Showing 61-80 of 84 for: Essential Evidence Topics > Dermatologic 
- Pityriasis rosea
Essential Evidence Topics, 28-Sep-2020
Overall Bottom Line: Diagnosis is based on clinical criteria. Look for herald patch preceding elliptical rash along Langer lines. Pityriasis rosea is distinguished by a collarette of scale just inside the erythematous border of the patch. A collarette
- Plantar and flat warts
Essential Evidence Topics, 7-Feb-2022
Overall Bottom Line: Eventual spontaneous resolution is normal for immunocompetent patients, so expectant management is a reasonable option. Treatment with topical salicylic acid and/or cryotherapy produces cure rates between 50% and 60% within weeks to
- Polymorphous light eruption and photodermatoses
Essential Evidence Topics, 17-Jul-2019
Overall Bottom Line: The appearance, timing and duration of lesions are key to diagnosing polymorphous light eruption (PMLE). The age and gender of the patient are also helpful. Avoidance of sunlight is an absolute must. Patients need explicit instructi
- Pruritus
Essential Evidence Topics, 21-Jul-2021
Overall Bottom Line: In patients with chronic pruritus (≥6 weeks), consider checking CBC, ferritin, ESR, CRP, glucose, serum creatinine, LFTs, TSH, LDH, and stool occult blood (for age ≥40). First-line treatment is with an H1-receptor blocker. Second-
- Pruritus ani
Essential Evidence Topics, 10-Nov-2021
Overall Bottom Line: Pruritus ani results from myriad dermatologic and anorectal conditions; idiopathic PA is therefore a diagnosis of exclusion. Important causes to consider include diet, cleansing and other applied products, and topical or ingested me
- Psoriasis
Essential Evidence Topics, 10-Aug-2022
Overall Bottom Line: Diagnosis is based on clinical recognition of typical skin, nail, and scalp lesions. Multiple types of psoriasis exist, making it essential to know the patterns for the less common types including inverse psoriasis and palmoplantar
- Punch biopsy (procedure)
Essential Evidence Topics, 20-Apr-2021
Indications: To diagnose of skin lesion to determine appropriate care, i.e. unknown dermatitis or possible malignant lesion. Punch biopsy is superior to shave biopsy for diagnosis and staging of malignant skin cancers. Removal of suspected pre-malignant s
- Purulent skin and soft tissue infections (furuncle, carbuncle, abscess)
Essential Evidence Topics, 16-Mar-2023
Overall Bottom Line: Purulent skin and soft tissue infections (SSTIs) present as furuncles (boils), carbuncles (interconnected boils), and abscesses. When clinical exam is uncertain, perform point-of-care ultrasonography (POCUS) to rule out the presence
- Scabies
Essential Evidence Topics, 4-Jul-2022
Overall Bottom Line: Consider scabies in a patient who presents with generalized pruritus that is worse at night and who has papules, vesicles, or burrows in the typical predilection sites, as well as household members or contacts with itch. A positive
- Scleroderma (progressive systemic sclerosis)
Essential Evidence Topics, 10-Aug-2022
Overall Bottom Line: The diagnosis of systemic scleroderma requires the presence of the lone major criterion (proximal scleroderma) or 2 minor criteria (sclerodactyly, digital pitting scars or a loss of substance from finger pads, or bibasilar pulmonary f
- Seborrheic dermatitis
Essential Evidence Topics, 14-Jan-2022
Overall Bottom Line: Consider a diagnosis of seborrheic dermatitis in patients presenting with intermittent pruritus, burning, erythematous patches, and greasy scales over the nasolabial folds, postauricular skin, central face, and anterior chest. Effec
- Serum sickness
Essential Evidence Topics, 8-Apr-2021
Overall Bottom Line: If possible, avoid cefaclor in children as it may be associated with an increased risk of serum sickness. Identification of the offending agent is the key to diagnosis. Fever is universal; rash, nearly so. Treatment with antihis
- Skin cancer (basal cell)
Essential Evidence Topics, 24-Jun-2022
Overall Bottom Line: Look for clinical features that are suspicious for all subtypes of basal cell carcinoma (BCC) including nodular (pearly with telangiectasias), superficial (scaling and thready border), and sclerosing (scarlike). Biopsy suspicious le
- Skin cancer (melanoma)
Essential Evidence Topics, 16-Jun-2022
Overall Bottom Line: Examine closely any lesion that a patient states is changing in size, shape, symptoms (itching, tenderness), surface (especially bleeding), and shades of color. Look for the ABCDE criteria (). Dermoscopy is more sensitive than the u
- Skin cancer (squamous cell carcinoma)
Essential Evidence Topics, 9-Dec-2022
Overall Bottom Line: Biopsy any growing or ulcerated lesion that does not heal, bleeds easily, or steadily grows in a sun-exposed area or a mucus membrane. Surgical resection for definitive treatment of squamous cell carcinoma (SCC) should include margi
- Staphylococcal scalded skin syndrome
Essential Evidence Topics, 14-Mar-2023
Overall Bottom Line: Staphylococcal scalded skin syndrome (SSSS) is most common in children younger than 5 years and occurs rarely in adults. SSSS is caused by a circulating exfoliative exotoxin, produced by some strains of Staphyloccus aureus . SSSS
- Stevens-Johnson syndrome
Essential Evidence Topics, 30-Mar-2022
Overall Bottom Line: If patient presents with prodromal febrile illness, target lesions, mucosal membrane involvement, and recent prescription use, Stevens–Johnson syndrome should be expected. Start supportive treatment and consider transfer to a burn c
- Tinea capitis and barbae
Essential Evidence Topics, 20-Apr-2021
Overall Bottom Line: Diagnosis of tinea capitis and barbae is by clinical appearance, microscopic evaluation, and optionally mycologic culture. Oral treatment is with appropriate dose of griseofulvin for 6 to 8 weeks or terbinafine for 2-4 weeks (approv
- Tinea versicolor
Essential Evidence Topics, 1-Feb-2021
Overall Bottom Line: Suspect tinea versicolor in patients with hypo- or hyperpigmented macules and patches with fine scale of the upper trunk and neck. Confim the diagnosis by looking for "spaghetti and meatball" pattern of Malassezia on potassium hyd
- Toenail removal (procedure)
Essential Evidence Topics, 8-Nov-2020
Indications for procedure: Moderate to severe onychocryptosis (ingrown toenail). Failed topical and oral treatment of onychomycosis (fungal infection of the toenail). Recurrent or chronic paronychia. Patients should be referred if sensitivity to anesth
