Dermatology Prescriptions
Dermatology Prescriptions
Dermatology Prescriptions
DERMATOLOGY
PRESCRIPTIONS
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INDEX
Common Prescriptions:
Hypersensitivity Reactions
Disorders Of Pigmentation
Eczema / Dermatitis
Infestations
Fungal Infections
Viral Infections
Bacterial Infections
Disorders of Keratinization
Bullous Disease
Pemphigus Vulgaris, Hailey Hailey Disease, Bullous Pemphigoid _______________ Page 113
Muco-cutaneous Ulcers
Hair-Related Disorders
ANATOMY
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HISTORY TAKING
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EXAMINATION
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COMMON TERMINOLOGIES
Dermatosis: It is a broad term that refers to any disease of the skin, especially one
that is not accompanied by inflammation
TOPICAL VEHICLES
( Lotion, Cream, Gel , Ointment )
TOPICAL STEROIDS
LOW-POTENCY ( For Face ) :
Methylprednisolone (Avate)
STEROID + ANTI-FUNGALS:
Hydrocortisone with Clotrimazole (Hydrozole, Clozox-H )
OTHERS:
Flucinolone with Tretinoin, Hydroquinone (Siton-plus)
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ANTI-HISTAMINE
OTHERS:
BD for 1 month
BD for 1 month
OD for 10 days
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SUNSCREEN
Suntek-60
Suncoat-60
Sunshade-60
Deemal sunscreen
Prote’sun Lotion
FOR HYPER-PIGMENTATION
Deemal fade out cream / Mark out cream / Scar gel BD for 2-3 months
Aprica cream on post-acne scars, apply thin layer at night for 2 months
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MULTIVITAMINS
(For Skin, Hair, Nails)
Cap Iberet
Tab Surbex-Z
Tab Maxidel
Syp Mosigan
Capsule/syrup Bio-Z
Syp Zincol
Tablet Ekstra
Tab Perfectil
Tab Vita-syn
Tab Cola-zinc
Tab Maxideen
OD for 3 months
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Olive oil
Physiogel
Glycream
Dermal cream
Hydrogel 50/50
Tarcyl ointment
Mixit Ointment
Soaps:
Softex Soap
Moisten soap
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SHAMPOO
( Anti-Dandruff, Anti-Hair fall )
Hair-x shampoo
Deemaal anti-dandruff shampoo
Oloprox-S shampoo
Cilox-S shampoo
Stieprox shampoo
Syntar shampoo
Ketowin shampoo
Photonic-max shampoo
Biolyn shampoo
Twice a week
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COMMON
PRESCRIPTIONS
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HYPERSENITIVITY REACTIONS
1. ALLERGY / PRURITIS :
Centrally acting Anti-Histamine
Peripherally acting / other Anti-Histamine
Oral Steroid ( optional )
OTHERS:
BD for 1 month
BD for 1 month
OD for 10 days
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Oral Steroids:
2. Urticaria :
Urticaria, also known as hives, is an outbreak of swollen,
pale red bumps or plaques (wheals) on the skin that appear
suddenly -- either as a result of the body's reaction to certain
allergens,drugs or for unknown reasons. Hives usually cause
itching, but may also burn or sting
Ask History
Investigations
Counsel
Centrally acting Anti-Histamine
Peripherally acting Anti-Histamine
Oral Steroid
Ask History :
Investigations:
Blood CP
Urine R/E
Counsel :
OD for 1 month
Oral Steroid:
3 + 3 OR 2 +2 +2 for 3 days
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Drugs can also cause hair and nail changes, affect the mucous membranes,
or cause itching without outward skin changes.
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OD for 1 Month
Oral Steroid:
3 + 3 OR 2 +2 +2 for 3 days
BD for 20 days
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Oral / IV Antibiotic
Centrally / Peripherally acting Anti-Histamine
Oral / IV Steroid
Topical Anti-bacterial ointment
Antibiotic Eye Drops
Oral / IV Antibiotic :
BD for 5 – 7 days
10 mg / kg X TDS
BD for 15 days
Oral / IV Steroid :
3 + 3 OR 2 +2 +2 for 3 days
BD for 20 days
2 drops X QID
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PEDIATRIC MANAGEMENT
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OTHERS :
Erythema Multiforme :
Erythema Nodosum :
ACNE VULGARIS
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OD for 1 month
Cap Isozam 10 mg or 20 mg
OD for 2 months initially then gradually increase dose till 6-8 months
Investigations :
Serum ALT
Serum triglyceride
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It may cause more acne in the beginning but DONOT discontinue the use.
It will cause dryness of lips & nose so keep White petroleum jelly in pocket and apply
around lips and nose every 2 hourly.
DONOT wear contact lenses as it causes dryness of eyes.
