DERMATOLOGY IN MEDICINE
1. PITYRIASIS VERSICOLOR:
Hypo/hyperpigmented macules predominantly on the upper chest due to Malassezia furfur.
Treatment:
- Ketoconazole 1- 2% shampoo apply for 5 minutes, use weekly for treatment
- Tab. Fluconazole 300mg stat and repeat after 2 weeks.
2. DERMATOPHYTOSIS:
Erythematous plaque with peripheral activity. It can be tinea corporis (body), tinea pedis (feet), tinea cruris(groin) or onychomycosis(nail).
Investigations include skin scraping, Nail clipping
Treatments:
1.Tab. Itraconazole 200 mg daily for 2 weeks (or 400 mg OD for a week)
2.Topical terbinafine once daily for 1 week
OR Tab. Terbinafine 250 mg OD 2-4 weeks.
3. PEDICULOSIS
Treatment:
1% permethrin lotion to be applied on two separate occasions 1 week apart.
Hair should be dry (oil free). Apply from root to trip of hair. Wash after 20 minutes.
4. CHICKEN POX (DERMATOLOGY IN MEDICINE)
Caused by varicella zoster virus. There will be history of contact with affected individual. Fever associated with vesicular lesion (‘dew drop appearance), which spreads in a centripetal fashion. Secondary bacterial infection may occur.
Treatments:
1.Oral acyclovir 400mg 5 times a day for 7 days.
2.T. Pantoprazole 40mg OD for 7 days.
3.Plenty of oral fluids and adequate rest.
4.Paracetamol and tepid sponging for fever.
5. T.CPM 4mg TDS in case of severe itching.
5. SHINGLES (herpes zoster)
Local reactivation of chicken pox. Confined to a definite dermatome.
Treated with oral acyclovir 400 mg 5 times daily for 7-10 days and analgesics.
Gabapentin 300mg OD for 3weeks also given.
may need sedatives.
6. ACNE VULGARIS
It can be mild, moderate or severe disease.
For mild disease, which is characterised by comedones:
Treatment:
Clindamycin ointment for LA.
If no response
T. Doxycyclin 100mg BD for 5 days.
7. SEBORRHOEIC DERMATITIS
Commonly known as dandruff.
Treated with antifungal shampoo:
2% ketoconazole twice weekly for 4 weeks.
8. ECZEMA
Skin reaction pattern characterised by erythema, edma, oozing, crusting, vesiculation in acute stage; papules and scales in sub-acute stage; lichenifiaction in chronic stage.
May be associated with bronchial asthma and atopic dermatitis. There can be severe itching. This may lead to secondary infection.
Treatments:
1.Saline compression: 5 Teaspoon of salt in glass of tap water soak cotton cloth, just squeeze it fold it for 3-4 times. Apply it for 2-3 minutes. Repeat it for 30 minutes.
2.Topical steroids:
Given according to severity of disease:
Betamethasone + neomycin/gentamycin (mild potent).
Clobetasol + gentamycin (strong potent).
3.Emollients: White soft paraffin or liquid paraffin can be applied locally.
4. Antihistamines:
T.CPM 4mg TDS can be given for itching
OR
T. Cetirizine 10mg HS.
5.Antibiotics are indicated in case of secondary infection.
T. Ampiclox 500mg 1-1-1-1 for 5 days.
9. APHTHOUS ULCER
Idiopathic painful superficial ulcer in oral cavity.
It can recur. it is treated with multivitamin tablets, local analgesics (mucopain gel can be applied locally). Chlorhexidine mouth wash can be given.
10. SCABIES
1.Initially scrub bath to open up the burrows.
2.Permethrin 5% lotion: applied from neck down, usually before bedtime, and left on for about 8 to 14 hours, then washed off in the morning. Repeat for moderate to severe infections 7 days later.
3.All clothes, towels, bed sheets should be washed in hot water and sun dried or ironed well.
4.Treat all family members at the same time
5.Antibiotics, if secondary infection occurs.
6.Anti histamines.
DERMATOLOGY IN MEDICINE
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