Contents Preface, xi Dedication, xii Abbreviations, xiii Part 1 General Dermatology Work-up Quick Reference, 3 Direct immunofl uorescence where to biopsy?, 3 False positive/negative DIFs, 4 Biopsy for GVHD, 4 The Dermatologic Differential Algorithm, 4 Alopecia Work-Up, 5 Associations, 5 Cicatricial or non-cicatricial?, 5 Aphthosis Classifi cation and Workup, 9 Morphologic classifi cation, 9 Classifi cation by cause, 9 Work-up for complex apthae, 9 Treatment, 9 Amyloidoses, 10 Xanthomas, 11 Hyperlipoproteinemias: Fredrickson Classifi cation, 12 Histiocytosis, 13 Lupus Erythematosus, 17 Systemic lupus erythematosus criteria (4 of 11), 17 Acute cutaneous lupus erythematosus, 17 Subacute cutaneous lupus erythematosus, 17 Chronic cutaneous lupus erythematosus, 17 Autoantibody sensitivities and specifi cities, 18 Antinuclear Antibodies, 20 Autoantibodies in Connective Tissue Diseases, 21 Vasculitis, 22 Treatment of ANCA-associated vasculitis, 22 Anti-neutrophil cytoplasmic antibody, 23 Small vessel vasculitis, 24 Medium ( small) vessel vasculitis, 26 Large vessel vasculitis, 27 Cryoglobulinemia, 28 CTCL Classifi cation, 29 Mycosis fungoides variants, 29 MF (TNMB) staging, 31 MF treatment algorithm, 32 Cutaneous B-cell Lymphoma, 33 v
Leukemia cutis, 33 Monoclonal Gammopathies, 34 Melanoma Classifi cation, 35 Breslow depth, 36 Melanoma staging and survival, 36 Melanoma treatment guidelines, 37 Infectious Disease, 39 Viruses and diseases, 39 Human papillomavirus, 41 Other viral diseases, 42 Mycoses, 45 Vector-borne diseases, 52 Creatures in dermatology, 58 Immunology, 63 Complement, 63 Complement defi ciencies, 64 Angioedema and complement levels, 64 Th profi les, 65 Bullous Disorders, 65 Intracorneal/subcorneal, 65 Intraepidermal blisters, 66 Suprabasilar blisters, 66 Subepidermal with little infl ammation, 66 Subepidermal with lymphocytes, 67 Subepidermal with eosinophils, 67 Subepidermal with neutrophils, 67 Subepidermal with mast cells, 68 Epidermolysis bullosa, 68 Major bullous diseases clinicopathologic fi ndings, 71 Glands, 75 Disorders or Drugs Associated with Skeletal, Ocular, and/or Nail Findings, 77 Dermatoses of Pregnancy, 88 Neonatal Vesiculopustular Eruptions, 90 Genital Ulcers, 95 Common Contact Allergens, 96 Features suggestive of specifi c irritant/toxin, 100 Plants and dermatoses, 100 Vitamin Defi ciencies/hypervitaminoses, 103 Genodermatoses, 107 Gene list, 107 Chromosome abnormalities, 133 Tumors, 134 Disorders of cornifi cation, 136 vi
Disorders of hair, nail, ectoderm, 139 Tumor syndromes, 144 Disorders of connective tissue, 146 Disorders of metabolism, 149 Disorders of pigmentation, 154 Disorders of vascularization, 156 Immunodefi ciency syndromes, 159 Miscellaneous, 162 Dermoscopy, 163 Pathology, 165 Histochemical staining, 165 Immunohistochemical staining, 167 Pathologic bodies, 170 Other derm path buzzwords, patterns, DDx, 175 Part 2 Surgery Surgical Margins Guidelines, 183 Indications for Mohs micrographic surgery, 183 Guideline for Prophylactic Antibiotics, 184 Algorithm for antibiotic prophylaxis, 185 Guideline for Prophylactic Antivirals, 186 Anesthetics, 186 Dose calculation, 186 Tumescent anesthesia, 186 Topical anesthetic, 187 Adverse reaction to local anesthetics, 187 Local anesthetic, 188 Nerve blocks, 189 Surgical Anatomy, 189 Anatomy of the face, 189 Anatomy of the nail, 193 Danger zones in surgery, 194 Dermatomal distribution of sensory nerves, 196 Anatomy of the lower extremity venous system, 197 Cutaneous Reconstruction, 198 Undermining depths in reconstruction, 199 Dangerzone of the neck: Erbs point, 196 Second intention, 199 Simple linear closure, 200 Transposition fl ap, 201 Advancement fl ap, 204 Interpolation fl ap, 206 Rotation fl ap, 207 Skin graft, 208 vii