DONOT get pregnant within 6 months as it is Teratogenic.
DONOT donate blood during its use as your donated blood can get transfused to a
pregnant women causing Teratogenicity.
Acne serum
Airol-N cleanser
Intensive eye orbital serum / Florence cream / Elastogen / Deemal Anti-aging cream /
Mandelac ( mandelic acid ) cream / Vivid cream
BD for 20 days
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DISORDERS OF PIGMENTATION
1. FRECKLES / MELASMA
FRECKLES:
MELASMA:
Sunscreen :
Suntek-60
Suncoat-60
Sunshade-60
Deemal sunscreen
Prote’sun Lotion
Multivitamins :
Cap Iberet
Tab Surbex-Z
Tab Maxidel
Tablet Ekstra
Tab Perfectil
Tab Vita-syn
Tab Cola-zinc
Tab Maxideen
OD for 3 months
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2. SCARS :
Deemal fade out cream / Mark out cream / Scar gel BD for 2-3 months
Aprica cream for post-acne scars, apply thin layer at night for 2 months
3. KELOID SCAR :
Injectable Steroids
Scar gel
Antibiotic
Anti-Histamine
Injectable Steroids :
Injection Lonacort / Kenacort / Tricort ( Triamcinolone )
Scar gel :
Contractubex scar gel
Antibiotic :
Cap Flustal ( Amoxicillin ) OR Cap Bactoxyl ( Amoxicillin, Floxacilin ) 500 mg
Anti-Histamine :
Tab Piriton ( Chlorpheniramine )
4. PITYRIASIS ALBA
( HYPO-PIGMENTATION ):
Topical Steroid
Zinc Supplements
Topical Steroid :
Avate ointment ( Methylprednisolone )
Zinc Supplements :
Syrup / Cap Bio-Z
Tab Cola-zinc
Tab Surbex-Z
Syp Zincol
OD for 1 month
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5. VITILIGO
( DE- PIGMENTATION ):
Long-term, Autoimmune disorder characterized by patches of skin losing
pigment due to destruction of Melanocytes. Affected areas have sharp
margins & may also involve hair, inside of mouth and nose.
It has a poor prognosis in old age, over bony areas such as elbows, or in
lips, finger tips and genital areas.
Topical Immunosuppressant
Topical Steroid
Oral Steroid
Zinc Supplements
Topical Immunosuppressant :
Crolimus 0.03% , 0.1 % / Eczemus ointment
0.01% , 0.03% (Tacrolimus)
Topical Steroid :
Avate ointment ( Methylprednisolone ) on face
Oral Steroid :
Syp Neupred ( Prednisolone )
2 + 2 for 3 days
1 + 1 for 3 days
6. OCHRONOSIS :
Topical Steroids :
Cutipro + Covate ( Clobetasol ) ointment
Oral Anti-Histamine :
Tab Piriton (Chlorpheniramine )
8. ROSACEA :
Rosacea (rose-AY-sha) is a
common skin disease. It often
begins with a tendency to
blush or flush more easily
than other people. The
redness can slowly spread
beyond the nose and cheeks
to the forehead and chin.
Even the ears, chest, and back
can be red all the time
Oral Tetracycline
Topical Agents
Oral Tetracycline :
Tab Adoxa / Oracea ( Doxycycline ) 100 mg
OD for 1 month
Topical Agents :
Rozamet ( Metronidazole ) Cream
9. TELANGIECTASIA ON FACE :
They commonly occur on the nose, chin, and
cheeks, where they may cause facial redness
9. PHOTOSENSITIVITY / ACTINIC
DERMATITIS / SOLAR KERATOSIS :
Oral Hydroxychloroquine
Oral Steroids
Topical Steroids
Sunscreen
CHRONIC ACTINIC
Cryotherapy DERMATITIS
Oral Hydroxychloroquine :
Tab HCQ 200 (hydroxychloroquine)
OD for 1 month
Contraindicated in Psoriasis
Oral Steroid :
Tab Deltacortril ( Prednisolone ) 5mg , after meal
3 + 3 for 3 days
2 + 2 for 3 days
1 + 1 for 3 days
Topical Steroid :
Avate ointment ( Methylprednisolone )
Sunscreen :
Suntek-60
Suncoat-60
Sunshade-60
Deemal sunscreen
Prote’sun Lotion
Cryotherapy :
For Solar Keratosis
10.BURNS :
Wound Care :
DONOT prescribe Quench cream (Silver Sulfadiazine) for long time as it leaves
pigmentation
Oral Antibiotics:
Cap / Syrup Flustal ( Amoxicillin ) OR Cap Bactoxyl ( Amoxicillin, Floxacilin ) 500 mg
Oral Anti-Histamine:
Tab / Syp Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
PSORIASIS
Counselling
Topical Steroids / Vitamin-D derivatives / Salicylic acid
Topical Emollients
Topical Coal Tar Preparations
Oral Anti-Histamine
Oral Immunosuppressants / Oral Retinoids
Phototherapy
Counselling :
It is not contagious
There is no complete cure
Avoid taking any steroid injection for this
Topical Emollients :
Calamine Lotion / Dermal cream for body
BD for 15 days
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thrice a week
Oral Anti-Histamine :
Tab Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
BD for 10 days
OD for 15 days
( give 2.5 mg stat then wait for 48 hours then give 7.5 - 30 mg / week )
OD for 1 month
Phototherapy :
For Extensive Disease
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ERYTHRODERMA
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ECZEMA / DERMATITIS
Topical Steroids :
