dermatology look- alikes

86 Pages·2016·36.21 MB·English

DERMATOLOGY
LOOK- ALIKES
Jeffrey C. Houin, Jr., M.D.,
F.A.A.D
Dermatology Center of North
Mississippi
Bilateral Facial Rashes
Bimalar Facial Rashes
54 y/o M- r/o lupus
n 
Present x 1 month
n 
No fever, jt pain,
n 
malaise
Burning, itching
n 
OTC meds not helpful
n 
ANA, CBC, CMP nl
n
Bimalar Facial Rashes
26 y/o F
n 
Started early summer
n 
Waited wks for appt
n 
OTC moisturizer and
n 
1% HC ineffective
Worsened, esp in sun
n
Diagnosis?
Seborrheic Dermatitis
Reddish-orange
n 
Sharply demarcated
n 
Sometimes annular
n 
Little edema, no
n 
warmth
Scaling (KOH neg)
n 
DDx: Contact
n 
Dermatits, Psoriasis
ANA nl
n
Seborrheic Dermatitis
Bx: spongiotic dermatitis (nonspecific)
n 
Dx by Hx and clinical presentation
n 
Recurrent and persistent
n 
Affects up to 20% of population
n 
Scaling, erythematous
n 
Scalp, eyebrows, NLF, glabella,
n 
postauricular, beard
+/- Malassezia furfur
n 
Tx: mild topical steroids, CNI, antifungals?
n
Cutaneous Lupus Erythematosus
Red, discreet and
n 
confluent papules/
nodules/plaques
(polycyclic)
Clearing or atrophic
n 
centers
Some scaling
n 
Sun exposed areas
n 
No fever/joint pain/
n 
malaise
Cutaneous Lupus Erythematosus
Bx: not specific; add DIF
n 
SCLE: F 15-40 y/o
n 
No scarring (unlike DLE)
n 
Photosensitive
n 
+ ANA (80%); +Ro/SSA
n 
Tx: photoprotection, antimalarials, possibly
n 
topical steroids
Drugs: HCTZ, ACEi, Ca Channel blockers
n 
DDx: EM, Psoriasis, Tertiary Syphilis, DM
n 
R/o SLE and Sjogren’s Syndrome
n
Growing Plaques With Scale