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Carrying the right items can turn a hectic audition day in dermatology into a smoother, more enjoyable experience. Here’s what I always pack in my beloved Poppy & Peonies tote —a bag that truly fits my life as a busy medical student in the clinic. https://us.poppyandpeonies.com/collections/totes/products/go-getter-tote-cognac Every morning starts with packing my non-negotiable supplies, ensuring I'm prepared for anything the day throws at me. Here are the key items I never leave home without: Lululemon Water Bottle (with a Lid): A must for staying hydrated, plus a lid or straw prevents any accidental spills. https://shop.lululemon.com/p/water-bottles/Back-To-Life-Sport-Bottle-MD/_/prod10390301?color=31382&sz=ONESIZE Vaseline (Pink!) and L’Oréal Paris Plump Ambition Lip Gloss: Hydrated, plump lips keep me comfortable and confident all day—thanks, sis, for the new favorite gloss! https://www.vaseline.com/us/en/p/vaseline-lip-therapy-rosy-mini.html/00305210231597 https://www.vaseline.com/us/en/p/vaseline-lip-therapy-rosy-lips-stick.html/00859581006853 https://www.lorealparisusa.com/makeup/lip-color/lip-gloss/plump-ambition-hyaluron-lip-oil-milky-nu-201 Medication Kit: I keep ibuprofen, Tums, and cough drops on hand for any sudden headaches or sore throats. Compact Umbrella: For surprise weather—nothing ruins a clinic day like being drenched. Fanny Pack with Wallet: When the day ends, I just grab my fanny pack (“belt bag” just doesn’t sound right) and leave the big tote behind. Study Materials: MedStudy Dermatology Core Book: My go-to in between patients for quick learning. No scrolling on my phone—looks much more professional. https://medstudy.com/collections/shop-all/products/medical-school-books Dermatology Pocket Guide, 5th Edition: Sometimes I seriously feel like a coach prepping my playbook! https://www.amazon.com/Dermatology-Dosing-Workup-Management-Card/dp/B074HG5FRC/ref=sr_1_19_sspa?crid=Z123YL7FCNI6&dib=eyJ2IjoiMSJ9.VI-DRhJHASRf1XGdhxSF5cSNcAaekNTYw-ifZl5o8nVUKhHZBzZECIESdX5D7Ee6P9Q6CrNwVp-4JtniaOWcR00QAuoLCZDsoxuCn-Nfck8LR2KYgeK3BMwku7woPFyLte_3DOf3Cioz4HL0zfkEDgiOMWSHzZLgSd0b72YLJct9sCXGFKFbNPb_6CQIbTFaV_LMdvW98YqG6ptAwxmJCOgu_LkqcVd4jXRuVkWGd2I.uMZmsB70UMIWU71OQlDtXSXE8o3xH8ftqBpG2sMm3ww&dib_tag=se&keywords=dermatology+pocket+guide&qid=1753487683&sprefix=dermatology+po%2Caps%2C178&sr=8-19-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9idGY&psc=1 English to Spanish Pocket Dermatology Guide by Dermlink Scholars: Perfect for bridging language gaps in patient care. https://www.medlinkscholars.com/store/p/english-to-spanish-dermatology-guide Derm Must-Haves: MadHippie Mineral-Based Sunscreen: Because being “sun smart” is foundational in dermatology! https://madhippie.com/collections/suncare/products/ultra-sheer-body-spf Coola Scalp Sunscreen Spray: Protects my scalp without leaving any greasy residue. https://coola.com/products/scalp-and-hair-spf-30-organic-sunscreen-spray Derm Samples (Cerave, Cetaphil, La Roche-Posay, Eucerin, Aquaphor): Not only for sharing with patients, but essential for myself too. Stationery: A collection of the best pens, a highlighter for my textbooks, and of course, my glasses—because reading tiny print and screens is a daily must. Technology: My laptop, charger, iPad, and AirPods are stowed and ready for studying and notes anytime a break pops up. Little Luxuries & Survival Tools: Stress Away Roll-On Essential Oil: My trick for stressful moments or particularly busy days. Gum: Great for freshening up between patient encounters. Extra Hair Ties and Tide To Go Pen: For high ponytail emergencies or inevitable coffee drips on my white coat. Food & Snacks: Packed Lunch: I always bring a PB&J sandwich, because it’s better to be prepared than to assume food will be available. High-Protein Snacks: Pistachios and sometimes an apple, and for breakfast, a high-protein yogurt and banana keep me fueled. Having these essentials in my tote makes every audition rotation less stressful and more enjoyable. My bag isn’t just for organization—it reflects how I bring a little fun, efficiency, and self-care to every clinic day. If you see me—and my overstuffed (but well-loved) Poppy & Peonies tote—no you didn't, hahah!