Covate , Clobevate (Clobetasol) OR Effidex , Valisone , Provate
(Betamethasone) OR Ticovate ointment (Fluticasone) OR Fucicort , Fuskin-B (
Fusidic acid with Betamethasone ) ointment + White petroleum jelly
Topical Emollients :
Keep skin moist, frequently massage with olive oil
Oral Antibiotics :
Cap / Syrup Flustal ( Amoxicillin ) OR Cap Bactoxyl ( Amoxicillin, Floxacilin ) 500 mg
BD for 10 days
2. POMPHOLYX
Topical Steroids :
Valisone-S ointment (betamethasone, salicylic acid) + WPJ
Topical Emollients :
Lacticare / Hydrophil 5% & 10% lotion ( Lactic acid )
3. DIAPER DERMATITIS
Diaper Hygiene
Oral Anti-Fungal :
Syp Flucoval ( Fluconazole ) to prevent Candidiasis
Thrice a week
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Oral Antimicrobials :
Syp Duricef ( cefadroxil 1st gen cephalosporin )
BD for 7 days
Oral Anti-Histamine :
Tab T-Day ( Levo-cetirizine )
OD for 10 days
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6. LICHEN SIMPLEX /
LICHENCIFICATION :
Lichen simplex chronicus (LSC) is a localized, well-circumscribed area of
thickened skin (lichenification) resulting from repeated rubbing, itching, and scratching of the
skin.
Topical Steroids
Oral Anti-Histamine
Oral Zinc Supplements
Topical Steroids :
Valisone-S , Provate-S (betamethasone, salicylic acid) OR
Ticovate / Cutivate ( Fluticone ) ointment + White Petroleum Jelly
Oral Anti-Histamine :
Tab Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
OD for 1 month
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INFESTATIONS
1. SCABIES:
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Counselling
Topical Permethrin Lotion
Topical Steroid
Oral Anti-Histamine
Oral Anti-Helminthic ( If infected )
Counselling :
It is Contagious infection with severe itching so advise proper Topical application of Permethrin
Lotion to the affected person ( twice ) as well as the unaffected person ( only once ) in close
contact.
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Scabfree lotion
Scabiderm lotion
Scabicap lotion
Malin lotion
Lotrix lotion
Scabizine ( Lindane )
Topical Steroid :
Fusac / Fusidin cream (fusidic acid) OR Fusic H,
Fusidin H, Fusac H, Fudic H ( Fusidic acid with
Hydrocortisone ) on body
BD for 10 days
Oral Anti-Histamine :
Tab / Syp Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
2. INSECT BITE :
Topical Steroid
Oral Anti-microbial
Oral Anti-Histamine
Topical Steroid :
Ticovate / Cutivate ( Fluticone ) Lotion
Oral Anti-microbial :
Cap / Syrup Flustal ( Amoxicillin ) OR Cap Bactoxyl ( Amoxicillin, Floxacilin ) 500 mg
Oral Anti-Histamine :
Tab / Syp Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
FUNGAL INFECTIONS
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Topical Anti-Fungals
Oral Anti-Fungals
Anti-Fungal Shampoo
Anti-Fungal Soap
Oral Anti-Histamine
Topical Anti-Fungals :
Hydrozole , Clozox-H (Hydrocortisone, clotrimazole) OR
Bifomyk ( Bifonazole ) OR
Oral Anti-Fungals :
Tab Terbisil ( Terbinafine) 125 mg Or 250 mg
OD for 1 month
OD for 1 month
2 tablets today
BD for 15 days
Anti-Fungal Shampoo :
Ketowin Shampoo
Oloprox-S shampoo
Cilox-S shampoo
Stieprox shampoo
Syntar shampoo
Silkin Shampoo
Thrice a week
Anti-Fungal Soap :
S N S bar
ZN bar
Salcid bar
Oral Anti-Histamine :
Tab / Syp Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
2. CANDIDIASIS :
Oral Thrush
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Oral Anti-Fungal
Topical Anti-Fungal
Anti-Histamine
Oral Anti-Fungal :
Syp Flucoval ( Fluconazole )
BD for 15 days
Topical Anti-Fungal :
Daktarin ( Miconazole) gel
Anti-Histamine :
Tab / Syp Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
3. PITYROSPORUM FOLLICULITIS /
MALASSEZIA :
Pityrosporum folliculitis is a condition in which the hair follicles of the sebaceous
areas (upper trunk, shoulders, and occasionally head and neck) are infected
with Pityrosporum (Malassezia) yeasts, resulting clinically in inflammatory
papules and pustules
Topical Ketoconazole
Oral Ketoconazole
Topical Ketoconazole :
Konaz, Ketowin ( Ketoconazole) Lotion
Oral Ketoconazole :
Tab Ketoval ( Ketoconazole ) 200mg
OD for 5 days
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4. PHAEO-HYPHOMYCOSIS :
Phaeohyphomycosis is a pigmented deep fungal infection caused by dematiaceous fungi which
usually involve the skin and subcutaneous tissue
Symptoms include papules, plaques and granulomatous changes on the skin & formation of
subcutaneous nodules. In extreme cases, it causes deep infections within the eyes, bones, heart
and central nervous system.
