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Primary Care Dermatology, An Issue of Primary Care: Clinics in Office Practice, E-Book

Primary Care Dermatology, An Issue of Primary Care: Clinics in Office Practice, E-Book

George G.A. Pujalte

(2016)

Additional Information

Book Details

Abstract

This issue of Primary Care: Clinics in Office Practice, Guest Edited by George G.A. Pujalte, MD, is devoted to Primary Care Dermatology. Dr. Pujalte has assembled a group of expert authors to review the following topics: Urticaria and allergy-mediated conditions; Dermatologic manifestations of systemic diseases; Viral skin infections; Fungal skin infections; Bacterial skin infections; Parasitic skin infections; Pressure and friction injuries to the skin; Sunburn, thermal, and chemical injuries to the skin; Acne; Alopecia; Nail deformities and injuries; and Skin cancer.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Primary Care Dermatology\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents vii
Foreword: Pattern Recognition\r vii
Preface: Beyond Superficial: Primary Care Dermatology\r vii
Evaluation and Management of Acne\r vii
Urticaria and Allergy-Mediated Conditions\r vii
Bacterial Skin Infections\r vii
Superficial Fungal Infections\r vii
Viral Skin Diseases\r viii
Evaluation and Management of the Hair Loss Patient in the Primary Care Setting\r viii
Sunburn, Thermal, and Chemical Injuries to the Skin\r viii
Dermatologic Manifestations of Systemic Diseases\r ix
Pressure and Friction Injuries in Primary Care\r ix
Skin Cancer\r ix
Parasitic Skin Infections for Primary Care Physicians\r ix
Nail Deformities and Injuries\r ix
PRIMARY CARE:\rCLINICS IN OFFICE PRACTICE\r xi
FORTHCOMING ISSUES xi
March 2016 xi
June 2016 xi
September 2016 xi
RECENT ISSUES xi
September 2015 xi
June 2015 xi
March 2015 xi
Foreword: Pattern Recognition \r xiii
REFERENCES xiv
Preface: Beyond Superficial: Primary Care Dermatology \r xv
Evaluation and Management of Acne 465
Key points 465
INTRODUCTION 465
EPIDEMIOLOGY 465
PATHOPHYSIOLOGY 466
DIAGNOSIS 466
TREATMENT 468
MANAGEMENT OF ACNE 468
TOPICAL RETINOIDS 468
TOPICAL ANTIMICROBIALS 469
ORAL ANTIBIOTICS 469
HORMONAL THERAPY AND ORAL CONTRACEPTIVES 470
ORAL RETINOIDS 470
TREATMENT OF ACNE MECHANICA (SPORTS-INDUCED ACNE) 470
SUMMARY 470
REFERENCES 470
Urticaria and Allergy-Mediated Conditions 473
Key points 473
DESCRIPTION 473
EPIDEMIOLOGY 475
Incidence 475
Prevalence 475
DIAGNOSIS 475
Causes 476
Treatment 477
ANGIOEDEMA 478
Description 478
Epidemiology 478
Pathogenesis and Causes 478
Diagnosis 478
Treatment 478
DERMATITIS 479
Description 479
Epidemiology 479
Diagnosis 479
Causes 480
Treatment 480
ECZEMA/ATOPIC DERMATITIS 481
Description 481
Epidemiology 481
Diagnosis 481
Treatment 481
REFERENCES 483
Bacterial Skin Infections 485
Key points 485
INTRODUCTION 485
IMPETIGO 486
Evaluation and Work-Up 486
Management Strategies 487
Pharmacologic Strategies 487
Follow-Up Care 488
ERYSIPELAS 488
Management Strategies 489
Pharmacologic Strategies 489
Follow-Up Care 489
CELLULITIS 490
Microbiology 490
Methicillin-Resistant Staphylococcus aureus Versus Methicillin-Sensitive Staphylococcus aureus 490
Evaluation/Work-Up 491
Patient history 491
Physical examination 492
Imaging and additional testing 492
Management Strategies 493
Treatment Strategies 493
Pharmacologic Strategies: Nonpurulent 493
Pharamacolic Strateges: Purulent 495
Nonpharmacologic Strategies 495
Self-Management Strategies 496
Evaluation, Adjustment, Recurrence 496
ABSCESSES 496
Evaluation/Work-Up 496
Patient history 496
Physical examination 496
Imaging and additional testing 497
Management Strategies 497
Pharmacologic Strategies 497
