Dermatology Check List 2024 PDF

DESCRIPTION: Three, Different Size & Shape, Will-Defined, Red Plaques Covered with White Silvery Scales, Present On Extensor Surface of Right Forearm. DIFFERINTIAL 1. Psoriasis. 2. Lichen Planus. 3. Pityriasis Rosea....

DESCRIPTION: Three, Different Size & Shape, Will-Defined, Red Plaques Covered with White Silvery Scales, Present On Extensor Surface of Right Forearm. DIFFERINTIAL 1. Psoriasis. 2. Lichen Planus. 3. Pityriasis Rosea. 4. Eczema. 5. Drug Eruption. 6. Fungal Infection. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Psoriasis Vulgaris. CAUSES: Unknown, Autoimmune, Genetic. TYPES: 1. Psoriasis Vulgaris. 2. Scalp Psoriasis. 3. Nail Psoriasis. 4. Guttat Psoriasis. 5. Psoriasis Inversus. 6. Psoriatic Arthritis. 7. Erythrodermic Psoriasis. 8. Pustular Psoriasis (Generalized & Palmo-Planter). SEVER TYPES: 1. Psoriatic Arthritis. 2. Erythrodermic Psoriasis. 3. Generalized Pustular Psoriasis. DIAGNOSIS & Clinically By Auspitz Sign & Candle Sign. Laboratory By Skin Biopsy Which Reveals: INVESTIGATIONS: Hyperkeratosis Acanthosis & Parakeratosis. TREATMENT: Local: Emollients (Vasline), Keratolytic Agent (Salicylic Acid), Coal Tar or Dithranol, Topical Retinoids, Topical Vitamin D Analogus, Tacrolimus Systemic: PUVA (Psoraline + UVA), Systemic Retinoids, Cyclosporin A In Case of Psoriatic Arthritis Give Methotrexate + Folic Acid. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Large, Will-Defined, Red Plaque, Covered with White Silvery Scales, Present On Extensor Surface of Left Elbow. DIFFERINTIAL 1. Psoriasis 2. Lichen Planus 3. Pityriasis Rosea 4. Eczema 5. Drug Eruption 6. Fungal Infection DIAGNOSIS: MOST LIKELY DIAGNOSIS: Psoriasis Vulgaris. CAUSES: 1. Unknown. 2. Autoimmune. 3. Genetic. TYPES: 1. Psoriasis Vulgaris. 2. Scalp Psoriasis. 3. Nail Psoriasis. 4. Guttat Psoriasis. 5. Psoriasis Inversus 6. Psoriatic Arthritis. 7. Erythrodermic Psoriasis. 8. Pustular Psoriasis (Generalized & Palmo-Planter). SEVER TYPES: 1. Psoriatic Arthritis. 2. Erythrodermic Psoriasis. 3. Generalized Pustular Psoriasis. DIAGNOSIS & Clinically: By Auspitz Sign & Candle Sign. INVESTIGATIONS: Laboratory: By Skin Biopsy Which Reveals: Hyperkeratosis Acanthosis & Parakeratosis. TREATMENT: Local: Emollients (Vasline), Keratolytic Agent (Salicylic Acid), Coal Tar or Dithranol, Topical Retinoids, Topical Vitamin D Analogus, Tacrolimus Systemic: PUVA (Psoraline + UVA), Systemic Retinoids, Cyclosporin A In Case of Psoriatic Arthritis Give Methotrexate + Folic Acid. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Large, Will-Defined, Red Plaque, Covered with White Silvery Scales, Present On the Scalp Following Hair Line. DIFFERINTIAL 1. Scalp Psoriasis. 2. Seborrhoic Dermatitis (Eczema). 3. Favus (Fungal Infection). 4. Drug Eruption. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Scalp Psoriasis. CAUSES: 1. Unknown. 2. Autoimmune. 3. Genetic. OTHER TYPES: 1. Psoriasis Vulgaris. 2. Nail Psoriasis. 3. Guttat Psoriasis. 4. Psoriasis Inversus. 5. Psoriatic Arthritis. 6. Erythrodermic Psoriasis. 7. Pustular Psoriasis (Generalized & Palmo-Planter). SEVER TYPES: 1. Psoriatic Arthritis. 2. Erythrodermic Psoriasis. 3. Generalized Pustular Psoriasis. DIAGNOSIS & Clinically: By Auspitz Sign & Candle Sign. INVESTIGATIONS: Laboratory: By Skin Biopsy Which Reveals: Hyperkeratosis Acanthosis & Parakeratosis. TREATMENT: Local: Emollients (Vasline), Keratolytic Agent (Salicylic Acid), Coal Tar or Dithranol, Topical Retinoids, Topical Vitamin D Analogus, Tacrolimus Systemic: PUVA (Psoraline + UVA), Systemic Retinoids, Cyclosporin A In Case of Psoriatic Arthritis Give Methotrexate + Folic Acid. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Will-Defined, Red Papules & Plaques, Covered with White Silvery Scales Present On The Back. DIFFERINTIAL 1. Guttate Psoriasis. 2. Pityriasis Rosea. 3. Secondary Syphilis. 4. Drug Eruption. 5. Fungal Infection. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Guttate Psoriasis. CAUSES: Groupe A Beta Hemolytic Streptococci. OTHER TYPES: 1. Psoriasis Vulgaris. 2. Nail Psoriasis. 3. Scalp Psoriasis. 4. Psoriasis Inversus. 5. Psoriatic Arthritis. 6. Erythrodermic Psoriasis. 7. Pustular Psoriasis (Generalized & Palmo-Planter). SEVER TYPES: 1. Psoriatic Arthritis. 2. Erythrodermic Psoriasis. 