As a med student and skincare enthusiast, I’m always on the lookout for fascinating ways nature and science intersect—especially when it comes to protecting our skin. Today’s fun fact? Fern extract may help reduce the severity of sunburns. Yep, you read that right—ferns aren’t just pretty green plants from your grandma’s backyard; they might actually be your skin’s new best friend. ☀️ Meet Polypodium leucotomos This tropical fern, native to Central and South America, has been used in traditional medicine for centuries. But what’s really exciting is how its extract is making waves in the dermatology world. Studies have shown that oral supplementation of Polypodium leucotomos extract (PLE) may offer photoprotection —helping shield the skin from the harmful effects of UV radiation. 🔬 What the Research Says Fern extract isn’t a replacement for sunscreen, but it may help reduce sunburn severity , DNA damage, and oxidative stress when taken orally. Some proposed mechanisms: It h as antioxidant properties that help neutralize free radicals created by UV exposure. It ma y preserve skin architecture , helping protect collagen and prevent UV-induced s kin aging. It seem s to modulate immune responses in the skin, which may reduce inflammation. Several studies have supported the use of PLE as an adjunctive form of sun protection—especially in people with sun-sensitive skin or photosensitive conditions like vitiligo (ME!) or lupus. 👩‍⚕️ Dermatologist's Take (who told me about this) While this isn't a substitute for broad-spectrum sunscreen (reapply every 2 hours!), fern extract could be a promising supplement to enhance protection—especially if you're outdoors frequently, have a history of skin cancer, or deal with photosensitive conditions. It’s a beautiful example of how natural compounds are being validated by science and could become part of our evidence-based skincare toolkit. So next time you’re studying in the sun (or beach-bound for a well-earned break), remember: sunscreen is a must, but a little fern-powered backup might not hurt either.

The day before Step 2 CK is a unique blend of excitement, nerves, and preparation. Over the years, I’ve learned that how you spend this day can make a huge difference in your mindset and performance on test day. It’s not just about studying harder—it’s about being strategic, calm, and intentional. Here’s a detailed look at my day-before routine that helps me feel grounded and ready. Early Morning: Start Strong with Anki and High-Yield Review I’m an early riser on purpose (I normally am not an early riser)—I wake up at 5 AM. I know it sounds intense, but by getting up this early, it ensures that I will be able to fall asleep that night, even with all the nerves. The first thing I do is complete my Anki cards due that day. This isn’t about cramming; it’s about reinforcing what I’ve already learned and keeping my recall sharp. Anki has been my constant companion throughout 3rd year of medical school, and I trust it to keep my memory fresh. After Anki, I dive into my high-yield (HY) document. This is a personalized compilation of the most important facts and concepts I need to know for Step 2 CK. I highlight even more key points as I review, focusing on topics I want to revisit first thing the next morning. This targeted approach prevents overwhelm and ensures I’m prioritizing the right material. Moving My Body: The Power of Exercise I never skip a workout on the day before the exam. Whether it’s a quick run, or a high inclined walk, exercise helps me manage stress and boosts my mood. It’s amazing how much clarity and calm a little sweat can bring. Plus, it helps me avoid feeling cooped up or anxious. Podcasts for Motivation and Last-Minute Pearls I have a few go-to podcasts that I listen to religiously before exams. On this day, I tuned into HY Divine episodes 123, 27, and 325. These episodes are packed with high-yield facts about ethics, screening guidelines, and risk factors that always help me day of exam. The Hotel Hack: Reducing Stress by Staying Close Since the testing center is usually far from where I live, I always book a hotel nearby for the night before. This is one of my best-kept secrets for reducing stress. No worrying about traffic, parking, or last-minute delays. Just a calm, short trip to the exam center in the morning. It’s worth every penny for the peace of mind it brings. Sometimes I even travel to the testing facility the day before to