Handbook of Dermatology

Margaret W. Mann is Associate Professor and Director of Aesthetic Dermatology, University Hospitals, Case Western School of Medicine, Cleveland, OH, USA. She is the Co-Founder of Innova Dermatology, Hendersonville, TN, USA. Daniel L. Popkin is Assistant Chief of Dermatology, Louis Stokes VA Medical Center and Assistant Professor of Dermatology, University Hospitals, Case Western School of Medicine, Cleveland, OH, USA. He is the Co-Founder of Innova Dermatology, Hendersonville, TN, USA.

• Preface xvAcknowledgments xviiPart 1 General Dermatology 1Common Work-Ups, Signs, and Management 3Dermatologic Differential Algorithm 3Direct Immunofluorescence (Dif) 3False positive/negative DIFs 3Workup Quick Reference Orders 4Acne 6Alopecia Workup 7Telogen effluvium 10Androgenic alopecia 10Alopecia areata 11Other alopecia treatments 12Aphthosis Workup and Treatment 13Dermatologic Signs 15Folliculitis 21Melasma 22Immunology and Immunologic Disease 24Lupus Erythematosus 24Autoantibody 26Sensitivities and specificities 26In connective tissue diseases 28Anti‐nuclear antibodies 29ANCA (Anti‐neutrophil cytoplasmic antibodies) 30Treatment of ANCA‐associated vasculitis 30Vasculitis 31Small vessel vasculitis 31Medium vessel vasculitis 33Large vessel vasculitis 34Cryoglobulinemia 34Bullous Disorders 36Intracorneal/subcorneal 36Intraepidermal 36Suprabasilar 37Subepidermal with little inflammation 37Epidermolysis bullosa 39Major bullous diseases – clinicopathologic findings 42Complement 46Angioedema and complement levels 46Complement deficiencies 47GVHD 47HLA associations 48Th profiles 50Special Sites: Glands, Nail, Bone, Mucosa 51Glands 51Nail terminology 53Disorders or drugs associated with nail, Bone, or ocular findings 57Genital ulcers 67Infection and Infestations 68Fungal Disease / Mycoses 68Laboratory tests 68Superficial mycoses 68Cutaneous mycoses 69Subcutaneous mycoses 71Systemic mycoses 73Opportunistic mycoses 75Viruses and diseases 78Human papilloma virus 79Other viral diseases 80Infections/Bugs 83Vector‐borne diseases 83Creatures in dermatology 88Contact and Plant Dermatitis 93Patch testing 93Common contact allergens 95Allergic vs. irritant contact dermatitis 104Allergens – location specific 105Features suggestive of specific irritant/toxin 106Plants and Dermatoses 106Tumors and Infiltrates 109Cutaneous T Cell Lyphoma 109Cutaneous B‐cell lymphoma 113Leukemia cutis 113Monoclonal Gammopathies in Dermatology 114Tumors and gene associations 115For Melanoma, BCC, and SCC, see Skin Cancer 221Systemic and Metabolic Diseases 117Amyloidoses 117Histiocytosis 119Xanthomas 124Hyperlipoproteinemias 125Vitamin Deficiencies/Hypervitaminoses 127Pediatric and Pregnancy Dermatology 131Vascular tumors and malformation 131Infantile Hemangioma (IH) Management 132Neonatal vesiculopustular eruptions 137Genodermatoses 142Chromosome abnormalities 171Disorders of cornification 171Disorders of connective tissue 175Ehlers–Danlos 177Collagen types 178Disorder of hair, Nail, ectoderm 179Tumor syndromes 185Disorders of vascularization 186Disorders of metabolism 189Porphyrias 191Disorders of pigmentation 193Immunodeficiency syndromes 196Miscellaneous 198Dermatoses of pregnancy 200Dermoscopy and Dermatopathology 202Dermoscopy 202Dermatopathology 206Histochemical staining 206Immunohistochemical staining 207Pathologic bodies 210Cysts 214Other derm path buzzwords, Patterns, DDx 215Part 2 Surgical and Cosmetic Dermatology 219Surgical Dermatology 221Skin cancer 221Surgical margin guidelines 221Indication for Mohs micrographic surgery 222Melanoma 223Squamous cell carcinoma (SCC) 228Prophylactic antibiotics and antivirals 230Guideline for Prophylactic antibiotics 230Algorithm for antibiotic prophylaxis 231Guideline for prophylactic antivirals 231Antiseptic scrubs 232Anesthetics 234Dose calculation 234Standard formula for buffered Lidocaine 234Tumescent anesthesia 234Topical anesthetic (see drug section pg. 316) 235Adverse reaction to local anesthetics 235Local