Understanding Common Skin Conditions: Pityriasis Versicolor, Lichen Planus, and More

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Pityriasis Versicolor

Pathogen: Malassezia furfur
Clinical Features:
  • Asymptomatic or pink scaly patches on the trunk
Lab Findings:
  • KOH preparation or black ink/stained dry smear/histopathology
  • Culture: Growing fungi
Diagnosis: Based on physical and lab findings
Treatment: Griseofulvin, polyenes, azoles

Lichen Planus

General:
  • Idiopathic inflammatory disease affecting skin, hair, nails, and mucosa
  • Common in middle-aged adults
Pathophysiology:
  • T cell and cytokine cell infiltration leading to IFN-gamma and TNF release
  • HLADR-8 overexpression and keratinocyte adhesion
  • Basal cell damage and reactive hyperkeratosis
Forms:
  • Subjective: Intense pruritus
  • Objective: Papules, fine scale
  • Mucosal: Tongue and buccal involvement
  • Nail: Plate thinning, long grooving and ridging, subungual hyperkeratosis
  • Location: Wrists, forearms, genitalia
Diagnosis:
  • Clinical features
  • Histology: Irregular acanthosis, colloid bodies in epidermis, linear fibrin degeneration
  • Direct IMF: IgM & complement deposits
Treatment:
  • Self-limited (8-12 months)
  • Topical steroids
  • Severe cases: Systemic steroids or PUVA

Neurosyphilis Staging

 General (15 years) / Meningovascular (5-10 years) / Tabes dorsalis (25-30 years)
Clinical Features:Blindness, confusion, depression, headache, paralysis, stiff neck, tremor
Diagnosis:Lumbar puncture (CSF) count, biochemistry (glucose, protein)
Treatment:Penicillin G 2-4 million units / 4 hours / 10-14 days

Congenital Syphilis

Classification (before birth)Early (Clinical Features):
  • Asymptomatic at birth
  • Rhinitis, serosanguineous nasal discharge
  • Lesions on lips, nose, anus (rhagades)
  • Bone abnormalities
  • Chorioretinitis
Late (Clinical Features):
  • Hutchinson's triad
  • Clutton's joints
  • 8th nerve deafness
Diagnosis:Screening, confirmation, follow-upTreatment: Obligatory Penicillin G (50-100 K IU/kg for 10-14 days)

Herpes Genitalis

General:
  • Caused by HSV-2
  • Sexually transmitted disease
 
Clinical Features:
  1. Malaise, fever, fatigue
  2. Painful urination
  3. Bilateral lymphadenopathy
  4. Lesions: Disseminated, rapidly eroded vesicles, painful ulcers
Diagnosis (for gonococcal infection):
  1. Gram stain
  2. Isolated culture
  3. Hybridization
Treatment:
  • Ceftriaxone (500mg IM)
  • Cefixime (400mg)
  • Cefixime + Azithromycin (2g)
Diagnosis:
  1. Serology (best)
  2. Clinical presentation
  3. Tzanck smear
  4. PCR
  5. Culture
Treatment:
  • Antiviral therapy
  • Drying measures (zinc oxide)
  • Vaccination against HSV-2

Condylomata Acuminata

General:
  • Most common STD, transmitted by HPV
Pathogen: HPV
Clinical Features:
  • Incubation period: 4-6 months
  • White papules that spread and enlarge (genitalia or perineum)
Diagnosis:
  • 5% acetic acid for coloration
  • Cervical examination in women
Treatment:
  • Podophyllotoxins 5%
  • Pregnancy: Trichloroacetic acid 50-85%
  • Cryotherapy (not for vaginal/perianal warts)
  • Imiquimod for 6 weeks
  • Electrocautery, curettage, or laser
Prophylaxis:
  • Examine sexual partners
  • Circumcision

Mononucleosis (EBV)

"Kissing Disease"

Cause: Human herpesvirus 4 (EBV)

Transmission: Saliva, bodily fluids

Diagnosis:

  1. Blood test: Elevated leukocytes

Treatment:

  • Relieve symptoms
  • Hydration
  • Avoid strenuous activity
Karma: 6%
Visits: 0

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Tags:
Congenital Syphilis Condylomata Acuminata Herpes Genitalis Mononucleosis Lichen Planus Neurosyphilis Pityriasis Versicolor