randomquestionsforPC2

Atopic Dermatitis

• Manifests as an itchy, red, and inflamed rash, appearing as dry, scaly patches, small bumps, or oozing, crusted blisters
• Hallmark symptom is intense itching
• Skin may appear red, inflamed, and swollen
• Skin can become dry and develop scaly patches
• Small, rough bumps may appear, especially in darker skin tones
• Tiny, clear fluid-containing blisters can form and weep
• Oozing blisters may crust over
• Repeated scratching thickens and hardens the skin, called lichenification
• Affected skin may appear temporarily lighter or darker after the condition has improved, particularly in people with darker skin tones
• Can appear anywhere on the body, commonly on the face, inside the elbows, behind the knees; in children, on the face, scalp, hands, and feet
• Rash can be painful, especially if infected
• Intense itching can disrupt sleep and cause difficulty concentrating
• Scratching increases the risk of secondary infections
• Tends to flare up periodically, with symptoms worsening and then subsiding

Rubeola

• Refers to measles, a highly contagious viral disease
• Characterized by fever, cough, runny nose, and a red, blotchy rash
• Preventable through vaccination
• Measles spreads through respiratory droplets when an infected person coughs or sneezes
• Symptoms include fever, cough, runny nose, red, blotchy rash that starts on the face and spreads, Koplik's spots (small, white spots inside the mouth), and conjunctivitis (red, inflamed eyes)
• Incubation period is typically 7 to 18 days
• People with measles are contagious from 4 days before to 4 days after the rash appears
• Prevented through vaccination with the MMR vaccine (measles, mumps, and rubella)
• There is no specific treatment, but symptoms can be managed with rest, fluids, and over-the-counter medications
• Complications include pneumonia, ear infections, encephalitis, and even death
• Measles (rubeola) is different from rubella (German measles), which also causes a rash

Diaper Dermatitis

• Acute inflammation of skin in the region of the perineum, buttocks, lower abdomen, and inner thighs (contact, atopic, candida, seborrheic)
• Common in pediatric patients and adults with urinary or fecal incontinence due to prolonged contact with wet/soiled diaper
• Leave open to air if possible, using skin barrier ointment (zinc oxide), topical antifungal, topical low-potency corticosteroid (combo products on market)

Scabies

• Contagious skin infestation caused by the microscopic mite, Sarcoptes scabiei
• Transmitted through direct skin-to-skin contact, sharing bedding, clothing, or towels
• Symptoms include intense itching, especially at night, and a pimple-like rash with burrows (thin, winding lines on the skin)
• May also present with crusty lesions in severe cases
• Common affected areas include wrists, hands, elbows, groin, genitals
• Diagnosed based on symptoms and a physical examination
• Doctor may look for burrows or take a skin scraping to examine for mites
• Treated with a topical medication, such as permethrin cream or ivermectin
• All household members and close contacts should also be treated to prevent re-infestation
• Prevent by avoiding close contact with infected individuals, washing bedding and clothing in hot water, and using a condom during sexual intercourse with an infected partner
• Can lead to secondary infections from scratching and crusty lesions over large areas
• More common in crowded living conditions
• Can affect people of all ages and socioeconomic backgrounds
• Children are especially susceptible
• Permethrin or Ivermectin or Malathion – this is highly poisonous

Lice

• Head lice infect hair on the head
• Tiny eggs on the hair may look like flakes of dandruff, but stay in place instead of flaking off
• Head lice can live up to 30 days on a human
• Eggs can live for more than 2 weeks
• Head lice spread easily, particularly among school children ages 3 to 11 years
• More common in close, overcrowded living conditions
• You can get head lice by coming in close contact with a person who has lice, touching clothing or bedding of someone who has lice, or sharing hats, towels, brushes, or combs
• Causes intense itching but does not lead to serious medical problems
• Unlike body lice, head lice never carry or spread diseases
• Does not mean the person has poor hygiene or low social status
• Symptoms include very bad itching of the scalp, small, red bumps on the scalp, neck, and shoulders (bumps may become crusty and ooze), and tiny white specks (eggs, or nits) on the bottom of each hair that are hard to get off
• Treat with premetherin shampoo