Nonpharmacologic Strategies 497
Self-Management Strategies 497
Evaluation, Adjustment, Recurrence 497
SUMMARY 498
REFERENCES 498
Superficial Fungal Infections 501
Key points 501
INTRODUCTION 501
Transmission 502
Classification 502
Diagnosis 502
TINEA PEDIS 502
Pitted Keratolysis 504
TINEA CRURIS 504
TINEA CORPORIS 505
Deep Inflammatory Lesions 505
TINEA OF THE HAND 506
Tinea Incognito 507
TINEA OF THE SCALP 507
Trichophyton tonsurans 508
TINEA OF THE BEARD 509
TINEA VERSICOLOR 510
CANDIDIASIS 511
Oropharyngeal Candidiasis 512
Genital Candidiasis 513
Candida Balanitis 513
SUMMARY 514
REFERENCES 514
Viral Skin Diseases 517
Key points 517
MEASLES (RUBEOLA) 517
MANAGEMENT STRATEGIES 518
Management Goals 518
Treatment Strategies 518
Nonpharmacologic strategies 518
Pharmacologic strategies 518
Self-Management Strategies 518
Evaluation, Adjustment, Recurrence 518
Complications 518
Recurrence 518
EVALUATION/WORKUP 518
Patient History 518
Physical Examination 519
Imaging and Additional Testing 520
RUBELLA (GERMAN MEASLES) 520
MANAGEMENT STRATEGIES 520
Management Goals 520
Treatment Strategies 521
Evaluation, Adjustment, Recurrence 521
Complications 521
Recurrence 521
Prevention 521
EVALUATION/WORKUP 521
Patient History 521
Physical Examination 521
Imaging and Additional Testing 522
ERYTHEMA INFECTIOSUM (FIFTH DISEASE) 523
MANAGEMENT STRATEGIES 523
Management Goals 523
Treatment Strategies 523
Evaluation, Adjustment, Recurrence 524
Complications 524
Recurrence 524
EVALUATION/WORKUP 524
Patient History 524
Physical Examination 524
Imaging and Additional Testing 524
ROSEOLA INFANTUM (SIXTH DISEASE OR ERYTHEMA SUBITUM) 526
MANAGEMENT STRATEGIES 526
Management Goals 526
Treatment Strategies 526
Evaluation, Adjustment, Recurrence 526
Complications 526
Recurrence 526
EVALUATION AND WORKUP 526
Patient History 526
Physical Examination 526
Imaging and Additional Testing 528
HERPES SIMPLEX 528
MANAGEMENT STRATEGIES 529
Management Goals 529
Treatment Strategies 529
Evaluation, Adjustment, Recurrence 529
Complications 529
Recurrence 530
EVALUATION/WORKUP 531
Imaging and Additional Testing 533
VARICELLA (CHICKENPOX) 534
MANAGEMENT STRATEGIES 534
Management Goals 534
Treatment Strategies 534
Evaluation, Adjustment, Recurrence 535
Complications 535
Recurrence 535
Prevention 535
EVALUATION/WORKUP 535
Patient History 535
Physical Examination 535
Imaging and Additional Testing 536
HERPES ZOSTER (SHINGLES) 536
MANAGEMENT STRATEGIES 536
Management Goals 536
Treatment Strategies 537
Nonpharmacologic treatment 537
Pharmacologic treatment 537
Self-Management Strategies 537
Evaluation, Adjustment, Recurrence 537
Recurrence 537
EVALUATION/WORKUP 537
Patient History 537
Physical Examination 539
Imaging and Additional Testing 540
KAPOSI SARCOMA–ASSOCIATED HERPESVIRUS 540
MANAGEMENT STRATEGIES 541
Management Goals 541
Treatment Strategies 542
Evaluation, Adjustment, Recurrence 542
Evaluation for other HHV-8-associated diseases 542
Complications associated with human herpesvirus-8 and Kaposi sarcoma treatment 542
Evaluation/Workup 543
Imaging and Additional Testing 544
WARTS (VERRUCA) 545
MANAGEMENT STRATEGIES 545
Management Goals 545
Treatment Strategies 545
Self-Management Strategies 545
Evaluation, Adjustment, Recurrence 545
Complications 545
Recurrence 546
Prevention 547
EVALUATION AND WORKUP 548
Patient History and Physical Examination 548
Imaging and Additional Testing 549
HAND, FOOT, AND MOUTH DISEASE 549
MANAGEMENT STRATEGIES 550
Management Goals 550
Treatment Strategies 550
Evaluation, Adjustment, Recurrence 550
Complications 550
Recurrence 550
EVALUATION/WORKUP 550
Patient History 550
Physical Examination 551
Imaging and Additional Testing 551
MOLLUSCUM CONTAGIOSUM 552
