Dermatology Basics David Surprenant MD Common Conditions Cellulitis

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 • If purulence, swab it for culture – Otherwise swab will only grow normal skin flora

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

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

Ask the patient if this is new or changing

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

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

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