Hookworm

• Transmitted through the skin, typically by walking barefoot on contaminated soil
• Initial symptoms include an itchy rash where the larvae enter the skin, known as "ground itch"
• If the infection progresses, symptoms can include abdominal pain, diarrhea, loss of appetite, and weight loss
• Hookworms feed on blood in the intestines, which can lead to iron-deficiency anemia
• Severe, chronic hookworm infections can lead to anemia, malnutrition, and stunted growth in children
• Treated with anti-parasitic medications, and iron supplements if anemia develops
• Oral albendazole and oral ivermectin are available for human use in the United States
• Ivermectin is contraindicated in children younger than 2 years age
• Prevented by avoiding contact with contaminated soil by wearing shoes, practicing good hygiene, and ensuring proper sanitation

Bed Bugs

• Treat with corticosteriods
• Bed bug bites are usually small, red, and itchy, often appearing in a line or cluster
• Bites can occur anywhere on the body, but are most common on exposed areas like arms, legs, and shoulders
• Some people react more strongly to bed bug bites, experiencing swelling, rashes, or hives
• Find small blood stains on sheets, mattresses, or pillows Visual Signs
• Live bed bugs are small, reddish-brown insects, about the size of an apple seed
• Bed bugs shed their skin as they grow, and you may find these translucent, hollow shells in places where they hide
• Bed bug eggs are tiny, white, and oval-shaped, and can be found in cracks and crevices
• Bed bug droppings appear as small, dark spots (often black or brown) on bedding, mattresses, or furniture
• Heavy infestations can produce a distinct, musty odor Where to Look
• Check mattresses, box springs, and headboards for signs of bed bugs
• Inspect seams, cushions, and cracks in chairs, couches, and other furniture
• Look for bed bugs and their signs in cracks, crevices, and along baseboards

Tinea Pedis

• Fungal infection of the feet that presents with itching, odor, burning sensation, maceration in toe webs, scaling or blistering on soles of feet
• Risks: athletes, immunocompromised, older adults, hot/humid, occlusive footwear
• Treat: Topical antifungal treatment for 4-6 weeks, aluminum acetate (Burrow/Domeboro) soak to decrease itching and eczema reaction

Tinea Corporis

• Caused by dermatophyte fungi, such as Trichophyton rubrum and Trichophyton mentagrophytes
• Fungi spread through direct contact with an infected person or animal, or by touching contaminated objects such as towels, clothing, or shower floors
• Symptoms include a ring-shaped rash with raised, scaly borders, itching, and redness
• May have small blisters or vesicles in some cases
• Can spread to other areas of the body
• Diagnosed based on its appearance; doctor may take a skin scraping to confirm the presence of fungi
• Antifungal creams or ointments applied topically to the affected area are the primary treatment
• In severe cases, oral antifungal medications may be prescribed
• Topical Antifungal Creams (Over-the-Counter or Prescription): Clotrimazole (Lotrimin AF) which is a common over-the-counter option, Miconazole (Micatin) is readily available over-the-counter, Terbinafine (Lamisil AT) over-the-counter and Ketoconazole which is prescription-strength
• Econazole and Butenafine exists as an alternative treatment.
• Oral Antifungal Medications (Prescription Only): Terbinafine is a common oral medication for more extensive or resistant cases
• Prevent through avoiding contact with infected individuals or animals, washing hands frequently, using clean towels and clothing, keeping feet and nails clean and dry, and wearing shoes in public showers and locker rooms
• Tinea corporis is contagious and can spread easily and has a incubation period of typically 4-14 days
• Most cases resolve with treatment within 2-3 weeks
• If left untreated, tinea corporis can spread to other parts of the body or become chronic

Tinea Cruris

• Fungal infection of the groin area, also known as jock itch
• Caused by fungal organisms, such as Trichophyton rubrum and T. mentagrophytes
• Also from warm, moist conditions in the groin area, friction from clothing or activities, and sharing contaminated towels or clothing
• Symptoms include an itchy, red rash in the groin area that may spread to the inner thighs or buttocks
• Ring-shaped lesions with raised borders and blisters or scaling also occur
• Diagnosis through visual examination and Potassium hydroxide (KOH) wet mount of skin scrapings
• Treats with topical antifungal creams or ointments (e.g., clotrimazole, terbinafine), oral antifungal medications (e.g., itraconazole), keeping the groin area clean and dry, and avoiding tight or wet clothing
• Prevent with loose-fitting, breathable clothing, keeping the groin area clean and dry, avoiding sharing towels or clothing, treating athlete's foot promptly, and using antifungal powder or spray in the groin area
• Complications include secondary bacterial infection and spread to other areas of the body
• Tinea cruris is contagious and can be spread through contact with infected skin or objects