Sutures, 210 Absorbable, 210 Non-absorbable, 211 Suture removal time, 212 Electrosurgery, 212 Wound Healing, 212 Wound dressing, 213 Antiseptic Scrubs, 214 Lasers, 216 Laser principles, 217 Thermal relaxation time, 217 Laser treatment of tattoo pigment, 218 Photoinduced eye injury, 218 Photodynamic Therapy, 220 Basic principles, 220 Applications, 220 Photosensitizer properties and options, 220 UV Spectrum, 222 UV Protection Measurements, 223 UV Associations/Specifi cities, 223 Glogau Wrinkle Scale, 224 Fitzpatrick Skin Type, 224 Peeling Agents, 224 TCA peel, 225 TCA peel frost level, 225 Jessner solution, 225 Baker-Gordon phenol, 226 Cook total body peel, 226 Pre-peel prep, 226 Post-peel wound care, 226 Botulinum Toxin, 226 Botox injection sites, 227 Fillers, 229 Sclerotherapy, 234 Determine vessel size using needle gauge, 236 Recommended maximum effective concentration of sclerosant to minimize side effects, 236 Part 3 Drugs and Therapies Medication Quick Reference, 239 Topical steroids, 239 Non-steroidals, 240 Commonly used drugs in dermatology, 240 Systemic Medications, 243 viii
Antimalarials, 243 Immunosuppressive agents, 244 Systemic retinoids, 246 Biologics, 247 General Reference, 249 Metric measurements, 249 Dosage calculation, 249 Drug dispensing and absorption, 249 Corticosteroid, 249 Acne Topical, 250 Antibiotics, 250 Keratolytics, 250 Acne Systemic, 251 Antibiotics, 251 Retinoids, 252 Others, 252 Alopecia, 252 Analgesics, 252 Anesthetics Topical, 253 Antibiotics, 253 Topical/Antiseptic, 253 Systemic, 254 Antibiotic preoperative prophylaxis, see p. 184 Antibiotic regimens, 255 STDs, 257 Antifungals, 257 Topical, 257 Systemic, 258 Antifungal regimens, 260 Antiparasitics, 261 Antivirals, 262 For HSV labialis topical agents, 262 For HSV 1 or 2 oral agents, 262 For HSV disseminated disease, 262 For herpes zoster/vzv, 262 For genital warts, 263 For verruca vulgaris, 263 For molluscum, 263 Antihistamines, 263 Sedating, 263 Non-sedating, 264 H2-blockers, 264 Antipruritic, 264 Topical, 264 ix
Oral, 264 Bleaching Agents/Depigmenting Agents, 265 Topical Chemotherapy, 266 Actinic keratoses (AK), 266 Basal cell carcinoma (BCC) superfi cial BCC, 266 CTCL, 266 Topical agents, 266 Oral agent, 266 Other agent, 267 Psoriasis, 267 Topical agents, 267 Tar, 267 Systemic agents, 267 Seborrheic Dermatitis, 268 Hypertrichosis, 268 Hyperhidrosis, 268 Wound Care, 269 Vitamins/Nutritional Supplements, 269 Miscellaneous Meds, 269 Cytochrome P-450 Interactions, 270 Pregnancy Categories of Commonly Used Dermatologic Agents, 272 Common Dermatologic Drugs and Teratogenic Effects, 273 Dermatologic Drugs Reportedly Associated with Contraceptive Failure, 273 Drug Eruptions, 274 Chemotherapeutic Agents and Skin Changes, 277 Antidote to extravasation of chemotherapeutic agents, 279 UV Light Treatment, 279 UVA/UVB dosing, 279 NBUVB dosing, 280 PUVA, 280 Washington University Dermatology Toxic Epidermal Necrolysis (TEN) Protocol, 282 Diagnosis of TEN, 282 Triage algorithm for TEN patients, 283 Treatment for all TEN patients, 283 Index, 287 Color plate section can be found facing page 208 x