3. Generalized Pustular Psoriasis. DIAGNOSIS & Clinically: By Auspitz Sign & Candle Sign. INVESTIGATIONS: Laboratory: By Skin Biopsy Which Reveals: Hyperkeratosis Acanthosis & Parakeratosis. TREATMENT: Local: Emollients (Vasline), Keratolytic Agent (Salicylic Acid), Coal Tar or Dithranol, Topical Retinoids, Topical Vitamin D Analogus, Tacrolimus. Systemic: PUVA (Psoraline + UVA), Systemic Retinoids, Cyclosporin A In Case of Psoriatic Arthritis Give Methotrexate + Folic Acid. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Will-Defined, Purple Plaques, Covered with White Scales, Present On the Dorsum of the Hand & Fingers. DIFFERINTIAL 1. Lichen Planus. 2. Psoriasis. 3. Pityriasis Rosea. 4. Eczema. 5. Drug Eruption. 6. Fungal Infection. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Lichen Planus. CAUSES: 1. Unknown. 2. Autoimmune. 3. Genetic. 4. Viral Infection (Hepatitis B & C). 5. Drugs (Diuritics, ACE Inhibitors). TYPES: 1. Classical. 2. Atrophic. 3. Hypertrophic. 4. Erythrodermic. 5. Ulcerative. 6. Linear. 7. Follicular. 8. Annular. 9. Actinic. DIAGNOSIS & Clinically. Laboratory: By Skin Biopsy Which Reveals: INVESTIGATIONS: Hypergranulosis, Hyperkeratosis, Basal Cell Layer Degerneration with Saw Teeth Appearance & Colloid Bodies. TREATMENT: Self-Limiting Within 9-12 Months. Local Steroid. Anti Histamine. Systemic Steroid, (Methotrexate Maybe Used in Some Cases). PUVA. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Will-Defined, Red Papules, & Single, Large, Patch, Covered with White Silvery Scales Present On The Trunk. DIFFERINTIAL 1. Pityriasis Rosea. 2. Guttate Psoriasis. 3. Secondary Syphilis. 4. Drug Eruption. 5. Fungal Infection. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Pityriasis Rosea. CAUSES: 1. Unknown. 2. Viral Infection (Influenza). 3. Influenza Vaccin. DIAGNOSIS & Clinically. Laboratory: By Skin Biopsy Which Reveals: INVESTIGATIONS: Focal Parakeratosis & Hyperplasia. TREATMENT: Self-Limiting Within 4-6 Weeks. Local Steroid. Anti Histamine. Systemic Steroid Maybe Used in Some Cases. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Bilateral, Different Size & Shape, Will-Defined, Macules & Patches, Scattered On the Dorsum of the Both Hand & Fingers. DIFFERINTIAL 1. Vitiligo. 2. Leprosy. 3. Pityriasis Vesicolor. 4. Pityriasis Alba. 5. Post Traumatic. 6. Post Inflammatory. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Vitiligo. PATHOGENIC THEORIES: Autoimmune Threory, Neurotoxic Theory, Self-Distruction Theory. TYPES: 1. Acral Type. 2. Segmental Type. 3. Universalis. 4. Vulgaris. 5. Acro-Facial. 6. Mucus Mambranus. DIAGNOSIS & Clinically. Woods Lamp  Milky White or Chalky White. INVESTIGATIONS: Laboratory: CBC (Lymphocytosis), Serology (Anti Melanocyte Ab), TFT. Skin Biopdy (Absent of Melanocyte). TREATMENT: Reassurance + Sun Screen. If Local Vitiligo Give Local Steroid or Tacroliumus + UVB + Camouflage. If Diffuse Vitiligo Give PUVA + Systemic Steroid. Melanocyte Graft If It is Possible. Depigmentation Therapy By Using Monobenzylether Hydroquinone For 3-12 Months Especially If Vitiligo Present in >80% of Body Surface. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Will-Defined, Macules & Patches, Scattered On the Both Upper Limbs, Shouders, Chest & Abdomen. DIFFERINTIAL 1. Vitiligo. 2. Leprosy. 3. Pityriasis Vesicolor. 4. Pityriasis Alba. 5. Post Traumatic. 6. Post Inflammatory. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Vitiligo Universalis. PATHOGENIC THEORIES: Autoimmune Threory, Neurotoxic Theory, Self-Distruction Theory. TYPES: 1. Acral Type. 2. Segmental Type. 3. Universalis. 4. Vulgaris. 5. Acro-Facial. 6. Mucus Mambranus. DIAGNOSIS & Clinically. Woods Lamp  Milky White or Chalky White. INVESTIGATIONS: Laboratory: CBC (Lymphocytosis), Serology (Anti Melanocyte Ab), TFT. Skin Biopdy (Absent of Melanocyte). TREATMENT: Reassurance + Sun Screen. If Local Vitiligo Give Local Steroid or Tacroliumus + UVB + Camouflage. If Diffuse Vitiligo Give PUVA + Systemic Steroid. Melanocyte Graft If It is Possible. Depigmentation Therapy By Using Monobenzylether Hydroquinone For 3-12 Months Especially If Vitiligo Present in >80% of Body Surface. DR. MOHCEN AL. HAJ NAME: Woods Lamp. WAVE LENGTH: 365 Nanometer. USES: Diagnosis of: 1. Vitiligo. 2. Erythrasma. 3. Pityriasis Vesicolor. 4.Tinea Capitis. COLORS: 1. Vitiligo  Milkey White or Chalky White. 2. Erythrasma  Coral Red. 3. Pityriasis Vesicolor  Golden Yellow. 4.Tinea Capitis  Flourscence Green. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Will-Defined, Oval Patch of Hair Loss, with No Signs of Inflammation & No Secondary Skin Lesions, Present On the Scalp. DIFFERINTIAL 1. Alopecia Areata. 