Tinea Capitis

• Fungal infection of the scalp presents round, patchy scales on scalp with/or without alopecia
• Treatments are Griseofulvin orally for 4 to 6 weeks, take with high-fat diet, wear sunscreen due to increased photosensitivity, monitor liver function reduces efficacy of oral contraceptives and contraindicated in pregnancy

Tinea Unguium

• Fungal infection of the fingernails/toenails (Onychomycosis)
• Risks occur with immunocompromised patients, tinea pedis, PVD, older adult, communal swimming pool
• Treat with Oral antifungal (terbinafine) which is preferred due to higher rate of cure but have systemic adverse effects, contraindicated in pregnancy and hepatic disease, test liver function initially and 1 month after, treat 6-12 weeks

Tinea Versicolor

• Fungal infection appearing with well-marginated lesions of varying color (white, red, brown)
• Common on shoulders, chest, back, and in axilla
• Higher risk with hot, humid climate, wet clothes , immunocompromised state
• Treatments are antifungal shampoo (note specific directions for application), oral antifungal monitor liver function do not share sports equipment, towels, clothes and remove wet clothing promptly do not avoid direct contact in public bathing

Tinea Barbae

• Ringworm of the beard, is a fungal infection affecting the hair follicles and skin in the beard and mustache area, primarily in adult males, and is often spread through contact with infected animals
• Symptoms include red, itchy, and scaly patches on the skin, potentially with pustules or blisters around hair follicles, swelling and redness around the infected area, and in some cases, hair loss
• Severe cases can develop a kerion (firm red nodules covered with pustules or scabs), potentially accompanied by fever and swollen lymph glands
• Can occur through a fungal infection, animal contact, or less common contact with contaminated soil or other humans
• Treatments are oral Antifungal Medications like griseofulvin, terbinafine, or itraconazole, warm Compresses to help remove crusts and debris, topical Antibiotics to Treat secondary bacterial infections, Corticosteroids to reduce symptoms and potentially prevent scarring and Hair Depilation which is shaving or hair depilation may be recommended to facilitate treatment

Oral Candidiasis

• Fungal infection of the membranes of the mouth that may involve the throat, esophagus, and trachea
• Appears as white oral plaques on erythematous base
• Risks occur with immunocompromised patients, use of inhaled corticosteroids, antibiotics, dentures, infant < 6 months
• Treat with oral antifungal agents (Nystatin oral suspension, fluconazole (Diflucan)) which resolves within 2 weeks

Fifth Disease

• Common viral infection caused by Parvovirus B 19; characterized by an eruptive rash, sore throat, mild fever, runny nose, nausea, headache, itching
• No contagious once rash develops and may return to school
• Phase 1: slapped cheek syndrome with circumoral pallor (2-4 days)
• Phase 2: erythematous maculopapular rash on extremities and trunk, fading into a centrally clear, lacy pattern (1-6 weeks)
• Phase 3: persistent, variable rash worse during heat, stress, sunlight (1-3 weeks), pregnant women can pass virus to fetus urgent referral to specialist supportive treatment

Paronychia

• Localized superficial infection of the perionychium (the skin bordering the nails) with Staphylococcus aureus more common pathogen
• Risks due to nail-biting, ingrown nails, trauma cause pain, erythema, redness around nail plate, abscess
• Treatments are topical mupirocin (Bactroban) TID for mild case, oral if abscess or suspected MRSA with oral flora), warm compress/soak, I&D if abscess, tetanus shot if not up-to-date