make sure I know where I will be going the next day. Connection and Calm: Family and Faith At some point during the day before, I call my parents. Hearing their voices and words of encouragement always calms my nerves. It reminds me that I’m not alone in this journey. I also take a few moments to pray, grounding myself spiritually and mentally. This practice centers me and helps me focus on the bigger picture beyond the exam. My Superstitious Comfort Food: Chicken Parm from Olive Garden I’m a little superstitious, and I’ve developed a tradition of ordering the same meal the night before every board exam: chicken parmesan from Olive Garden. It’s silly, but this ritual helps me get into the right mindset. It’s comforting, familiar, and signals to my brain that it’s time to focus and perform. Caffeine Prep and Relaxation I pick up my Starbucks matcha + espresso drink for test day and put it in a thermos. Having this ready the night before means one less thing to worry about in the morning. Once at the hotel, I relax by watching TV and using my suboccipital release tool—a lifesaver for tension headaches and neck tightness. I try to avoid screens too close to bedtime, but a little light entertainment helps me unwind. Bedtime Routine: Essential Oils and Early Sleep By 10 PM, I’m in bed with my essential oils diffusing around me. Good sleep is non-negotiable. I remind myself that rest is just as important as study. Final Thoughts The day before Step 2 CK isn’t about frantic last-minute studying. It’s about setting yourself up mentally, physically, and emotionally for success. My rituals—from early Anki to Olive Garden chicken parm—might seem quirky, but they work for me. Find what calms your brain and stick to it. You’ve done the work. Now it’s time to trust yourself and get ready to crush the exam.

S Salmon patch / Nevus simplex Etiology : vasomotor immaturity Appearance : pink to red blanchable patches Location : nape of neck, eyelids, glabella Tx : none Prog : fades within first 2 yrs of life To play, press and hold the enter key. To stop, release the enter key. Scabies Etiology : Sarcoptes scabiei Appearance : scattered pink papules, burrows, vesicles, and excoriations At risk : living in close quarters (dorms, nursing homes, homeless) Location : web spaces of fingers, umbilicus, belt line, groin, axillae Tx : 2 doses of permethrin given 10 days apart or with oral ivermectin 1/9 Scalded Skin Syndrome Etiology: Cause: S. Aureus (exfoliative toxin) Description: red rash with wrinkled tissue or paper-like consistency that typically starts on the face and flexural regions, then spreads rapidly to other parts of the body; bullae can form post-rash and easily rupture causing sloughing of the skin in large sheets At risk: <5 yo, RF immunosuppressed, DM Location: skin folds and then disseminates in 48 hrs Tx: burn unit/ICU, IV abx Scarlet fever / Second Disease Etiology: Cause: S. pyogenes (exotoxins A, B, C) Description: fine blanching rash post sore throat; “goose skin or sandpaper like” Sebaceous Hyperplasia Etiology: Appearance: skin-colored or yellowish umbilicated papules Vs. BCC – pearly, waxy with telangiectasia that will bleed or scab easily Prog: expect more in coming years Dermoscopy: “crown vessel” pattern with vessels that are blurry and restricted to the periphery Seborrheic Dermatitis Etiology: Appearance: erythematous patches with overlying scale; greasy yellow plaque with scale Location: scalp, eyebrows, eyelids, nasolabial folds, external auditory canal, central chest Tx: ketoconazole twice daily, desonide cream twice daily for 1-2 weeks, antidandruff shampoo Cause: increased activity of sebaceous glands due to presence of Malassezia Description: erythematous, well-demarcated plaques with greasy yellow scales in areas rich in sebaceous glands; worsens in winter and early spring; in darker skin, the plaques and scales can make the skin appear lighter Location: scalp, face, periocular Associated with: Parkinson’s Disease Hypopigmentation due to widespread SD Faint redness and scaling along creases of nose Slight scale Fine scaliness and redness along nose and cheeks Beard is common location for SD SD affecting eyelid The fold behind the ear is a common location for seborrheic dermatitis. SD common in ear canal Scale and erythema due to seborrhoeic dermattis on the glabella and brows Confluent erythema and scale due to scalp seborrhoeic dermatitis Flexural seborrhoeic dermatitis in