anesthetic 236Nerve blocks 237Surgical anatomy 237Anatomy of the face 237Danger zones in surgery 242Dermatomal distribution of sensory nerves 244Anatomy of the lower extremity venous system 245Anatomy of the nail 246Cutaneous reconstruction 247Undermining depths in reconstruction 248Reconstruction algorithm: STAIRS 248Sutures 260Absorbable 260Nonabsorbable 261Suture removal time 262Electrosurgery 262Wound healing 262Wound dressing 263Cosmetic Dermatology 264Laser 264Laser fundamentals 264Laser treatment of tattoo pigment 266Photoinduced eye injury 267Laser wavelength depth of penetration and the electromagnetic spectrum 268Absorption spectra of major skin chromophores 268Photodynamic therapy 269Photosensitizer properties and options 269PDT Protocol 270UV spectrum 271UV spectrum and wavelengths 271UVB protection vs SPF 272UV protection measurements 272UV associations/specificities 273Glogau wrinkle scale 273Fitzpatrick skin type 274Chemical peels 274Pre‐peel consideration 274Peeling agents 275Botulinum toxin 277Injectable for adipolysis 280Fillers 281Protocol for vascular occlusion from fillers 288Venous disease treatment 288Vein treatment algorithm 288Sclerotherapy 289Preparing dilution of sclerosants 290CEAP classification for venous disease 292Venous clinical severity score 292Part 3 Drugs and Therapies 293Medication Quick Reference 295Topical steroids classified by strength 295Nonsteroidals 297Commonly used drugs in dermatology 297Systemic Medications 302Antimalarials 302Immunosuppressive agents 303Systemic retinoids 306Biologics 307General Reference 310Metric measurements 310Dose calculations 310Topical medication dispensing and absorption 310Corticosteroid Dosage Equivalence 311Acne – Topical 311Antibiotics/antimicrobial 311Keratolytics 312Retinoids 313Others 313Acne – Oral 314Antibiotics 314Retinoids 315Others 315Analgesics 315Anesthetics – topical (see also topical anesthetic pg. 235) 316Anesthetics – topical compounded 316Antibiotics 316Topical/antiseptic 316Systemic 317Preoperative prophylaxis see pg. 230Postoperative skin infection 319Sensitivity 321Regimens 322STDs 323Antifungals 324Topical 324Oral 325Antifungal regimens 327Candidal infection 327Pityrosporum folliculitis 327Onychomycosis 327Tinea versicolor (Malassezia) 328Tinea capitis 328Tinea corporis 328Tinea pedis 329Antiparasitics 330Scabies 330Lice 330Antivirals 331HSV 331Herpes zoster/VZV 333Genital warts 333Verruca vulgaris 334Molluscum 334Antihistamines 334Sedating 335Nonsedating 335H2‐blockers 335Antipruritic 336Topical 336Oral 336Anxiolytics/Sedation 338Benzodiazepines 338Antihistamines 339Bleaching Agents/Depigmenting Agents 340Hair 341Alopecia – androgenic 341Alopecia – areata 341Hypertrichosis 342Hypotrichosis – eyelash 342Hyperhidrosis 342Psoriasis 343Topical agents 343Tar 343Anthralin/dithranol 343Systemic agents 343 (see also Systemic Medications pg. 306)Rosacea 344Antibiotics/antimicrobial – topical 344Keratolytics 344Vasoconstrictor 344Other 344Antibiotics – systemic 344Seborrheic Dermatitis 345Skin Cancer – Topical and Oral Chemotherapy 345Actinic keratoses (AK) 345Basal cell carcinoma (BCC) 346CTCL 346Melanoma 347Vasoactive/Antiplatelet Agents 347Vitamins/Nutritional Supplements 348Wound Care 348Miscellaneous Meds 348Cytochrome P‐450 interactions 349Pregnancy Categories of Commonly Used Dermatologic Agents 350Common Dermatologic Drugs and Teratogenic Effects 351Dermatologic Drugs Reportedly Associated with Contraceptive Failure 352Drug Eruptions 352Chemotherapeutic Agents and Skin Changes 355Antidote to extravasation of chemotherapeutic agents 358UV Light Treatment 359UVA/UVB dosing 359NBUVB dosing 359PUVA 359Toxic Epidermal Necrolysis (TEN) Protocol 361Diagnosis of TEN 361Triage algorithm for TEN patients 362Treatment for all TEN patients 363Appendix I American Burn Assocation Burn Center Referral Criteria 364Appendix SCORTEN Score 365Appendix III IVIg 365Appendix IV Further Reading for TEN/SJS 366Index 367Color plate section can be found facing page 208