MANAGEMENT STRATEGIES 552
Management Goals 552
Treatment Strategies 552
Evaluation, Adjustment, Recurrence 552
Complications 552
Recurrence 552
EVALUATION AND WORKUP 552
Patient History 552
Physical Examination 553
Imaging and Additional Testing 555
GIANOTTI-CROSTI SYNDROME 555
MANAGEMENT STRATEGIES 555
Management Goals 555
Treatment Strategies 555
Evaluation, Adjustment, Recurrence 556
EVALUATION AND WORKUP 556
Patient History 556
Physical Examination 556
Imaging and Additional Testing 556
ORF (CONTAGIOUS ECTHYMA) 557
MANAGEMENT STRATEGIES 558
Management Goals 558
Treatment Strategies 558
Evaluation, Adjustment, Recurrence 558
Complication 558
Recurrence 558
EVALUATION/WORKUP 558
Patient History 558
Physical Examination 558
Imaging and Additional Testing 559
MONKEYPOX 559
MANAGEMENT STRATEGIES 559
Management Goals 559
Treatment Strategies 559
Nonpharmacologic strategies 559
Pharmacologic strategies 559
Self-Management Strategies 559
Evaluation, Adjustment, Recurrence 560
Complications 560
EVALUATION AND WORKUP 560
Patient History 560
Physical Examination 560
Imaging and Additional Testing 560
SMALLPOX 560
MANAGEMENT STRATEGIES 561
Management Goals 561
Treatment Strategies 561
Evaluation, Adjustment, Recurrence 561
EVALUATION AND WORKUP 561
Patient History 561
Physical Examination 561
OTHER VIRAL ILLNESS WITH CUTANEOUS MANIFESTATIONS 561
Herpangina 561
Infectious Mononucleosis 562
Ebola 563
Chikungunya Fever 563
Dengue Fever 563
Viral Hemorrhagic Fever 564
Vaccination 564
SUMMARY 566
REFERENCES 566
Evaluation and Management of the Hair Loss Patient in the Primary Care Setting 569
Key points 569
INTRODUCTION 569
CLASSIFICATION OF ALOPECIAS 570
Noncicatricial Alopecias 570
Androgenetic/pattern alopecia 570
Alopecia areata 572
Telogen effluvium 573
Tinea capitis 574
Traction alopecia 576
Trichotillomania 577
Cicatricial Alopecias 579
APPROACH TO THE PATIENT WITH ALOPECIA 581
Diagnosis 581
Clinical history 581
Physical examination 583
The scalp biopsy 583
Management 584
Laboratory work-up 584
Treatment 584
When to refer to a dermatologist 586
SUMMARY 586
REFERENCES 587
Sunburn, Thermal, and Chemical Injuries to the Skin 591
Key points 591
BODY SURFACE AREA 592
THERMAL BURNS 592
Frostbite 594
Chemical Burns 595
SUNBURN 596
Background 596
Cancer Risk 598
Melanoma 598
Nonmelanoma skin cancer 598
Eye Injury 598
Prevention 598
Sunscreen 598
Clothing 599
Management of Burns 599
ACUTE MANAGEMENT 600
SPECIAL CONSIDERATION FOR SPECIFIC BURN SITES 600
Facial Burns 600
Ocular Burns 600
Chemical Burns of the Face and Eye 601
Hand Burns 601
Immersion Burns 601
TREATMENT OF BURNS 601
Fluid Resuscitation 601
COMPARTMENT SYNDROME AND CIRCUMFERENTIAL BURNS 602
TOPICAL AND SYSTEMIC TREATMENTS 602
OUTCOMES OF BURN INJURY 602
SUMMARY 603
REFERENCES 603
Dermatologic Manifestations of Systemic Diseases 607
Key points 607
PYODERMA GANGRENOSUM 607
Definition 607
Epidemiology 608
Clinical Presentation 608
Differential Diagnosis 608
Associated Gastrointestinal Conditions 608
Diagnosis 609
Treatment 609
Prognosis 609
ERYTHEMA NODOSUM 609
Definition 609
Epidemiology 609
Clinical Presentation 609
Lesions of erythema nodosum 609
Differential Diagnosis 610
Associated Gastrointestinal Conditions 610
Diagnosis 610
Laboratory evaluation 610
Evaluation of inflammatory bowel disease 610
Deep incisional or excisional skin biopsy 610
Treatment 611
Prognosis 611
APTHOUS STOMATITIS 611
Definition 611
Epidemiology 611
Clinical Presentation 611
Differential Diagnosis 612
Associated Gastrointestinal Conditions 612
Diagnosis 612
Treatment 612
Prognosis 612
DERMATITIS HERPETIFORMIS 613
Definition 613
Epidemiology 613
Clinical Presentation 613
Differential Diagnosis 613