Treatment:
There is no standard therapy. Treatment depends on the clinical symptoms and status of the
patient and includes a combination of antifungal drugs along with surgical intervention.
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VIRAL INFECTIONS
1. CHICKEN POX:
Chickenpox ( varicella ) is a viral infection that causes an itchy rash with small, fluid-
filled blisters.
Chickenpox is highly contagious to people who haven't had the disease or been
vaccinated against it.
It usually lasts about 5 to 10 days.
Signs and symptoms, which may appear one to two days before the rash,
include:
Fever
Loss of appetite
Headache
Malaise
Chicken pox rash follows a Centripetal pattern that is, it appears on trunk region first &
then covers face, arm, legs & mucosal surfaces.
The rash appears in crops ( Polymorphic ) & goes through three phases:
i. Raised pink or red bumps (papules), which break out over several days
iii. Crusts and scabs, which cover the broken blisters and take several more days to heal
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Oral Anti-Viral :
Tab Viracure ( Famciclovir ) 250 mg
2 + 2 + 2 + 2 for 5 days
Oral Anti-Bacterial :
Cap / Syrup Flustal ( Amoxicillin ) OR Cap Bactoxyl ( Amoxicillin, Floxacilin ) 500 mg
Oral Anti-Histamine ;
Tab / Syp Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
Herpes Labialis
2. HERPES SIMPLEX:
Herpes simplex is a viral infection caused by the HSV 1 & HSV 2
Herpes Labialis ( cold sore ) & Genital Herpes : with painful ulceration
Herpetic Gingivostomatitis : painful lesions of oral &
pharyngeal mucosa
Herpetic Whitlow : intensely painful blisters on fingers
( common on index finger & thumb )
Eczema Herpeticum : diffuse painful erosions over head & upper body, formed on an
underlying dermatological condition
Oral Anti-Viral :
Tab Viracure ( Famciclovir ) 250 mg
Eczema Herpeticum
2 tablets TDS for 7 days
2 + 2 + 2 + 2 for 5 days
Oral Anti-Bacterial :
Cap / Syrup Flustal ( Amoxicillin ) OR Cap Bactoxyl ( Amoxicillin, Floxacilin ) 500 mg
TDS for 7 days
Oral Anti-Histamine ;
Tab / Syp Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine) BD for 10 days
Besides Anti-Microbials, also give analgesics & advise cold compresses, splinting and
elevation to reduce swelling
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Eye damage, which can occur if you have a rash or blister too close to your eye
(the cornea is particularly susceptible)
Bacterial skin infections, which can easily occur from open blisters and can be
severe
Ramsay Hunt syndrome, which can occur if shingles affects the nerves in your
head and can result in partial facial paralysis or hearing loss if left untreated (if
treated early, most patients make a full recovery)
Pneumonia
Encephalitis or Meningitis, which is serious and life-threatening
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Oral Anti-Viral
Oral Analgesic, Anti-Inflammatory, Anti-Histamine
Anti-Convulsant / Tricyclic Anti-Depressant for Nerve pain
Topical Anti-microbial, Numbing agent
Oral Anti-Viral :
Tab Viracure ( Famciclovir ) 250 mg
2 + 2 + 2 + 2 for 5 days
2 + 2 + 2 for 10 days
OD for 10 days
4. WARTS :
Viral Warts are typically small, rough, and benign hard growths on skin caused by infection with
human papilloma virus (HPV ). They are contagious, usually occur on the hands and feet but
can also affect other locations. They typically do not result in other symptoms, except when on
the bottom of the feet where they may be painful.