the axilla Pigmented paranasal seborrhoeic dermatitis in skin of colour Seborrhoeic blepharitis and dermatitis on the cheeks Seborrhoeic dermatitis around the hair line and forehead in skin of colour Inflammatory infantile seborrhoeic dermatitis – note lesions in the body folds Thick yellow scale in crade cap Seborrheic Keratosis (SK) Etiology : mutations in FGFR3 genes At risk : > 30 yo Appearance : "stuck on" appearing warty plaque or patches Dermoscopy : moth eaten borders, keratin pseudocysts Tx : cryo (light skin), EDC (darker skin) Senile Purpura Etiology: steroids, blood thinners, poor nutritional status, fair skin, age Location : dorsal hands , forearms Tx : none 1/10 Sézary Syndrome Etiology: Cause: unknown Description: Lighter skin = diffuse red rash with pruritis and edema covering >80% of body. Darker skin = gray, purple or brown. Early symptoms of rash appears like eczema or psoriasis At risk: elderly 1/3 Sjögren-Larsson syndrome Etiology: Define: rare genetic disorder characterized by ichthyosis (scaly skin), intellectual disability, and spasticity Etiology: deficiency in fatty aldehyde dehydrogenase (FALDH), which is encoded by the ALDH3A2 gene Inheritance: AR Tx: leukotriene B4 Skin Tags / Acrochordons / Fibroepithelial Polyp Etiology: Cause: excess friction Description: smooth or slightly wrinkled, flesh-colored, or darker, and hanging off the skin by a small stalk Locations: areas of high friction: armpits, under breasts, groin, neck Associated with: obesity, diabetes, pregnancy, acromegaly To play, press and hold the enter key. To stop, release the enter key. Smallpox Etiology: Cause: smallpox virus Description: 1. after 2-4 days of fever, body aches and headache, a rash develops 2. rash becomes raised bumps that then become fluid-filled with a depression in the center (umbilicated) 3. bumps turn into pustules that are raised, round and firm to touch 4. after about 5 days pustules begin to form a crust and then scab 5. scabs fall off leaving marks on the skin that eventually become pitted scars Location: Rash spreads to face, arms, legs, hands and feet and to all parts of the body within 24 hours Solar Elastosis / Actinic Elastosis Etiology: Cause: chronic sun damage + smoking Description: dry, thick, and yellow skin, with bumps, wrinkles, or furrowing Solar Lentigo / Sun spot Etiology: Appearance: hyperpigmented macules and patches Tx: bleaching creams, LN, chemical peels, lasers Solitary (Juvenile) Xanthogranuloma (JXG) Etiology: Appearance: Histo: touton giant cells, lots of eos Spider angioma / Spider naevus / Spider telangiectasia Etiology: Cause: increased estrogen Description: spider webs or tree branches (arteriole) Associated with: liver cirrhosis + pregnancy Spitz nevus Etiology: Appearance: raised, dome-shaped mole, typically reddish or pinkish At risk: children + young adults Vs. melanoma due to appearance Splinter hemorrhages Etiology: Cause: S. aureus (mostly), S. viridans (anything that can increase IC deposition) Description: linear hemorrhage lesions Location: nail bed 1/6 Squamous Cell Carcinoma (SCC) Etiology : UV exposure over a lifetime Location : lower legs (women), chest/back (men) At risk : Fitzpatrick types I + II, smoking, arsenic exposure, immunosuppression, scars, tanning bed use, HPV infection Appearance : firm, skin to pink colored, infiltrative papule or plaque that is sometimes ulcerated or covered in crust Dermoscopy : focal scale, glomerular vessels, pinpoint hemorrhages, central keratin mass, hairpin vessels Tx : excision, Mohs, radiation or cryo in select cases Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link Go to link 1/2 Stevens-Johnson Syndrome (SJS) / Toxic Epidermal Necrolysis (TEN) Etiology: Sx: fever, HA, rhinitis, and myalgias precede mucocutaneous lesions by 1-3 days; eruption initially symmetric and pain is a prominent symptom Location: face, upper trunk, proximal extemities Appearance: erythematous irregularly shaped, dusky red to purpuric macules with dark center which progressively coalesce; + Nikolsky sign SJS <10% TEN >30% Tx: stop drug, go to a burn unit, IVIG, IV CS Cause: type IV HS drug reaction Description: circular non-pruritic rash that is darker in the middle and lighter on the border; progresses to blisters and sores which are painful and easily peel Location: usually starts on the upper body before quickly spreading to the face, arms, legs, genitals + mucosal surfaces Associated with: TEN (SJS that