2. Androgenic Alopecia. 3. Tractional Alopecia. 4. Trichotelomenia. DIAGNOSIS: 5. Non Inflammatory Tinea Capitis. 6. Cicatritial Alopecia. MOST LIKELY DIAGNOSIS: Alopecia Areata. TYPES: 1. Alopecia Totalis 2. Alopecia Universalis 3. Ophiasis Pattern POOR PROGNOSTIC 1. Alopecia Totalis. 2. Alopecia Universalis. 3. Ophiasis Pattern. 4. Nail Changes. 5. Young Patient FEATURES: 6. If Associated with Done Syndrome or Atopy. 7. +ve Family History. DIAGNOSIS & Clinically. Laboratory: By Skin Biopsy Which Reveals: T-Lymphocyte Infiltration. INVESTIGATIONS: Other Investigations: CBC, TFT, Zinc, Ferritin, Folate Vitamin B12. TREATMENT: Reassurance. Local or Intra-Lesion Steroids. Local Tacrolimus. Dithranol. Minoxidil. Systemic Immune Therapy (Cyclopsporin, Baricitinib). PUVA. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Red Papules & Pastules, Scattered On the Forehead. DIFFERINTIAL 1. Acne. 2. Rosecea. 3. Worts. 4. Eczema. 5. Drug Eruption. 6. Fungal Infection. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Acne Vulgaris. TYPES: 1. Acne Vulgaris. 2. Infantile Acne. 3. Excoriated Acne. 4. Drug Induced Acne. 5. Steroid Induced Acne. 6. Acne Conglubata (Severe). 7. Acne Fulminance (Severe). DIAGNOSIS & Clinically. No Need For Investigations Except: INVESTIGATIONS:  If Lady Presented with Acne & Hairisitism Do Ultrasound Pelvis & Hormonal Assay to Exclude PCOs.  In Case of Severe Types Send CBC & Swab For Culture & Sensitivity. TREATMENT: Grade I & II Mild: Topical Erythromycin Combined with Benzyl Peroxide. Topical Retinoids (Tretinoin). Azelaic Acid (Reduce Post Inflammatory Pigmentation). Grade II Sever & Grade III: Sytemic Tetracycline For 6 Weeks or Doxycycline or Clindamycin. Sytemic Retinoids (Isotretinoin) For 3 to 4 Months. DR. MOHCEN AL. HAJ MOST LIKELY DIAGNOSIS: Rosacea. TYPES: 1. Erythemato-Telangeictatic Rosacea. 2. Papulo-Pustular Rosacea. 3. Phymatous Rosacea. 4. Ocular Rosacea. TREATMENT: 1. Avoid Precipitating Factor as: Hot or Cold Weather, Caffeine, Hot Drinks, Spicy Food, Stress, Alcohol. 2. Daily Use Sunscreen. 3. Topical Antibiotics (Metronidazole Gel). 4. Systemic Antibiotic. 5. Systemic Retinoid (Isotretinoin). Especially For Phymatous Rosacea. 6. Laser Therapy. 7. Electro-Surgical Intervention Especially For Telageictasia & Rhinophyma. DR. MOHCEN AL. HAJ NAME: Rhinophyma. DISEASE: Rosacea. OTHER COMPLICATIONS: 1. Blepheritis. 2. Red Eyes. 3. Edema Around the Eyes. TREATMENT: 1. Laser Therapy. 2. Electro-Surgical Intervention. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Bilateral, Red Nodules, Present On Anterior Aspect of Both Legs. DIFFERINTIAL 1. Erythema Nodosum. 2. Erytherma Induratum. 3. Insect Bite. 4. Phlepitis. DIAGNOSIS: 5. Eczema. 6. Drug Eruption. 7. Fungal Infection. MOST LIKELY DIAGNOSIS: Erythema Nodosum CAUSES: Sterptococci (Most Common). Bacterial (TB, Mycoplasma, Salmonella, Shigella). Parasite (Toxoplasmosis). Drugs (OCP, Sulphonamides, Gold). Bachcet Disease, Crhons Disease. Idiopathic. DIAGNOSIS & Clinically. Laboratory: CBC, ESR, CRP Throat Swab (ASO Titer). INVESTIGATIONS: Chest X Ray & Tuberculin Test (to Exclude TB). TREATMENT: Bed Rest. Elevation of Legs. Cold Compression. NSAIDs (Indomethacin or Aspirin or Colchicine). Topical Antibiotics. Systemic Antibiotic Maybe Used. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Target Lesions, Present On the Palm of the Hand & Fingers. DIAGNOSIS: Erythema Mutiform. TYPES: 1. Erythema Multiform Minor. 2. Erythema Multiform Major. 3. Steven Johnson Syndrome (SJS)  Severe Type. 4. Toxic Epidermolytic Toxica (TEN)  Severe Type. CAUSES: Herpes Simplex (Most Common). Viral (HIV, Hepatitis B, Mumps, Meals). Bacterial (Mycoplasma Pneumonia). Drugs (OCP, Sulphonamides, Penicillin, Barbiturates). Idiopathic. COMPLICATIONS: 1. Red Eye (Conjunctivitis, Uveitis), Blindness. 2. Dehydration & Secondary Bacterial Infection. 3. Pneumonia. 4. Renal & Liver Failure. DIAGNOSIS & Clinically. No Specific Laboratory Test: CBC, ESR, CRP. INVESTIGATIONS: TREATMENT: Erythema Multiform Minor: Self Limiting (4-6 Weeks). Others: Admission, IV Fluid, Topical Steroid, Systemic Steroid, Systemic Acyclovir 400mg, Systemic Antibiotic Maybe Used. DR. MOHCEN AL. HAJ DESCRIPTION: Three Different Size & Shape Wheals Present On Anterior Aspect of Right Leg. DIAGNOSIS: Urticaria. TYPES: 1. Solar Urticaria. 2. Colar Urticaria. 3. Pressure Urticaria. 