Treatment:
Avoid scratching as these are contagious
Keep hands/ feet in warm water for 10 minutes 2-3 times daily so that warts can get
Cryotherapy
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Oral Anti-Bacterial
Topical Anti-Bacterial
Oral Anti-Histamine
Oral Anti-Bacterial :
Tab Adoxa / Oracea ( Doxycycline ) 100 mg
BD for 15 days
Topical Anti-Bacterial :
Clycin-T lotion ( Clindamycin)
Oral Anti-Histamine :
Tab Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
2. BOIL ( FURUNCULOSIS ) :
A boil, also called a furuncle, is a deep folliculitis that is, infection of the
hair follicle along with surrounding skin, It is most commonly caused by
bacterium Staphylococcus Aureus, resulting in a painful swollen area on
the skin ( accumulation of pus and dead tissue )
BD for 15 days
AND
Oral Anti-Histamine :
Tab Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
3. CARBUNCLE :
A carbuncle is a red, swollen, and painful cluster of boils that are connected to each
other under the skin.
MANAGENENT :
BD for 15 days
4. ERYSIPELAS :
Erysipelas is a superficial form of cellulitis, affecting the
upper dermis and extending into the superficial cutaneous
lymphatics. It is caused by Group A Streptcoccus. It is a
tender, intensely erythematous, indurated plaque with a
sharply demarcated border, commomly affects face, arms &
legs.
MANAGENENT :
Analgesics
5. IMPETIGO:
Impetigo is a bacterial infection that involves the
superficial skin, commonly found in infants &
children. It is caused by bacterium Staphylococcus
Aureus or group A Sttreptococcus. The most
common presentation is yellowish ( honey-
colored ) crusts on the face, arms, or legs. Less
commonly there may be large blisters which affect
the groin or armpits. The lesions may be painful
or itchy. It is Contagious
Advice :
Avoid scratching. Take bed rest for 2-3 days as it is contagious
Oral Anti-Bacterial :
Syrup Amoxil, Flustal ( Amoxicillin ) OR Syp Bactoxyl ( Amoxicillin, Floxacilin )
Topical Anti-Bacterial :
Fusic , Fusac, Fusidin , Fudic ( Fucidic acid ) cream
Oral Anti-Histamine :
Syp Avil ( pheniramine)
6. CUTANEOUS TB :
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MANAGEMENT :
Oral ATT
Topical Anti-Bacterial Ointment
Anti-Histamine
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7. LEPROSY:
Symptoms: Initially, infection is without symptoms and typically remains this way
for 5 to 20 years. It then causes decreased ability to feel pain leading to
discoloration and lumps on the skin and, in severe cases, disfigurement and
deformities.
CUTANEOUS LEISHMANIASIS:
It is the tropical and subtropical Skin disease caused by Leishmania and transmitted by the bite
of sandflies. The clinical spectrum of Leishmaniasis ranges from a self-resolving cutaneous
ulcer to a mutilating mucocutaneous disease and even to a
lethal systemic illness.
MANAGEMENT :
Injection Glucantime /
Sodium Stibogluconate
Oral Anti-Microbials
Topical Anti-Microbials
Oral Anti-Microbials :
Tab Terbisil ( Terbinafine ) 250 mg
OD for 1 month
BD for 15 days
Topical Anti-Microbials :
Mupir ( Mupirocin ) cream
Advice
Topical Steroids
Oral Vasodilators
Oral Anti-Histamine
Oral Anti-Inflammatory drugs
Advice :
Keep the affected area warm & avoid sudden exposure to extreme temperature changes
Topical Steroids ;
Valisone . Provate ( Betamethasone ) OR Clobederam ( Clobetasol ) OR Fusic , Fusac,
Fusidin , Fudic ( Fucidic acid ) ointment + White petroleum Jelly
Oral Vasodilators :
Tab Nifedil / Adalat ( Nifedipine ) 10mg
BD for 10 days
BD for 10 days
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Oral Anti-Histamine
Tab Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
BD for 10 days
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LICHEN PLANUS:
Lichen planus (LP) is a chronic inflammatory
Autoimmune disease of the skin, mucous
membranes and nails. It is characterized by recurrent,
pruritic papules that are polygonal, flat-topped,
purple in color and can coalesce into plaques.
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3 + 3 for 3 days
2 + 2 for 3 days
1 + 1 for 3 days
1 + 1 for 3 days
Oral Anti-Histamine :
Tab Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine)
OD for 1 month
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DISORDERS OF KERATINIZATION :
1. BURNING / CRACKED HEELS :
Multi-Vitamins :
Tab Cecon ( ascorbic acid ) OD for 1 month
Others :
Tab Gabica ( Pregabalin ) 100 mg
OD for 10 days
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2. TYLOSIS
( PalmoPlantar Keratoderma ) :
Dermal cream
Hydrogel 50/50
Tarcyl ointment
QID daily
Others :
Topical or Oral Retinoids can also be prescribed if indicated
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OTHER DISORDERS :
PAPILLON-LEFEVRE SYNDROME:
Papillon–Lefèvre syndrome (PLS) is a rare autosomal
recessive disorder, characterized by diffuse
palmoplantar keratoderma and precocious
aggressive periodontitis, leading to premature loss of
deciduous and permanent dentition at a very young age.
