* / / scheme

Diagnosis and treatment of fungal infection 1- Clinical presentation. 2- Direct microscopy + KOH drop 1 -2 ! + "arming. #- Culture on $a%ouraod&s agar ' 2- ( )ee*s+ (- "ood&s light, Coryne%acterium minutissimum -- Coral red .icrosporum canis -- /reen 0.o1ale -- /olden yello). 2- 3iopsy for deep infection. 4reatment, 1- $ystemic, a. /riseoful1in, 12.2 mg/*g/day 5-6 )ee*s in 4inea capitis. 2-( )ee*s in 4inea corporis. 6-1 )ee*s in 7a1us. 5 months in finger nails onychomycosis 12 )ee*s in toe nails. it&s not effecti1e in Candidiasis 8 0ityriasis 1ersicolor. %. 3road specrum 9ntifungal , Ketocona:ol; <tracona:ole. 2- 4opical, - 4incture <odine 2- 2 !. - "hitefield Ointment = $alicylate # + 3en:oate 5 + >anoline 1 + ?aseline 1 - 4opical 3$ antifungal , Clotrima:ole; Ketocona:ole; @cona:ole; 7lucona:ole. - 9Aueous solution of 2 -22! Ba Hyposulfite in pityriasis ?ersicolor #- Candida , - 4opical antifungal , Clotrima:ole. - $ystemic 3roadspectrum antifungal , as %( eCcept /riseoful1in as it&s not effecti1e in candidaisis. $ca%ies Diagnosis , Clinical * <tching more at night. * .ore than one family mem%er. * Characteristic distri%ution. 4reatment, 1- $ystemic, <1ermectin - Oral antihistaminics. 2- 4opical, a. $ulfur 2-1 ! in petroleum after hot %ath )ith hard %rush ( successi1e nights. %. /amma %en:ene heCachloride 1! ' lindaine+ %ut a1oid hot %ath -- increase a%sorption -- CB$ toCicity. <t&s )ashed after 6-12 hours. c. permethrin 2.2 - 2 ! )ashed after 6 - 1( hours. d. .alathione .2! e. Crotamitone 1 ! once daily for # successi1e days )ithout %athing. f. 3en:yl 3en:oate emulsion 22-##! B.3, in pregnant female use $ulfur and 0ermethrin only.

0ediculous humanus Capitis 1- ttt of pyogenic infection , $ystemic 9nti%iotic. 2- 9ntipediculous agents ' 0ermethrin; .alathione; /amma %en:ene heCachloride 1!; 3en:yl %en:oate emulsion 22!-##!+. #- Demo1al of nits %y fine toothed com%. 0ediculous humanus corporis 1- <roning of clothes. 2- 9ntipediculous lotions 0hthirus pu%is $ha1ing + .alathione. 9lopecia 9reata 1- 4opical, * >ocal irritant ' 4incture iodine; tincture capsicum; tincture cantharidis + * Contact allergens ' DBC3 + * 4opical and <B4D9>@$<OB9> steroids. 2- 0hototherapy, 0E?9; E?3. #- $ystemic corticosteroids. 9ndrogenic 9lopecia, * 4opical minoCidil 2-2 ! * $ystemic antiandrogens in females. 9cne ?ulgaris ' ( topical and ( systemic+ 1- 4opical, * 0eeling agent ' $alicylate #! or $ulfur in calamine lotion 2! or . 2! Detinoic acid+ * 9nti%iotics ' @rythromycin; Clindamycin + * 3en:oyl 0eroCide. * 4opical 9:aleic acid ' Keratolytic and Decrease se%um+ 2- $ystemic, * 9nti%iotics ' 4etracycline; Clindamycin; .inocycline; DoCycycline+ in therapeutic doses they are %acteriostatic; in su%-therapeutic doses they are anti-lipase. * 9ntiandrogens, Cyproterone acetate. * $ystemic Detinoids ' isotretinoin + .2-1 mg/*g/day <t&s teratogenic so a1oid in the 1st trimester; ta*e OC0 and stop # months %efore pregnancy. * 0ost acne scaring, Derma%rasion; Chemical %eeling; Desurfacing %y laser therapy. 0soriasis Diagnosis, 1- Clinical presentation. 2- /rattage test -- +1e 9uspit: sign. #- Histopathology ' 0ara*eratosis; 0apillomatosis and elongated rete ridges; 9canthosis; $terile pustules in stratum malpighii and Dilated tortuous capillaries+ 4reatment, 1- 4opical , * @molients.