Scarlet Fever

• Infectious bacterial disease caused by Streptococcus pyogenes (group A strep bacteria), affecting children between 5 and 15
• Symptoms include sore throat, fever, rash that starts as red spots on the face, neck, and chest, and spreads to the rest of the body
• Can have swollen lymph nodes in the neck, headache, nausea and vomiting, chills, and malaise
• Caused by the spread of Streptococcus pyogenes bacteria through respiratory droplets from an infected person
• Treat with antibiotics, such as penicillin or amoxicillin, to be taken for 10 days
• Rare cases result in complications such as rheumatic fever, kidney damage, and Heart damage
• Prevent through wash hands frequently with soap and water, avoiding contact with people who are sick, covering coughs and sneezes with a tissue or your elbow, and get vaccinated against the flu
• Most people with scarlet fever recover fully within a few weeks with prompt antibiotic treatment,

Burns

• Injuries to the skin or underlying tissues caused by heat, electricity, radiation, or chemicals
• First-degree burns are superficial burns that affect only the outer layer of skin (epidermis) causing redness, pain, and mild swelling
• second-degree burns are partial-thickness burns that damage both the epidermis and part of the dermis causing redness, pain, swelling, and blisters
• third-degree burns are full-thickness burns that destroy all layers of skin and may extend into underlying tissues(muscle, fat, bone) causing white or charred and may be painless due to nerve damage
• Can be caused by hot liquids (scalds), fire, hot objects, electricity, radiation, and chemicals
• Result inRedness, Pain, Swelling, Blisters, and White or charred skin
• Treatments are first-degree burns where you cool the burn with cool water for 20 minutes, apply an over-the-counter pain reliever, and protect the area from further irritation
• second-degree burns where you cover the burn with a loose, sterile bandage, apply cool compresses, and seek medical attention
• third-degree burns results in calling emergency services immediately and treatment which involves surgery, skin grafts, and rehabilitation

Pediculosis

• Infestation of the body, head, or pubic area by lice, incubation 1 month
• Head and body lice are common in children
• Risks include prolonged proximity to infected people, sharing hats/combs, contact with infected linens or clothes
• Presents as itchy, prickly sensation on scalp, dandruff that moves, itchy body, 2-4 mm papules, macular rash in area of infestation, nits found on base of hair shaft
• Treatment is Primerthrin 1% (Nix) applied to dry hair for 10 minutes, cream leave on 8-14 hours then wash off, repeat in one week, the scratching May get secondary bacterial infection from the scratching
• Clean linens, vacuum, seal in a bag 2 weeks

Impetigo

• Contagious superficial skin infection prominent on exposed areas of the face and extremities and most common in children without school for 48 hours
• Risks include sports, daycare, warm, humid environment,
• Appears as small superficial vesicles with “honey crusted"
• Treat with topical mupirocin (Bactroban) TID and wash with antibacterial soap or chlorhexidine (Hibiclens)

Roseola

• Common viral infection caused by the human herpesvirus 6 (HHV-6) that primarily affects young children, as known as sixth disease
• spread through contact with saliva or respiratory droplets from an infected person
• Classic symptoms include high fever (103-105°F) that lasts for 3-5 days that rash that appears after the fever subsides
• Can cause irritability, runny nose or sore throat, swollen glands in the neck
• Diagnosis usually diagnosed based on symptoms, but a blood test may be done to confirm if other conditions are suspected
• There is no specific treatment for roseola
• Treatment involves fever-reducing medications (e.g., acetaminophen or ibuprofen), keeping the child hydrated, and providing comfort and rest
• Complications are rare in rare cases, such as febrile seizures (seizures caused by high fever) and encephalitis (inflammation of the brain)
• Prevent with good hygiene practices, such as hand washing and avoiding contact with infected individuals

Pityriasis Rosea

• Idiopathic, self-limited skin eruption characterized by widespread papulosquamous lesions most common on face, trunk, and distal extremities
• Hallmark sign is 2-10cm salmon-colored oval patches or plaque known as herald patch
• Followed by generalized rash 1-2 weeks later and oval lesions appear parallel to each other as known as "Christmas tree rash"
• Treat mild pruritis with oral or topical antihistamine, topical steroids, oral steroid if itching severe Resolves in 6-12 weeks

Herpangina

• Is a Viral infection that causes fever and multiple vesicles, followed by painful mouth ulcerations involving the soft palate, uvula, and tonsils
• Can transmit usually by fecal-oral route but can be resp droplet
• Leads to onset of fever, sore throat , yellowish/grey/white vesicles surrounded by red halo
• Treat symptoms with analgesics topical anesthetics which resolves in 7-10 days but viral shedding lasts 4 to 6 weeks