4. Vibration Urticaria. 5. Cholinergic Urticaria. 6. Dermographism Urticaria. 7. Aquagenic Uricaria. COMPLICATIONS: 1. Hypotension. 2. Shock (Anaphylactic). 3. Angioedema. 4. Laryngeal Edema. DIAGNOSIS & Clinically. No Need For Laboratory Investigations. INVESTIGATIONS: TREATMENT: Systemic Steroid (Hydrocortisone Usually Single Dose). Anti Histamine. In Case of Laryngeal Edema; Give  IM or S/C Adrenaline. DR. MOHCEN AL. HAJ DIAGNOSIS: Lamerllar Ichthyosis. PATHOGNOMONIC Bilateral Ectropion. FEATURE: OTHER CLINICAL TYPES: Ichthyosis Vulgaris. Icthyrosis Negricans. Harequin Ichthiosis (Most Severe Type). DIAGNOSIS & Clinically. INVESTIGATIONS: TREATMENT: No Specific Treatment. Symptomatic Treatment: Emolients & Keratolytic Agents. Retinoid Maybr Used. Treat Eyes Complications. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Will-Defined, Vesicle Containing Serous Fluid, with Mltiple Erosions & Crusts, Scattered On The Back, Shoulders & Upper Limbs. DIFFERINTIAL 1. Pemphigoid 2. Pemphigus 3. Erythema Multiform 4. Burns 5. Chemical Trauma 6. Drug Eruption 7. Epidermolysis Bullousa DIAGNOSIS: MOST LIKELY DIAGNOSIS: Pemphigus. CAUSES: Autoimmune. TYPES: 1. Pemphigus Vulgaris. 2. Pemphigus Foliaceus. 3. Pemphigus Erythromatosus. 4. Drug-Induced Pemphigus. DIAGNOSIS & Clinically: Nikolisky Sign  Positive. Skin Biopsy & Histopathology: Intra-Epidermal Thin Wall Bullous, Free of INVESTIGATIONS: Blood with Acantholysis. Immune-Fluorescence Study: Direct Show: Inter-Cellular IgG Indirect (ELISA) Not Favor. Tzank Smear  Positive. TREATMENT: Systemic Steroid (Prednisolone), Azathioprine (Imuran), Methotrexate, Rituximab, Plasmaphoresis. Topical Steroid + Topical Antibiotic + Anti-Septic Mouth Wash + Potassium Permanganate. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Will-Defined, Vesicle Containing Serous Fluid & Blood, with Mltiple Erosions & Crusts, Scattered On The Back, Shoulders & Upper Limbs. DIFFERINTIAL 1. Pemphigus 2. Pemphigoid 3. Erythema Multiform 4. Burns 5. Chemical Trauma 6. Drug Eruption 7. Epidermolysis Bullousa DIAGNOSIS: MOST LIKELY DIAGNOSIS: Pemphigoid. CAUSES: Autoimmune. TYPES: 1. Bullous Pemphigoid. 2. Mucous Membrane Pemphigoid. 3. Occular Cicatritial Pemphigoid. 4. Pemphigoid Gestationis. DIAGNOSIS & Clinically: Nikolisky Sign  Negative. Skin Biopsy & Histopathology: Sub-Epidermal Thick Wall Bullous Filled with INVESTIGATIONS: Blood (No Acantholysis). Immune-Fluorescence Study: Direct Show: IgG On Basement Membrane Indirect: IgG in Blood (in 70% of Pts). Tzank Smear  Negative. TREATMENT: Systemic Steroid (Prednisolone), Azathioprine (Imuran). Topical Steroid + Topical Antibiotic + Anti-Septic Mouth Wash + Potassium Permanganate. DR. MOHCEN AL. HAJ DESCRIPTION: Thick, Honey Yellow, Crust, Adherent Around the Mouth & Nostrils. DIFFERINTIAL 1. Impetigo 2. Herpes Simplex 3. Herpes Zoster 4. Eczema 5. Drug Eruption 6. Burns 7. Chemicals DIAGNOSIS: MOST LIKELY DIAGNOSIS: Impetigo Contagiosum. TYPES: 1. Non Bullous Impetigo (Most Common). 2. Bullous Impetigo. CAUSATIVE ORGANISM: Non Bullous Impetigo  Staphylococci & Streptococci. Bullous Impetigo  Staphylococci Only. COMPLICATIONS: Abscess, Bactereamia, Toxieamia, Spticeamia, Lymphangitis, Lymphadenitis, Lymphedema Erysipelas, Cellulitis, Glomerulonephritis. DIAGNOSIS & Clinically. No Need For Laboratory Investigations (May: CBC, CRP, Swab Culture). INVESTIGATIONS: TREATMENT: Topical Antibiotic (Fucidin Ointment). Potassium Permengenate. Systemic Antibiotic Maybe Used. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Oval, Irregular Ulcer, On Erythematous Base, Covered with Yellow Crust, Present On the Lower Limb. DIFFERINTIAL 1. Ecthyma 2. Cutaneous Leishmmaniasis 3. Syphilis 4. Squamous Cell Carcinoma 5. Basal Cell Carcinoma DIAGNOSIS: 6. Venous Ulcer 7. Traumati Ulcer 8. Drug Eruption MOST LIKELY DIAGNOSIS: Ecthyma. CAUSATIVE ORGANISM: Staphylococci & Streptococci. COMPLICATIONS: Abscess, Bactereamia, Toxieamia, Spticeamia, Lymphangitis, Lymphadenitis, Lymphedema Erysipelas, Cellulitis, Glomerulonephritis. DIAGNOSIS & Clinically. No Need For Laboratory Investigations (May: CBC, CRP, Swab Culture). INVESTIGATIONS: TREATMENT: Topical Antibiotic (Fucidin Ointment). Potassium Permengenate. Systemic Antibiotic Maybe Used. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Red, Well-Defined Nodule, On Erythematous Base, with Single, Yellow Pustule, Present On the Base of the Neck. DIFFERINTIAL 1. Cutaneous Leishmmaniasis 2. Furuncle 3. Carbuncle 4. Syphilis 5. Lupus Vulgaris 6. Basal Cell Carcinoma DIAGNOSIS: 7. Squamous Cell Carcinoma MOST LIKELY DIAGNOSIS: Furuncle. CAUSATIVE ORGANISM: Staphylococci. COMPLICATIONS: Abscess, Bactereamia, Toxieamia, Spticeamia, Lymphangitis, Lymphadenitis, Lymphedema Erysipelas, Cellulitis, Glomerulonephritis, Cavernous Sinus Thrombosis. DIAGNOSIS & Clinically. No Need For Laboratory Investigations Except: INVESTIGATIONS: Send Swab For Culture & Sensitivity, CBC, CRP. TREATMENT: Topical Antibiotic (Fucidin Ointment). Systemic Antibiotic (Flucloxaciline or Vancomycine). Drain the Pus. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Red Nodule, On Erythematous Base, Discharging Pus From Single Opening, Present On the Back of the Neck. MOST LIKELY DIAGNOSIS: Furuncle. CAUSATIVE ORGANISM: Staphylococci. COMPLICATIONS: Abscess, Bactereamia, Toxieamia, Spticeamia, Lymphangitis, Lymphadenitis, Lymphedema Erysipelas, Cellulitis, Glomerulonephritis, Cavernous Sinus Thrombosis. DIAGNOSIS & Clinically. No Need For Laboratory Investigations Except: INVESTIGATIONS: Send Swab For Culture & Sensitivity, CBC, CRP. TREATMENT: Topical Antibiotic (Fucidin Ointment). Systemic Antibiotic (Flucloxaciline or Vancomycine). Drain the Pus. DR. MOHCEN AL. HAJ DESCRIPTION: Three, Large, Red Nodules, On Erythematous Bases, Discharging Pus From Multiple Openings, Present On the Back of the Neck. MOST LIKELY DIAGNOSIS: Carbuncles. CAUSATIVE ORGANISM: Staphylococci. COMPLICATIONS: Abscess, Bactereamia, Toxieamia, Spticeamia, Lymphangitis, Lymphadenitis, Lymphedema Erysipelas, Cellulitis, Glomerulonephritis, Cavernous Sinus Thrombosis. DIAGNOSIS & Clinically. No Need For Laboratory Investigations Except: INVESTIGATIONS: Send Swab For Culture & Sensitivity, CBC, CRP. Screening For DM (Fasting Blood Sugar & HbA1c). TREATMENT: Topical Antibiotic (Fucidin Ointment). Systemic Antibiotic (Flucloxaciline or Vancomycine). Drain the Pus. DR. MOHCEN AL. HAJ DESCRIPTION: Ill-Defined, Shiny, Large, Red Swelling, On the Dorsum of the Foot. DIFFERINTIAL 1. Cellulitis 2. Erysipelas 3. Insect Bite 4. Phlepitis 5. Eczema 6. Drug Eruption 7. Fungal Infection DIAGNOSIS: 8. DVT 9. Trauma MOST LIKELY DIAGNOSIS: Cellulitis. CAUSATIVE ORGANISM: Streptococci, Staphylococci & H. Influenza. COMPLICATIONS: Abscess, Bactereamia, Toxieamia, Spticeamia, Lymphangitis, Lymphadenitis, Lymphedema Glomerulonephritis. DIAGNOSIS & Clinically. No Need For Laboratory Investigations Except: INVESTIGATIONS: Send Swab For Culture & Sensitivity, CBC, CRP. TREATMENT: Topical Antibiotic (Fucidin Ointment). Systemic Antibiotic (Flucloxaciline or Vancomycine or Peniillin). DR. MOHCEN AL. HAJ DESCRIPTION: Will-Defined, Large, Red Swelling, Present On the Right Cheek. DIFFERINTIAL 1. Cellulitis 2. Erysipelas 3. Insect Bite 4. Phlepitis 5. Eczema 6. Drug Eruption 7. Fungal Infection 8. Trauma DIAGNOSIS: MOST LIKELY DIAGNOSIS: Erysipelas. CAUSATIVE ORGANISM: Streptococci. COMPLICATIONS: Abscess, Bactereamia, Toxieamia, Spticeamia, Lymphangitis, Lymphadenitis, Lymphedema Cellulitis, Glomerulonephritis. DIAGNOSIS & Clinically. No Need For Laboratory Investigations Except: INVESTIGATIONS: Send Swab For Culture & Sensitivity, CBC, CRP. TREATMENT: Topical Antibiotic (Fucidin Ointment). Systemic Antibiotic (Flucloxaciline or Vancomycine or Peniillin). DR. MOHCEN AL. HAJ DESCRIPTION: Single, Large, Will-Defined, Irregular, Brown Patch, Present On Axilla. DIFFERINTIAL 1. Erythrasma. 2. Candidiasis. 3. Psoriasis Inversus. 4. Eczema. 5. Drug Eruption. 6. Fungal Infection. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Erythrasma. CAUSATIVE ORGANISM: Coryneabacterium. COMPLICATIONS: Abscess, Bactereamia, Toxieamia, Spticeamia, Lymphangitis, Lymphadenitis, Lymphedema. DIAGNOSIS & Clinically. Woods Lamp  Coral Red. INVESTIGATIONS: TREATMENT: Topical Antibiotic (Fucidin Ointment). Topical Anti Fungal. Systemic Antibiotic Maybe Used. Systemic Anti Fungal Maybe Used. DR. MOHCEN AL. HAJ DIAGNOSIS: Lepromatous Leprosy. CAUSATIVE ORGANISM: Micobacterium Leprae. OTHER CLINICAL TYPES: 1. Tuberculoid Leprosy. 2. Mid-Border Line Leprosy. 3. Border Line Tuberuloid Leprosy. 4. Border Line Lerpromatous Leprosy. 5. Indeterminate Leprosy. DIAGNOSIS & Clinically. Laboratory Include: INVESTIGATIONS: Skin Biopsy By Slit & Smear Using Zeihl-Nelsen Stain. Lepromin Skin Test. Serology, CBC, LFT. TREATMENT: Dapson (PABA Antagonist So Prevent Folic Acid Formation). Rifampicin (Inhibit Bacterial DNA Synthesis). Clofazimine (No Longer Used). Clarithromycin Maybe Used. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Large, Apple Jelly Nodule, Present On the Right Cheek. DIFFERINTIAL 1. Lupus Vulgaris. 2. Cutaneous Leishmmaniasis. 3. Furuncle. 4. Carbuncle. 5. Syphilis. 6. Basal Cell Carcinoma. DIAGNOSIS: 7. Squamous Cell Carcinoma. MOST LIKELY DIAGNOSIS: Lupus Vulgaris. CAUSATIVE ORGANISM: Mycobacterium Tuberculous. COMPLICATIONS: Pre-Malignant, Scarring. DIAGNOSIS & Clinically. Skin Biopsy Using Zeihl-Nelsen Stain. INVESTIGATIONS: Tuberculin Skin Test. TREATMENT: Surgical Excision of Scar. Anti- TB For 9 Months. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size Vesicles, On Erythematous Base, Present On the Angle of the Mouth. DIFFERINTIAL 1. Herpes Simplex 2. Herpes Zoster 3. Impetigo 4. Eczema 5. Drug Eruption 6. Burns 7. Chemicals DIAGNOSIS: MOST LIKELY DIAGNOSIS: Herpes Simples Type I (Herpes Libialis). CAUSATIVE ORGANISM: Herpes Simlpex Virus (HSV). TYPES: 1. Herpes Libialis 2. Genital Herpes 3. Herpatic Gingivo-Stomatitis 4. Herpatic Pharyngo-Tonsillitis 5. Herpatic Whitlow 6. Herpes Gladiatorum 7. Eczema Herpaticum COMPLICATIONS: 1. Secondary Bacterial Infection 2. Erythema Multiform 3. Eczema Herpaticum 4. Corneal Ulcer 5. Meningitis & Encephalitis 6. Cancer Cervix 7. Dissemination of Virus in Low Immune Patients DIAGNOSIS & Clinically. Tzank Smear Using Giemza Stain Which Reveals: INVESTIGATIONS: Multinucleated Giant Cells. PCR, Serology. TREATMENT: Topical Acyclovir 5%, 5 Times Per Day, For 5 Days. Systemic Acyclovir (Oral or IV) In Case of: Genital Herpes, Neonatal Herpes, Eczema Herpaticum, Immunocompremized Patients. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Unilateral, Different Size & Shape Vesicles, On Erythematous Base, Following Dermatome, Present On the Left Side of the Chest. DIFFERINTIAL 1. Herpes Zoster 2. Herpes Simplex 3. Impetigo 4. Eczema 5. Drug Eruption 6. Burns 7. Chemicals 8. Dermatitis Herpitiformis DIAGNOSIS: MOST LIKELY DIAGNOSIS: Herpes Zoster. CAUSATIVE ORGANISM: Varicella Zoster Virus (VZV). PRIMARY INFECTION: Chicken Pox. COMPLICATIONS: 1. Secondary Bacterial Infection 2. Corneal Ulcer 3. Meningitis 4. Facial Nerve Palsy 5. Post Herpatic Neuralgia 6. Post Herpatic Scar 7. Dissemination of Virus in Low Immune Patient DIAGNOSIS & Clinically. Tzank Smear Using Giemza Stain Which Reveals: INVESTIGATIONS: Multinucleated Giant Cells. PCR, Serology. TREATMENT: Systemic Acyclovir Oral 800mg, 5 Times Per Day, For 7 to 10 Days Topical & SystemicAnalgesia (Ibuprofen). Gabapentin Maybe Used. Oral Vitamin B6 & B12. DR. MOHCEN AL. HAJ MOST LIKELY DIAGNOSIS: Hutchinson’s Sign. DISEASE: Herpes Zoster. CAUSATIVE ORGANISM: Varicella Zoster Virus (VZV). PRIMARY INFECTION: Chicken Pox. COMPLICATIONS: 1. Secondary Bacterial Infection 2. Corneal Ulcer 3. Meningitis 4. Facial Nerve Palsy 5. Post Herpatic Neuralgia 6. Post Herpatic Scar 7. Dissemination of Virus in Low Immune Patient DIAGNOSIS & Clinically. Tzank Smear Using Giemza Stain Which Reveals: INVESTIGATIONS: Multinucleated Giant Cells. PCR, Serology. TREATMENT: Systemic Acyclovir Oral 800mg, 5 Times Per Day, For 7 to 10 Days Topical & SystemicAnalgesia (Ibuprofen). Gabapentin Maybe Used. Oral Vitamin B6 & B12. DR. MOHCEN AL. HAJ MOST LIKELY DIAGNOSIS: Ramsey Hunt Syndrome. DISEASE: Herpes Zoster. CAUSATIVE ORGANISM: Varicella Zoster Virus (VZV). PRIMARY INFECTION: Chicken Pox. COMPLICATIONS: 1. Secondary Bacterial Infection 2. Corneal Ulcer 3. Meningitis 4. Facial Nerve Palsy 5. Post Herpatic Neuralgia 6. Post Herpatic Scar 7. Dissemination of Virus in Low Immune Patient DIAGNOSIS & Clinically. Tzank Smear Using Giemza Stain Which Reveals: INVESTIGATIONS: Multinucleated Giant Cells. PCR, Serology. TREATMENT: Systemic Acyclovir Oral 800mg, 5 Times Per Day, For 7 to 10 Days Topical & SystemicAnalgesia (Ibuprofen). Gabapentin Maybe Used. Oral Vitamin B6 & B12. DR. MOHCEN AL. HAJ DESCRIPTION: Single Papule with Multiple Black Dots Present On the Planter Surface. DIFFERINTIAL 1. Planter Wart. 2. Callosity. 3. Forign Body. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Planter Wart. CAUSATIVE ORGANISM: Human Papilloma Virus (HPV). COMPARE BETWEEN YOUR Planter Wart: Callosity: DEFFIRINTIAL Black Dot. No Black Dot. DIAGNOSIS: Bleeds After Scrapping. Doesn’t Bleed. Present Anywhere. Present in Pressure Areas. Painfull Side to Side. Painfull Vertically. DIAGNOSIS & Clinically. INVESTIGATIONS: TREATMENT: Topical Salicylic Acid. Cryotherapy By Liquid Nitrogen (Temperature: -196). DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Will-Defined Papules, with Rough Surface, Scattered On The Dorsum of The Hand & Fingers. MOST LIKELY DIAGNOSIS: Common Wart (Varucca Vulgaris). CAUSE: Human Papilloma Virus (HPV). OTHER TYPES: 1. Flat Wart. 2. Planter Wart. 3. Filliform Wart. 4. Genital Wart. 5. Mosaic Wart. TREATMENT: Cryotherapy (Using Liquid Nitrogen). Trichloroecetic Acid (TCA). Cytotoxic Therapy: Podophyllin. Antiviral Therapy: Cidofovir. Salicylic Acid. DR. MOHCEN AL. HAJ DESCRIPTION: Sinle, Will-Defined, Long Slender Growth Papule, Present On Outer Lower Border of The Lower Lip. MOST LIKELY DIAGNOSIS: Filliform Wart. CAUSE: Human Papilloma Virus (HPV). OTHER TYPES: 1. Flat Wart. 2. Planter Wart. 3. Common Wart. 4. Genital Wart. 5. Mosaic Wart. TREATMENT: Electrodessication & Curettage. DR. MOHCEN AL. HAJ DESCRIPTION: Multiple Different Size & Shape Will-Defined Pink Papules with Umblicated Heads. MOST LIKELY DIAGNOSIS: Molluscum Contagiosum. CAUSE: Pox Virus. DIAGNOSIS & Clinically. If Diagnosis Doubt; Do Tzank Smear Which Reveals: Intracytoplasmin INVESTIGATIONS: Inclusion Bodies Called Handerson-Paterson Bodies. TREATMENT: Crytherapy. Curettage Also Used. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Will-Defined, Oval Patch, of Hair Loss, with No Signs of Inflammation & No Secondary Skin Lesion Present On Scalp. DIFFERINTIAL 1. Non Inflammatory Tinea Capitis. 2. Alopecia Areata. 3. Androgenic Alopecia. DIAGNOSIS: 4. Tractional Alopecia. 5. Trichotelomenia. 6. Cicatritial Alopecia. MOST LIKELY DIAGNOSIS: Non Inflammatory Tinea Capitis. OTHER CLINICAL TYPES: Kerion (Inflammatory). Favus (Inflammatory). DIAGNOSIS & Clinically KOH Microscopic Examination Which Reveals: Hyphea & Spores. INVESTIGATIONS: Woods Lamp  Flurescence Green. Other Investigations: CBC, TFT, Zinc, Ferritin, Folate Vitamin B12. TREATMENT: Systemic Anti-Fungal: Griseofulvin 20-25mgxkg Per Day or Terbinafine 250mg Per Day (Both For 4-6 Weeks) or Itraconazole. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Red Nodule, Covered with Yellow Crust, Present On Will-Defined, Oval Patch, of Hair Loss, Present On Scalp. DIFFERINTIAL 1. Kerion 2. Lupus Vulgaris 3. Cutaneous Leishmmaniasis 4. Furuncle 5. Carbuncle 6. Syphilis 6. Basal Cell Carcinoma DIAGNOSIS: 7. Squamous Cell Carcinoma MOST LIKELY DIAGNOSIS: Kerion. OTHER CLINICAL TYPES: Non-Inflammatory Tinea Capitis. Favus (Inflammatory). DIAGNOSIS & Clinically. KOH Microscopic Examination Which Reveals: Hyphea & Spores INVESTIGATIONS: Woods Lamp  Flurescence Green. TREATMENT: Systemic Anti-Fungal: Griseofulvin 20-25mgxkg Per Day or Terbinafine 250mg Per Day (Both For 4-6 Weeks) or Itraconazole. Topical Steroid Maybe Used in Severe Cases. DR. MOHCEN AL. HAJ DESCRIPTION: Diffuse, Yellow Crusts, Adherent On Scalpe, with Multiple Patches of Hair Loss, Present On Scalp. DIFFERINTIAL 1. Favus. 2. Scalp Psoriasis. 3. Sebhorroic Dermatitis. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Favus. OTHER CLINICAL TYPES: Non-Inflammatory Tinea Capitis. Kerion (Inflammatory). DIAGNOSIS & Clinically (Mouse Smell). KOH Microscopic Examination Which Reveals: Hyphea & Spores INVESTIGATIONS: Woods Lamp  Flurescence Green. TREATMENT: Systemic Anti-Fungal: Griseofulvin 20-25mgxkg Per Day or Terbinafine 250mg Per Day (Both For 4-6 Weeks) or Itraconazole. Topical Steroid Maybe Used in Severe Cases. DR. MOHCEN AL. HAJ MOST LIKELY DIAGNOSIS: Tinea Unguium. CAUSE: Dermatophytes (Trichophytes & Epidermophytes). TYPES: 1. Proximal Onychomycosis (Common in HIV Patients). 2. Disto-Lateral Onychomycosis. 3. Superficial White Onychomycosis. DIAGNOSIS & Microscopic KOH Examination. INVESTIGATIONS: TREATMENT: Systemic Anti-Fungal: Griseofulvin 20-25mgxkg Per Day or Terbinafine 250mg Per Day (Both For 4-6 Weeks). DR. MOHCEN AL. HAJ MOST LIKELY DIAGNOSIS: Tinea Pedis (Athletic Foot). CAUSE: Dermatophytes (Trichophytes). COMMON IN: 1. Athletic People. 2. Diabetic Patient. DIAGNOSIS & Microscopic KOH Examination. INVESTIGATIONS: TREATMENT: Topical Anti-Fungal: Imidazole Derivatives (Ketoconazole, Miconazole, Econazole, Fluconazole, Itraconazole). DR. MOHCEN AL. HAJ DESCRIPTION: Multiple, Different Size & Shape, Hypopigmented Macules & Patches, Scattered On the Neck & Back. DIFFERINTIAL 1. Pityriasis Vesicolor. 