DARIERS DISEASE:
Keratosis follicularis, also known as Darier disease (DD) or Darier-White disease, is an autosomal
dominantly inherited disorder characterized by greasy foul-smelling hyperkeratotic plaques / pustules
in seborrheic regions ( Including scalp, forehead, upper arms, chest, back, knees, elbows, and behind
the ear ) , nail abnormalities such as red and white streaks in the nails with an irregular texture, and
small pits in the palms of the hands and soles of the feet , and mucous membrane changes.
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GUNTHER’S DISEASE :
ICHTHYOSIS: ( ik-thee-O-sis )
A genetic disorder of skin, may be congenital or acquired, which causes the epidermis to
become dry and horny like fish scales.
Ichthyosis vulgaris occurs when your skin doesn't shed its dead skin cells.
Treatment: Exfoliating creams and ointments, containing lactic acid and
glycolic acid, help control scaling and increase skin moisture. Oral Retinoids
to reduce the production of skin cells
Harlequin ichthyosis is a severe genetic disorder. Infants with this condition are
born with very hard, thick skin covering most of their bodies. The skin forms large,
diamond-shaped plates that are separated by deep cracks (fissures).
Treatment; Infants will need one-on-one nursing care along with Oral Antibiotics &
Retinoids.
The Collodion baby is another form of Ichthyosis in which the infant born is encased
in a tight shiny Collodion membrane that resembles plastic wrap.
Treatment : The collodion membrane should not be debrided. Give regular emollients
such as petroleum jelly to keep the skin moist. For Pain relief give paracetamol.
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BULLOUS DISEASE:
1. PEMPHIGUS VULGARIS & BULLOUS
PEMPHIGOID :
Pemphigus was derived from the Greek word pemphix, meaning blister.
Hailey-Hailey disease , also called familial benign chronic pemphigus is a disease that causes
painful rash and blistering in skin folds, such as the armpits, groin, neck, under the breasts, and
between the buttocks.
Bullous pemphigoid is a more common disease than pemphigus that is less aggressive and,
generally, not considered life-threatening. Autoantibodies against hemidesmosomes are the
reason for the subepidermal blistering seen in pemphigoid
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Counselling :
Counsel the patient that it is a life-threatening disease with no
complete cure
Oral Immunosuppressants :
Tab Imuran ( Azathioprine ) 50 mg
BD……continue use
Oral Steroids :
Tab Deltacortril ( Prednisolone )
Oral Anti-Microbial :
Tab Nezkil / Linzid ( Linezolid ) 600 mg
BD for 15 days
Oral Anti-Histamine :
Tab Atarax / Roxyzin ( hydoxyzine )
BD for 1 month
2. EPIDERMOLYSIS BULLOSA:
Epidermolysis bullosa is a group of genetic conditions that cause
the skin to be very fragile and to blister easily. Blisters and skin
erosions form in response to minor injury or friction, such as
rubbing or scratching.
Dystrophic epidermolysis bullosa (DEB) is one of the major
forms of epidermolysis bullosa in which contractures & hand
deformities also occur with a poor life expectancy.
Counsel the patient to take care of the skin & protect it from trauma
BD for 20 days
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Causes: It is mostly idiopathic & self-limiting in children. In Adults, it tends to occur with an
internal malignancy, infection, and other autoimmune diseases like rheumatoid arthritis. Other
cases of LABD are drug-induced often due to Vancomycin.
Symptoms: Blisters are formed on the base of red or normal-appearing skin with mild itching to
a severe burning sensation. Blisters may appear as a "cluster of jewels” or "string of beads”.
Patient may also experience mucous membrane and ocular involvement including burning and
discharge from the eyes.
Treatment: Idiopathic cases of LABD have been successfully treated with dapsone,
mycophenolate mofetil, colchicine, intravenous immunoglobulin, and Dicloxacillin. A short
course of corticosteroids may also be given to decrease inflammation. Infected lesions may be
treated with topical mupirocin and sterile dressing changes twice daily. For drug-induced cases,
the treatment involves removing the offending drug from one’s drug regimen.