Cat Scratch Disease

• Result in Subacute tender lymphadenitis that develops after contact with a cat, scratch being most common
• A red macule develops at contact site and evolves into fluid- filled vesicles and crusts, unilateral lymphadenopathy within 1-2 weeks & may last 2 to 8 weeks
• Can be self-limiting and resolves in 2 to 6 months with treatment with analgesics, antibiotic in immunocompromised

Varicella

• Also known as chicken pox,which is a highly contagious viral infection that causes a characteristic itchy, blister-like rash.
• caused by the varicella-zoster virus (VZV)and spreads through direct contact with the fluid from the blisters or with respiratory droplets from an infected person
• Typical symptoms include fever headache fatigue and loss of appetite
• Itchy, blister-like rash that typically starts on the face, chest, and back and then spreads to the rest of the body where the rash progresses through stages, from small red bumps to fluid-filled blisters, and eventually to scabs
• The incubation period for chickenpox is 10 to 21 days
• It is highly contagious where it can spread it from 1 to 2 days before the rash appears until all the blisters have crusted over
• Most cases of chickenpox are mild, but some complications can occur for people those with weakened immune systems such as bacterial skin infections, pneumonia, Brain inflammation, and Reye's syndrome
• There is no specific cure for chickenpox, but most cases resolve on their own within 7 to 10 days which involved rest,Caladryl lotion or oatmeal baths to soothe the itch, over-the-counter pain relievers such as acetaminophen or ibuprofen and with possible antiviral medications

Rubella

• Also known as German measles, which is a viral infection that is highly contagious where it is caused by the rubella
• Results in mild symptoms of fever,rash that starts on the face and spreads to the rest of the body swollen lymph nodes in the neck and behind the ears headache joint pain runny nose sore throat
• Can result in serious complications for pregnant women known as congenital rubella syndrome (CRS),CRS causes hearing loss, vision problems, heart defects, and developmental disabilities
• Prevent with vaccination and typically givenas part of the MMR (measles, mumps, rubella) vaccine and highly effective in preventing rubella infection
• Most common in children and young adults, it has a infection period of about of 10-21 days
• Not common in United States due to widespread vaccination and is still a concern in some parts of the world

Subungual Hematoma

• Bleeding under the nail, is a common injury to the fingernail or toenail which results in a collection of the blood and fluid, often causing the pain and discoloration
• caused by trauma or direct blows that cause crushing injuries to the nail bed
• Wearing tight-fitting shoes can trap blood in the toes, leading to increased pressure and potential injury
• Symptoms include throbbing pain which worsens as blood pools,
• Discoloration that may appear red, purple, maroon, or black
• Tenderness or soreness to the touch, a feeling of pressure a swelling of the tip of the finger or toe
• Treatments involves rest, ice, elevation, and compression and Over-the-counter pain medication, nail trephination where a small hole is made in the nail to drain the blood and relieve pressure
• Seeks medical attention if pain is severe or doesn't improve within a few days, or if there are signs of infection.if damaged then a Damaged nail may will likely fall off on its own if not removed
• Prevent injuries by wearing shoes with a wide toe box, file toenails short, and consider silicone toecaps

Hand Foot and Mouth Disease

• Highly contagious viral illness (Group A coxsackievirus) characterized by lesions on buccal mucosa, palate, palms of the hands, soles of the feet, and buttocks
• May self-limiting from 7-10 days
• PresentsProdrome of fever, URI symptoms, sore throat,painful mouth lesions often precede skin lesions, rash on hands and feet with with avoiding aspirin in children with febrile illness due to Reye’s syndrome

Erysipelas

• Distinct form of cellulitis notable for acute, well-demarcated, superficial bacterial skin infection, that is more common on face, scalp, and extremities
• Most common pathogen is Streptococcus pyogenes that leads to fever, headache, vomiting,chills and arthralgia
• Treat with penicillin, Bactrim, cefazolin since the chronic form exists

Intertrigo

• Classified a superficial fungal skin infection located on intertigenous areas with increased warmth, humidity, or friction
• Classic case includes obese patient complaining of bright-red and shiny lesions that itch or burn under the breasts, axillae, abdomen or groin
• Treat with Nystatin powder and/or cream in skin folds BID. OTC topicals miconazole and clotrimazole work well.