Rashes 6

Question 1

HS tx

Answer 1

Mild: avoid heat, sweating, humidity, decrease shaving (if irritation), 
No tight clothing or synthetic
PanOxyl soap and Cleocin T
Warm compresses
WEIGHT LOSS
NO SMOKING

Moderate: Doxy x 2 weeks for flares

Severe: excision if only 1 lesion left after Doxy (don’t want to chase them)

Question 2

Tumoral Amyloidosis in association with SCC means what?

Answer 2

Tumor means not associated with systemic disease, so no further workup.
Means could be invasive SCC deeper to what was biopsied

Question 3

Ill-defined cyst on neck, deep and not inflamed, what tx

Answer 3

5 mg ILK (0.5 cc) (50/50)

Question 4

Scalp folliculitis with picking

Answer 4

Pt had 4 spot (bx 3 came back as ulcers and inflamm papules)

Start Doxy 100 HS with food to control pimples and tx staph

Question 5

Doxycycline in 16 yo education

Answer 5

Can’t get pregnant while on this medication - can cause birth defects so if you plan on being sexually active, you would need to use birth control pills or use condoms. If you are interested, we can offer you a urine pregnancy test here today. It’s up to you if its something you would like to do here today.

Even RETINA or Epiduo can cause birth defects

Plan: discussed the importance of using condoms while on doxy as she CANNOT get pregnant on medication (JMO plan). Not on birth control, LMP 8/28/18

Question 6

TINEA pedis and nail oral tx

Answer 6

Baseline CMP

TERBINAFIN 250 daily x 4 weeks for t pedis

Question 7

Pyoderma gangrenosum

Answer 7

Non healing wound

Question 8

Lintayo oral for

Answer 8

Metastatic SCC or SCC not candidate for other tx

Question 9

LP tx

Answer 9

Eczemer laser
Or Plaquinil (get CMP and annual eye exams)
Or flagyl for LP (doxy or Plaquinil for LPP)
Aloe Vera

Question 10

Benign mole reassurance

Answer 10

Healthy looking mole, uniform in color, border and structure/network
White spots in it - gland around hair follicle, all cell have it but dark mole makes it more prominent
Has it changed over the last few months?
Pain or tingling sensation is likely has nothing to do with mole itself - could be referred from shoulder or hitting something (nerve bruising)
If see any darker spots in it or changes, rtc
RTC in 6 months to recheck (photo and measure today)

Question 11

Tx for extensive TINEA corpora

Answer 11

Lamisil 250 mg QD x 2 weeks (no need for baseline or any CMP)
Lamisil cream bid x 2 weeks
Ketoconazole shampoo? For 2 weeks and occasionally for maintenance
Fungus spreads form toes so color bleach socks, Tinactin for shoes and keep shoes dry

Question 12

Nail fungus

Answer 12

If mound: Lamisil won’t work but iteaconazole is only 30-40% success
200 mg x 12 weeks
Baseline CMP and at 6 weeks
SE: Liver failure/ heart failure/ neuropathy
CI: in congestive heart failure