* Keratolytics -- $alicylic acid #!. * 4ar ' crude coal tar -- 9ntiproliferati1e + * 9nthraline -- 9ntimitosis. * 4opical and <ntralesional steroids. * ?it D# analogues ' calcipotriol -- inhi%it cell proliferation and stimulate *eratinocyte differentiation + * 4opical Detinoids. 2- $ystemic, * .ethotreCate .2 - .( mg/*g * @tretinate 1mg/*g/day. * Com%ined therapy -- De-0E?9. * 3iological therapy -- 4B7 <. #- 0hototherapy, * 0E?9 - E?3 ' Baro) %and - 3road %and +. 0ityriasis Dosea 1- Deassurance. 2- $oothing lotion. #- 9ntihistaminics -- <f itchy. >ichen planus, 1- 4opical , #$ * $teroids. * <ntralesional steroids -- Hypertrophic lichen planus. * $un screen ' >ichen planus actinicus +. 2- $ystemic, * 9ntihistaminics. * $teroids. * 9ntimalarials -- 9ctinic lichen planus. * 4ranAuili:ers. Herpes simpleC, 1- 4opical , /entian 1iolet 2! paint + 9cyclo1ir cream in 1st (6 hours. 2- $ystemic , 2 mg 9cyclo1ir 2/day for 2 days. Chic*en 0oC, 1- 4opical, /entian 1iolet + Calamine lotion. 2- $ystemic, 9cyclo1ir + 9ntihistaminics. Herpes Foster, 1- 4opical , /entian 1iolet + 9cyclo1ir cream. 2- $ystemic , 6 mg 9cyclo1ir 2/day for G-1 days + 0ain *illers. ?iral )arts, $elf limiting. 1- Chemical cautery, * /lacial acetic acid. * $alicylic acid 1 - 5 !. * $alicylate + >actic acid in felCi%le collodion.

2- @lectric cautery. #- Cryotherapy )ith liAuid nitrogen 1H5 degee cel:ius. (- Car%on dioCide laser. 2- 4opical *eratolutic , Detinoic acid. 5- /enital )arts, 22! podophylline in tincture %en:oin - 4opical imiAuimod cream. .olluscum contagiosum 1- .echanical -- @Cpression %y forceps of curettage + Conc. 0henol to the %ase. 2- Conc. phenol paint. #- @lectric cautery. (- Cryotherapy and CO2 laser. @c:ema 1- /eneral , 9ntihistaminics; 9nti%iotics; $teroids. 2- >ocal, * 9cute , K permanganate 1/6 ; >ead su%acetate .2! 1/1 ; Corticosteroid cream. * $u%acute , corticosteroid cream; Finc oCide paste. * Chronic , 4opical steroids. * 9topic dermatitis, >ong term use of emollients. #- $earch for the cause and a1oid it. Erticaria, 1- 9drenaline 1/1 1cc $C. 2- 9ntihistaminics lenofeCidine. #- Ca++ gluconate 1 ! 1 cc slo) <?< (- $ystemic steroids. 2- 7ind the cause and a1oid it. 0apular urticaria 1- 91oid insect %ite. 2- 9ntihistaminics. #- $hort term oral steroids. (- 9nti%iotics. 2- $oothing lotion. @rythema multiforme 1- ttt of the cause ' hypersensiti1ity+ 2- 9nti%iotic for 2ry infection. #- $ystemic corticosteroids in se1ere cases. 7iCed drug eruption 1- $top the drug. 2- @molients. #- 4opical steroids. ?itiligo 1- 4opical, $teroids and 0E?9. 2- $ystemic, 0E?9 - 6 methoCy psoralen + E?9 ' #2 - (

nm +

#- Barro) %and E?3 ' #11 - #1# nm + "ithout systemic therapy. (- $urgical , .icropigimetation ; 9utografting. Chloasma, 1- 91oid sun eCposure + $un screen. 2- $top OC0. #- 4opical remedies that decrease melanocyte acti1ity ' 9:aleic acid; HydroAuinone + (- Chemical peeling , #2! trichloroacetic

9. ?iral infection
D.D of Herpes $impleC impetigo Herpes Foster

D.D of chic*en poC 0apular urticaria sca%ies

D.D of 1erruca plantaris ' plantar )art + is callus D.D of condyloma accuminata ' genital )art + is syphilitic condyloma lata

3. 0arasitic infestation

D.D of sca%ies impetigo papular urticaria insects %ite contact 8 atopic dermatatis

c. scaly scalp
psoriasis impetigo se%orrheic dermatitis discoid lupus erythematosis

D. 0yogenic infection
D.D of cellulitis erysipelas acute ec:ema

D.D of @rysipelas

cellulitis acute ec:ema angioedema

D.D of sycosis %ar%ae pseudofolliculitis tinea %ar%ae

@. 9llergic diseases

D.D of pityriasis al%a 1itiligo leprosy pityriasis 1ersicolor

7. D.D of macerated toe )e%

Dermatophytes candidiasis / -1e %acilli

/. @rythematosAuamous eruptions

D.D of lichen planus lichenoid drug eruptions ....eg. gold ; antimalarias ; streptomycin

D.D of pityriasis rosea tinea circinata 2ry syphilitic rash pityriasis drug eruptions

H. 0igmentary disorders

D.D of 1itiligo pityriasis al%a pityriasis 1ersicolor

tu%erculoid leprosy al%inism post inflammatory hypopigmentation na1us anemicus

<. Hair

D.D of allopecia areata scaly ring )orm