covers >30% of body surface) Strawberry / Infantile Hemangioma Etiology : expresses higher levels of vasculogenic factors than normal tissue (VEGF) Appearance : well-defined bordered erythematous papules or nodules At risk : before 4 weeks of age Location : head + neck Tx : most are self resolving; if it is high risk (airway, liver, GI involvement, periorbital, PHACE syndrome, rapidly growing) then oral propranolol Prog : involution typically begins between 6-12 mo of age Stucco keratoses Etiology: Appearance: small white-gray SKs Location: dorsal feet/ankles At risk: older light-skin Tx: cryo, curettage, ED, Amlactin Sturge-Weber syndrome Etiology: Cause: somatic mosaicism of activating mutation in 1 copy of GNAQ gene Description: port-wine stain in trigeminal nerve territory Sweet Syndrome / Acute febrile neutrophilic dermatosis Etiology: Appearance: sudden onset of painful, red or purple, “juicy”, raised lesions (plaques, papules, or nodules) Sx: fever Ass. conditions: infections, IBD, + hematologic malignancies Tx: pred Cause: Description: erythematous, edematous, well-demarcated, tender plaques that are asymmetrically distributed Location: face, neck, + upper extremities Associated with: IBD 1/8 Swimmer’s Itch / Cercarial Dermatitis Etiology: Cause: Schistosoma mansoni Description: 1. occurs within hours of exposure after the film of water has dried on the skin 2. itch or a tingling sensation which settles quickly, leaving tiny red spots where skin penetration by the cercariae/larvae 3. Intense itch develops over hours and the red spots can enlarge to form papules and hives 4. Blisters may develop over the next 24 to 48 hours At risk: anyone swimming in waters with infested snails To play, press and hold the enter key. To stop, release the enter key. Syphilis Etiology: Treponema pallidum pallidum Appearance : primary = chancre (firm, painless, oozes fluid) secondary = maculopapular rash including palms + soles; condylomata lata (smooth, painless, warlike white lesions on genitals) tertiary = gumma Tx : penicillin tertiary syphilis tertiary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis secondary syphilis primary syphilis primary syphilis primary syphilis primary syphilis primary syphilis primary syphilis primary syphilis Systemic Lupus Erythematosus (SLE) Etiology : systemic autoimmune condition Types/Appearance : Acute cutaneous LE : butterfly/malar rash that spares nasolabial folds Subacute cutaneous LE : annular scaly erythematous macules + plaques on head + extremities DLE : pink infiltrative scaly patches + plaques that heal with atrophy, depigmentation, scarring Tx : antimalarials, CS, immunosuppressants, dapsone discoid lupus discoid lupus discoid lupus discoid lupus discoid lupus discoid lupus discoid lupus discoid lupus acute SLE acute SLE acute SLE acute SLE acute SLE acute SLE subacute SLE subacute SLE subacute SLE subacute SLE subacute SLE chronic SLE chronic SLE chronic SLE Systemic Scleroderma (SSc) Etiology: Cause: autoimmune condition with noninflammatory vasculopathy and collagen deposition with fibrosis (anti-Scl-70 Ab, anti-RNA polymerase III Ab, anti-centromere Ab) Description: Limited SSc = only involving fingers and face = calcinosis cutis, Raynaud phenomenon, sclerodactyly, telangiectasia Diffuse SSc = widespread skin thickening, shiny appearance, feeling of tightness + visceral involvement; sometimes have a “salt and pepper” appearance on darker skin Syringoma Etiology: Define: benign skin growths that originate from sweat ducts Appearance: small, skin-colored or yellowish bumps Location: clustered around the eyes, but can also occur on neck, chest, abdomen, and genitals Cause: overgrowth of eccrine sweat glands Description: firm bump that resembles a pimple (papule) on your skin that usually forms in small clusters or groups on your skin Location: face (lower eyelid + upper cheeks) Ass: Down syndrome A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Welcome Welcome Welcome Welcome Welcome to DalyDermatology! 