when used after adequate hydration. Salicylic acid 2%-10%: Do not use on greater than 20% of the…

Therapeutic Strategies in Dermatology

Candidiasis: Key Points

…several tests may confirm the diagnosis. A KOH preparation of scale or pustule fluid contents will reveal pseudohyphae and possibly also yeast forms; oral candidiasis is caused only by the hyphal form of C. albicans. Standard bacterial cultures (with…

Therapeutic Strategies in Dermatology

Warts: Clinical Cases

…Improved (lesion much smaller in size) Excess hyperkeratotic scale and dead skin debrided by scalpel Repeat cryosurgery and ongoing application of salicylic acid under occlusion Follow-up in 3 week intervals (requires 3 additional visits to eradicat…

Therapeutic Strategies in Dermatology

Nummular Dermatitis: Overview

…y) may be of benefit for some recalcitrant cases. Cultures of crusted lesions may grow S. aureus, and sensitivity patterns can be used to guide antibiotic choice. Antihistamines (e.g., hydroxyzine 25-50 mg or doxepin 25 mg), especially at bedtime, ma…

Therapeutic Strategies in Dermatology

Superficial Fungal Infections: Clinical Cases

…up evaluation Evaluation reveals persistent erythema, subtle scale, and alopecia KOH examination reveals persistent branching hyphae The fungal culture data is reviewed. The infection is susceptible to griseofulvin. Griseofulvin is continued another…

Therapeutic Strategies in Dermatology

Seborrheic Dermatitis: Clinical Cases

…65-year-old man long-standing erythema with overlying greasy scale on the nasolabial folds, melolabial folds, glabella, and chin Improves with sun exposure Initial treatment Ketoconazole 2% cream b.i.d. Ketoconazole 2% shampoo every other day (10…

Therapeutic Strategies in Dermatology

Candidiasis: Clinical Cases

…here are brightly erythematous macerated patches with minimal scale and satellite pustules KOH prep of fluid taken from unroofed pustule reveals pseudohyphae and yeast forms Diagnosis: Candidiasis Recommendation: clotrimazole 1% cream b.i.d. to affec…

Therapeutic Strategies in Dermatology

Hand Dermatitis: Treatment

…ns may be added to the above treatment. These will reduce the scale and enhance the penetration of the active agents. Subsequent steps Patients with severe recalcitrant hand dermatitis may be treated with soak or oral PUVA, UVB, or UVA-1 photothera…