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Topical Steroids :
Provate , Valisone Ointment ( Betamethasone ) + WPJ
BD for 20 days on body
Avate Ointment ( Methylprednisolone )
BD For 10 days on face
Topical Anti-Histamine :
Tab Avil ( pheniramine) or Tab Piriton ( Chlorpheniramine )
Half BD for 10 days
Tab Softin, Antial (Loratidine ) 10mg
OD for 10 days
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3.LUPUS PROFUNDUS:
Lupus profundus is a chronic form of cutaneous lupus erythematosus characterized by the
presence of discoid skin plaques with varying degrees of swelling, redness, scaliness, and skin
atrophy. This co-occurs with panniculitis; the inflammation of the fat under the skin. It involves
the arms, face, buttocks, chest, and, less frequently, the abdomen, back, and neck
Symptoms: growth of yellowish bumps on the skin of the neck, Laxity and redundant
(excessive) skin folds under the arms, or in the groin area; reduced vision; periodic weakness in
the legs (claudication); or bleeding in the gastrointestinal tract, particularly the stomach.
5.LIPOID PROTEINOSIS :
Lipoid proteinosis is a rare autosomal recessive disorder characterized by the deposition of an
amorphous hyaline material in the skin, mucosa, and viscera.
Symptoms include Dry scarred skin, peculiar eyelid papules, abnormality of gums, hoarse cry,
upper respiratory infections and neurological complications including seizures & intellectual
disability.
Treatment: Treatment is based on the signs and symptoms present in each person. The skin
abnormalities may be treated with certain medications, including corticosteriods, dimethyl
sulfoxide, Retinoids, d-penicillamine. Carbon dioxide laser surgery may play a role to cure
growths over vocal cord & eyelids. Anticonvulsant medications are prescribed to people
with seizures.
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MUCOCUTANEOUS ULCERS
APHTHOUS ULCERS ;
Canker sores, also called Aphthous ulcers, are small, shallow round or oval
lesions with a white or yellow center and a red border that develop on or under the
tongue, inside the cheeks or lips, at the base of gums, or on soft palate , can also
occur on genital region. Unlike cold sores, canker sores don't occur on the surface
of your lips and they aren't contagious. They can be painful.
Causes : The cause of canker sores is not known, but most theories involve an
immune abnormality. Certain blood diseases, vitamin and mineral deficiencies,
allergies, trauma and Crohn's disease
cause similar ulcers.
2. PYODERMA GANGRENOSUM :
Pyoderma gangrenosum is a condition that causes tissue to become necrotic, causing deep
ulcers that usually occur on the legs. When they occur, they can lead to chronic wounds.
Ulcers usually initially look like small bug bites or papules, and they progress to larger
ulcers.
CAUSES : It's often associated with autoimmune diseases such as ulcerative colitis,
Crohn's disease and arthritis. And it may have a genetic component. If you have
pyoderma gangrenosum, new skin trauma, such as a cut or puncture wound, may trigger
new ulcers
TREATMENT :
Treatment of pyoderma
gangrenosum is aimed
at reducing
inflammation,
controlling pain,
promoting wound
healing and controlling
any underlying disease.
Give Steroids &
Immunosuppressant
including
Cyclosporin,Infliximab,
Canakinmab
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3. BEHCET’S DISEASE:
4. Sweet’s Syndrome :
Sweet’s syndrome, also known as acute febrile neutrophilic
dermatosis, is a very rare inflammatory skin condition
characterized by a sudden onset of fever and painful rash on
the arms, legs, trunk, face, or neck.
5. MILIARIA
( Sweat Rash in Hot, Humid conditions ) :
Miliaria Crystilline Miliaria Rubra (Prickly heat rash) Miliaria Pustulosa Miliaria Profunda
Treatment: Usually needs no Treatment. Treatment is indicated for cosmetic reasons only &
includes Laser therapy
MILIA:
Milia are small, bump-like cysts found under the skin. They are
usually 1 to 2 millimeters (mm) in size. They form when skin flakes
or keratin become trapped under the skin. Milia most often appear on
the face, commonly around the eyelids and cheeks, though they can
occur anywhere.
Treatment :
Treatment ;
Treatment is indicated for cosmetic reasons only & includes Laser therapy
Treatment ;
( No role of Steroids )
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NEVUS DEPIGMENTOSUS ;
Nevus depigmentosus or nevus achromicus is a loss of pigment in
the skin which can be easily differentiated from vitiligo. It is an
uncommon birthmark (naevus) characterised by a well-
defined pale patch. Shape and size varies. Often,
smaller hypopigmented macules arise around the edges, resembling a
splash of paint.
Treatment ;
Most patients with nevus depigmentosus do not pursue treatment for their lesion. There is no
way to repigment the skin. If, however, the lesion is of cosmetic concern, camouflage makeup is
effective. If the lesion is small one could also consider excision & grafting .
HALO NEVUS :
A halo nevus is a mole surrounded by a white ring or halo.
These moles are almost always benign, meaning they aren't
cancerous. Halo nevi (the plural of nevus) are sometimes called
Sutton nevi or leukoderma acquisitum centrifugum. They're
fairly common in both children and young adults.