Associated Gastrointestinal Condition 613
Diagnosis 613
Treatment 614
Prognosis 614
LICHEN PLANUS 614
Definition 614
Epidemiology 614
Clinical Features 614
Differential Diagnosis 614
Associated Gastrointestinal Condition 615
Diagnosis 615
Treatment 616
Cutaneous lichen planus 616
Oral lichen planus 616
Other treatment modalities 616
Prognosis 616
ACUTE CUTANEOUS LUPUS FROM SYSTEMIC LUPUS ERYTHEMATOSUS 616
Definition 616
Epidemiology 617
Clinical Presentation 617
Differential Diagnosis 617
Diagnosis 617
Treatment 618
Prognosis 618
DISCOID LUPUS ERYTHEMATOUS 619
Definition 619
Epidemiology 619
Clinical Presentation 619
Differential Diagnosis 620
Diagnosis 620
Treatment 620
Prognosis 620
HELIOTROPE RASH AND GOTTRON PAPULES OF DERMATOMYOSITIS 620
Definition 620
Epidemiology 620
Clinical Presentation 621
Differential Diagnosis 621
Diagnosis 622
Treatment 622
Prognosis 623
SKIN SCLEROSIS AND RAYNAUD PHENOMENON OF SCLERODERMA 623
Definition 623
Epidemiology 623
Clinical Presentation 623
CREST SYNDROME 624
Differential Diagnosis 625
Diagnosis 626
Treatment 626
Prognosis 626
MORPHEA 627
Definition 627
Epidemiology 627
Clinical Presentation 627
Differential Diagnosis 627
Diagnosis 627
Treatment/Prognosis 628
SUMMARY 628
REFERENCES 628
Pressure and Friction Injuries in Primary Care 631
Key points 631
INTRODUCTION 631
PRESSURE INJURY 632
Pressure Ulcer 632
History 632
Examination 632
Treatment 635
Prevention 636
Special population: athletes 636
Talon Noir 637
Skin Cancer 645
Key points 645
INTRODUCTION 645
SKIN BIOPSY 646
Indication to Biopsy 646
Contraindications to Biopsy 646
Site Selection 646
Types of Skin Biopsy 646
Punch Biopsy 646
Shave Biopsy 647
Excisional Biopsy 647
BASAL CELL CARCINOMA 647
Epidemiology 648
Risk Factors 648
Clinical Presentation 648
Nodular Basal Cell Carcinoma 648
Superficial Basal Cell Carcinoma 648
Morpheaform Basal Cell Carcinoma 649
Treatment 649
SQUAMOUS CELL CARCINOMA 650
Epidemiology 650
Bowen Disease 650
Erythroplasia of Queyrat 650
Risk Factors 650
Clinical Presentation 650
Diagnosis 650
Treatment 651
Risk Factors for Recurrence of Cutaneous Squamous Cell Carcinoma 651
MELANOMA 651
Epidemiology 652
Superficial Melanoma 652
Nodular Melanoma 652
Lentigo Maligna Melanoma 652
Acral Lentiginous 653
Melanonychia Differential 653
Risk Factors 654
Clinical Presentation 654
Diagnosis 657
Treatment 657
Monitoring 658
Skin Cancer Prevention 658
REFERENCES 658
Parasitic Skin Infections for Primary Care Physicians 661
Key points 661
INTRODUCTION 661
SCABIES 662
General Information and Cause 662
Pathophysiology 662
Risk Factors 662
Transmission 663
Presentation 663
Diagnosis 664
Treatment 664
Complications 664
Prevention 664
PEDICULOSIS 664
General Information 664
PEDICULOSIS CAPITIS 665
Cause and Risk Factors 665
Epidemiology 665
Transmission 666
Presentation 666
Diagnosis 666
Treatment 667
Complications 667
Prevention 667
PEDICULOSIS PUBIS 667
Cause 667
Transmission 670
Epidemiology 670
Presentation 670
Diagnosis 671
Treatment 671
Complications 672
Prevention 672
PEDICULOSIS CORPORIS 672
Cause 672
Epidemiology and Risk Factors 673
Transmission 673
Presentation 673
Diagnosis 673
Treatment 673
Complications 674
Prevention 674
SUMMARY/DISCUSSION 674
REFERENCES 674
Nail Deformities and Injuries 677
Key points 677
NAIL ANATOMY 677
NAIL ABNORMALITIES 678
Onychomycosis 678
Leukonychia 679
Mees lines 680
Terry nails 680
Lindsay nail 680
Muehrcke lines 680
Melanonychia, Longitudinal 680
Nail Pitting 680
Subungual Hematoma 681
Beau Lines 682
Onycholysis 682
Pterygium Unguis 683
Longitudinal Ridging (Onychorrhexis) 683
Trachyonychia 684
Clubbing 684
Paronychia 686
Ingrown Toenails 687
Nail Avulsion Procedure 689
SUMMARY 691
REFERENCES 691