Patient will be 40 - 60 years old
Complaining of painful flaccid bullae on mucosal surfaces
PE will show flaccid blisters that extend with lateral pressure (Nikolsky sign positive)
involving mucous membranes
Diagnosis is made by biopsy
Most common cause is autoimmune
Treatment is high dose steroids
Rapid Review
Pityriasis Rosea - Pityriasis Rosea
Patient with a history of a larger lesion 1 week prior, "Herald Patch"
Complaining of rash on the back
PE will show diffuse papulosquamous rash on the trunk, "Christmas tree-like"
distribution
Treatment is self-limiting disease, itching with antihistamines
Rapid Review
Acne Vulgaris - Acne Vulgaris
Patient will be an adolescent
Complaining of rash on face, neck, upper chest and back
PE will show closed comedones (whiteheads), open comedones (blackheads), papules
and pustules
Most commonly caused by Propionibacterium acnes
Treatment is:
Mild to moderate: topical retinoids, topical antibiotics, or benzoyl peroxide
Moderate to severe: add oral antibiotics
Severe: oral isotretinoin (Pregnancy class X, must have two forms of birth control)
Rapid Review
, Bullous Pemphigoid - Bullous Pemphigoid
Patient will be older than 60
Complaining of intensely pruritic papules that became large, tense blisters/bullae
PE will show tense and firm blisters that do not extend with lateral pressure (Nikolsky
sign negative)
Most commonly caused by chronic autoimmune blistering disease
Treatment is corticosteroids and immunosuppressants
Rapid Review
Herpes Zoster - Herpes Zoster
Age, immunodeficiency
Reactivation of latent VZV in dorsal root ganglion
Grouped vesicles on an erythematous base, dermatomal
Postherpetic neuralgia, Ramsay Hunt syndrome, zoster ophthalmicus
Acyclovir
Patient will be a women
With a history of lesions that have waxed and waned over the past few years
Complaining of tender nodules in her axillae and anogenital area
PE will show lesions that are tender, malodorous, often with exudative drainage, sinus
tracts
Treatment is intralesional triamcinolone, topical clindamycin
Comments: Hurley staging system describes the severity of disease
Rapid Review
Onychomycosis - Onychomycosis
Patient will be complaining of thickened and discolored toenails
Diagnosis is made by KOH preparation of nail scraping
Treatment is oral terbinafine
Comments: Serum aminotransferases should be monitored before starting treatment
with terbinafine and during the treatment due to hepatotoxicity
Rapid Review
Cat Bite - Cat Bite
Most commonly caused by Pasteurella multocida
Treatment is irrigate, leave wound open, amoxicillin - clavulanate
Complications: Osteomyelitis, Tenosynovitis
Rapid Review
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