KERATOCANTHOMA:
Keratoacanthoma (KA) is a common low-grade rapidly-growing skin tumor that is
believed to originate from the hair follicle ( pilosebaceous unit ) and can
resemble squamous cell carcinoma. It is a dome-shaped lesion filled with keratinous
material that usually occurs on sun-exposed areas of the body, especially around the
head and neck.
Surgical removal
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HEMANGIOMA:
Hemangioma is a benign blood vessel tumor, commonly found in infants as strawberry like birth marks
on skin. Treatment :
LYMPHANGIOMA CICRCUMSCRIPTUM:
Lymphangioma circumscriptum is a congenital benign 'microcytic' lymphatic
malformation which appears as a cluster of small firm blisters filled with
lymph fluid.
Treatment :
NEUROFIBROMATOSIS :
Neurofibromatosis is a genetic disorder of the
nervous system which causes tumors to grow on
nerves & affects how nerve cells form and
grow. It has following main symptoms :
Treatment :
There is no known treatment or cure for neurofibromatosis. In some cases, growths may be
removed surgically or reduced with radiation therapy.
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BOWEN’S DISEASE :
Bowen’s disease, also known as squamous cell carcinoma in situ, is a pre-cancerous skin
condition affecting the epidermal layer of the skin.
Causes: Prolonged sun-exposure & aging are the two main factors. Others include
immunosuppression, a pre-existing HPV cutaneous infection & chronic exposure to arsenic.
Symptoms: Mostly affects the sun-exposed areas of the body but may also affect other regions
including head, neck, palms, soles, lower legs and genitals.
It appears as a slow-growing, persistent reddish-brown patches of dry, scaly skin which may
become warty, fissured, darkly pigmented & crusted. Other symptoms that may develop are
itching, oozing pus & bleeding.
Treatment:
A wide variety of treatment options exist for individuals with Bowen disease including topical
chemotherapy ( with 5-fluorouracil and imiquimod 5% ) , cryotherapy, curettage, photodynamic
therapy and surgery.
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Treatment:
Capillary Malformation: It can be improved by laser therapy, sclerotherapy
or sometimes resection and closure of the skin or replacement with a split-
thickness skin graft.
PORT-WINE STAIN
Lymphatic Malformation: Macrocystic malformations can be deflated by sclerotherapy (injection
of irritating solutions), whereas, microcystic malformations may require resection.
Venous Malformation: Blood stagnates in large dilated veins, and thus there is a risk for
initiating a clotting disorder or thrombosis and pulmonary embolism.
Anticoagulation with heparin is often necessary prior to radiologic or surgical
intervention. Large venous channels can be obliterated by sclerotherapy or
endovascular laser. Chronic bleeding from the colon may require surgical
resection. Bleeding lesions in the bladder can be controlled by laser through a
cystoscope. An elastic compressive stocking is often useful to minimize
discomfort and swelling due to venous distension in the limb.
Overgrowth: Enlarged toes may require amputation to narrow the foot and
permit footwear. Discrepancy in leg length can be corrected by inserting a lift
in the shoe on the normal foot to prevent compensatory curvature of the spine
(scoliosis). Surgical closure of the growth plate at the knee (epiphysiodesis) is
often needed to equalize leg length.
.
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Trichotillomania (trik-o-til-o-MAY-nee-uh)
Also called hair-pulling disorder, is a mental disorder that
involves recurrent, irresistible urges to pull out hair from your
scalp, eyebrows or other areas of your body, despite trying
to stop.
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Hair Tonic
Minoxidil Hair Spray
Shampoo
Multi-vitamins
Hair Tonic :
Twice daily
Shampoo :
Hair-x shampoo
Photonic-max shampoo
Biolyn shampoo
Twice a week
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Multi-vitamins :
Tab Surbex-Z
Tab Maxidel
Capsule/syrup Bio-Z
Tablet Ekstra
Tab Perfectil
Tab Vita-syn
Tab Cola-zinc
Tab Maxideen
OD for 3 months
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MANAGEMENT :
Gromaxx 5F lotion
BD for 2 months
Injectable Steroid :
Lonacort , Kenacort,, Tricort ( Triamcinolone ) injection
Oral Steroid :
Syrup Neupred ( prednisolone, prednisone )
1 + 1 for 3 days
3 + 3 for 3 days
with
OD before breakfast
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HYPER-TRICHOSIS :
Excessive hair growth among both males & females that appear in Non-Androgen dependent
areas of body like forehead, forearm, hands.
It is caused by malnutrition, hypothyroidism or other endocrine disorders & can also occur by the
use of systemic steroids, minoxidil, etc
Management :
Treat the underlying cause
BD for 1 month
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