SKIN DISEASES

• PAPULAR ITCHING RASH (PRURIGO)

  • Itching rash with small papules and scratch marks. Dark spots with pale centres
  • treatment - calamine lotion, antihistamine oral, 1% hydrocortisone

  
• RINGWORM (TINEA)

  • An itchy circular lesion with a raised edge and fine scaly area in the center with loss of hair
  • Whitfield ointment/antifungal cream
  • Ketoconazole for 2 up to 12 months(6-10 kg) 40mg
  • 2 months - 5 years - 60 mg per day
  • griseofulvin - 10mg/kg/day

  
• SCABIES

  • rash and excoriations on torso; burrows in web space and wrists. face spared
  • anti scabies: 25% topical Benzyl Benzoate at night
  • 1% lindane cream or lotion once wash off after 12 hours

  
• CHICKEN POX

  • Vesicles over the body. Vesicles appear progressively over days and form scabs after they rupture
  • Refer URGENTLY if pneumonia or jaundice appear

  
• HERPES ZOSTER

  • Vesicles in one area on one side of the body with intense pain or scars plus shooting pain.
  • Uncommon in children except if infected with HIV
  • Lesions - antiseptic
  • Eye - acyclovir 20mg/kg 4 times daily

  
• IMPETIGO/FOLLICULITIS

  • Red, tender, warm crusts or small lesions
  • Start cloxacillin if size >4cm or red streaks or tender nodes or multiple abscesses for 5 days ( 25-50 mg/kg every 6 hours)

  
• MOLLUSCUM CONTAGIOSUM

  • Skin-coloured pearly white papules with a central umbilication. It is most commonly seen on the face and trunk in children.
  • phenol Electrodesiccation Liquid nitrogen

  
• WARTS

  • the common wart appears as papules or nodules with a rough (verrucous) surface

  
• SEBORRHEA

  • greasy scales and redness on central face, body folds
  • Ketoconazole shampoo
  • severe - seborrheic dermatitis: 1% hydrocortisone cream X 2 daily

  
• FIXED DRUG REACTIONS

  • Generalized red, wide spread with small bumps or blisters; or one or more dark skin areas (fixed drug reactions)
  • Stop medications give oral antihistamines, if pealing rash refer

  
• ECZEMA

  • Wet, oozing sores or excoriated, thick patches
  • use of topical steroid cream not on face

  
• STEVEN JOHNSON SYNDROME

  • Severe reaction due to cotrimoxazole or NVP involving the skin as well as the eyes and the mouth. Might cause difficulty in breathing