2. Pityriasis Alba. 3. Post Inflammatory. 4. Post Traumatic. 5. Vitiligo. 6. Leprosy. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Pityriasis Vesicolor. CAUSATIVE ORGANISM: Malassezia Furfur. DIAGNOSIS & Clinically. KOH Microscopic Examination Which Reveals Spaghetti Meat Ball Form INVESTIGATIONS: Woods Lamp  Golden Yellow. TREATMENT: Topical Anti Fungal Ketoconazole (Nizoral Shampoo). Selenium Sulfate Shampoo. Systemic Anti Fungal (Itrakonazole 100mg or Fluconazole 150mg). Salicylic Acid Maybe Used. DR. MOHCEN AL. HAJ MOST LIKELY DIAGNOSIS: Oral Candidiasis (Oral Trush). CAUSE: Candida Albicans. OTHER PICTURES: 1. Intertrigon Candidiasis. 2. Candidal Paronychia. 3. Genital Candidiasis. 4. Systemic Candidiasis. DIAGNOSIS & Microscopic KOH Examination. INVESTIGATIONS: TREATMENT: Topical Anti-Fungal: Nystatin (D.O.C) or Imidazoles Also Systemic Imidazoles Can Be Used. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Oval, Regular Ulcer, On Erythematous Base, Covered with Yellow Crust, Present On the Lower Limb (Leg). DIFFERINTIAL 1. Cutaneous Leishmaniasis 2. Ecthyma 3. Syphilis 4. Squamous Cell Carcinoma 5. Basal Cell Carcinoma DIAGNOSIS: 6. Venous Ulcer 7. Traumati Ulcer 8. Drug Eruption MOST LIKELY DIAGNOSIS: Cutaneous Leishmaniasis or Oriented Sore (If Painless Ulcer). CAUSATIVE ORGANISM: Leishmania. TYPES: 1. Leishmania Tropica Major. 2. Leishmania Tropica Minor. VICTOR: Female Sand Fly (Phlebotomus Papatazii). RESIRVOIR HOST: Rodents & Dogs. DIAGNOSIS & Clinically. Slit & Smear & Use Giemza Stain Which Reveals Amastigote. INVESTIGATIONS: Biopsy & Culture NNN Media Which Reveals Promastigote. PCR Assay. Montenigro Test (Not Used). TREATMENT: Topical Pentostam (If 5-10 Ulcers). Systemic Pentostam 20mgxKg Give If: Multiple Ulcers (>10), Ear Involevment & Lymphatic Infiltration. Miltefosine (Impavido). Pentamidine. Crytherapy. DR. MOHCEN AL. HAJ NAME: Burrow. DISEASE: Scabies. CAUSATIVE ORGANISM: Sarcoptes Scabiei Hominis. DIAGNOSIS & 1. Clinically (History & Presence of Burrow). 2. Skin Scraping Test: Definitive Test & But KOH 10-20% Help to INVESTIGATIONS: Identification of Mites, Eggs & Feces. 3. Burrow Ink Test. 4. Tetracycline Test. COMPLICATIONS: 1. Secondary Bacterial Infection. 2. Spread to Community. 3. Scabie-Phobia. 4. Pruritic Nodules. 5. Urticatia. 6. Chronic Scabies. TREATMENT: Treat All Close Contact People. 1.Topical Scabicidal: Topical Permithrin (D.O.C) Alternative Scabicidal Agents are: Sulfur Ointment, Benzyl Benzoate, Lindane Crotamiton & Ivermectine. 2. Anti-Microbial: For Secondary Bacterial Infection. 3. Anti-Histamine For Itching. DR. MOHCEN AL. HAJ DEFINE: Head Louse. DISEASE: Pediculosis Capitis. DIAGNOSIS & Clinically. INVESTIGATIONS: TREATMENT: Using Hot Water & Dried By Hot Air Cycle +/- Vaccum. Pyrethrins with Piperonyl Butoxide. Permethrin Lotion. Ivermectine Lotion. Lindane Shampoo. DR. MOHCEN AL. HAJ DESCRIPTION: Single, Oval, Regular Ulcer, Covered with Hemorrhagic Crust, Present On the Upper Lip. DIFFERINTIAL 1. Syphilis 2. Cutaneous Leishmmaniasis 3. Ecthyma 4. Squamous Cell Carcinoma 5. Basal Cell Carcinoma DIAGNOSIS: 6. Traumati Ulcer 7. Drug Eruption MOST LIKELY DIAGNOSIS: Primary Syphilis (Chuncre). CAUSATIVE ORGANISM: Treponema Pallidum. DIAGNOSIS & Clinically. Dark Fiel Microsopic Examination Which Reveals: INVESTIGATIONS: Spiral Shape Organism ith Rotator Movement. Serology (TPHA Test & VDRL) Give False Negative. TREATMENT: Single Dose Penzatine Penicillin 2.4Mega Unit IM Injection. DR. MOHCEN AL. HAJ DESCRIPTION: Diffuse, Macculo-Papular Rash, Scattered On the Back. DIFFERINTIAL 1. Secondary Syphilis. 2. Pityriasis Rosea. 3. Guttate Psoriasis. 4. Drug Eruption. 5. Fungal Infection. DIAGNOSIS: MOST LIKELY DIAGNOSIS: Secondary Syphilis. CAUSATIVE ORGANISM: Treponema Pallidum. DIAGNOSIS & Clinically. Serology: INVESTIGATIONS: Treponema Heam-Agglutination Test (TPHA). Venereal Disease Research Laboratory Test (VDRL). TREATMENT: 3 Doses of Penzatine Penicillin 2.4Mega Unit IM Injection For 3 Weeks. DR. MOHCEN AL. HAJ DIAGNOSIS: Moth Eaten Alopecia. DISEASE: Secondary Syphilis. CAUSATIVE ORGANISM: Treponema Pallidum. DIAGNOSIS & Clinically. Serology: INVESTIGATIONS: Treponema Pallidum Heam-Agglutination Test (TPHA). Venereal Disease Research Laboratory Test (VDRL). TREATMENT: 3 Doses of Penzatine Penicillin 2.4Mega Unit IM Injection For 3 Weeks. ‫ اللهم آمني يارب العاملني‬.... ‫حتياتي ومتنياتي للجميع بالنجاح‬ DR. MOHCEN AL.HAJ ‫دكتور حمسن احلاج‬