💖 Join me on my journey as a medical student exploring the science behind healthy, radiant skin—and working to make dermatology more inclusive for everyone. Inspired by the lack of diverse skin images in medical education, I created Daly’s Diverse Dermatology Dictionary: a free resource showing how skin conditions appear across all skin tones. My passion is to bridge gaps in knowledge, encourage equity, and help our medical community better serve every patient. Thanks for being here—let’s learn and grow together! ✨ Check out my most recent blogs! Derm Dream Bag: My Dermatology Audition Rotation Essentials Discover the ultimate dermatology audition bag essentials! From pink Vaseline and L’Oréal lip gloss to study guides, sunscreen, meds, and snacks—this tote is packed for a busy med student’s clinic day. Stay prepped, polished, and confident with these must-haves in your Poppy & Peonies tote. Fern-tastic Protection? How Fern Extract Might Help Prevent Sunburns Did you know fern extract might help protect your skin from the sun? 🌿 Polypodium leucotomos, a tropical fern, has shown promise in reducing sunburn severity and UV damage. While it’s not a sunscreen replacement, it could be a powerful supplement in your sun-protection routine. Science and nature, teaming up for better skin! ☀️ The Day Before Step 2 CK: My Rituals, Mindset, and Must-Do’s for Success Curious how I prep the day before Step 2 CK? From early-morning Anki to my superstitious Olive Garden dinner, I share my rituals, mindset, and self-care strategies that help me stay calm, focused, and ready to conquer exam day. Discover my step-by-step routine and tips for setting yourself up for success! Bridging the Gap: Daly's Diverse Dermatology Dictionary After realizing most dermatology images in my training only showed conditions on white skin, I began collecting and organizing photos of skin diseases across all skin tones. This project grew into Daly’s Diverse Dermatology Dictionary—a free, ever-expanding resource designed to fill this gap and help students, clinicians, and educators recognize skin diseases on every patient. My goal is to make dermatology education more inclusive, accurate, and truly reflective of the diversity in our world, so we can provide better, more equitable care for all. Click Here Follow me on Instagram @dalyderm Load more

P Paget disease Etiology: Cause: DCIS Description: erythematous, pruritic, ulcerated skin at the nipple and breast Palmoplantar Verruca Etiology: Appearance: thick, endophytic papules Papillary Hidradenoma / Hidradenoma Papilliferum Etiology: Cause: unknown cause; thought to arise from anogenital mammary-like glands Description: slow-growing painless, firm, flesh to red nodule Location: labia majora + interlabial folds Papillon-Lefure Syndrome Etiology: Appearance: hyperhidrosis + periodontitis with severe gingivitis Inheritance: AR Peau d’orange Etiology: Cause: blockage of lymphatic drainage with or without associated stromal infiltration; inflammatory breast cancer Description: thick and pitted, with a texture and appearance similar to that of orange peel Pemphigoid Gestationis / Herpes Gestationis Etiology : IgG autoantibodies that target BP180 Appearance : erythematous papules or plaque around the umbilicus + then spreads to most areas of body, but sparing face + mucous membranes; 2-4 weeks later large, tense bullae form Sx : intensely itchy Tx : high potency topical CS, but many end up requiring oral CS Risk to fetus = prematurity Pemphigus Foliaceus Etiology : IgG autoantibodies to desmoglein 1 At risk : Tunisia Appearance : flaccid, superficial bullae that rupture easily Location : seb derm distribution (NO oral lesions) Tx : systemic CS Pemphigus Vegetans Locations : Intertriginous Pemphigus Vulgaris Etiology : IgG autoantibodies to desmoglein-1 and/or desmoglein-3; can be triggered by meds (#1 captopril + penicillamine) Location : mucosal membrane + skin Appearance : flaccid bullae that easily rupture (+ Nikolsky sign; + Asboe-Hansen sign) Sx : extremely painful At risk : middle aged to young adults ; Ashkenazi Jews Tx : systemic CS Periorificial Dermatitis Etiology: Tx: taper steroids, oral tetracycline, topical metronidazole, erythromycin, tacrolimus Petechiae Etiology: Description: Tiny 1-2 mm, initially purpuric, non-blanchable macules resulting from tiny hemorrhages Peutz-Jeghers Syndrome (PJS) Etiology: Cause: autosomal dominant condition with mutations in serine/threonine kinase 11 (STK11) Description: Tan, dark brown, or bluish black flat patches 1 to 5 mm in size Location: around the mouth, lips, gums, inner lining of the mouth, eyes, hands and feet, fingers and toes, anus and genital areas Associated with: GI polyps Piebaldism Etiology: Define: rare, inherited genetic disorder characterized by patches of skin and hair that lack pigment Cause: AD mutation inactivating c-KIT gene Description: white forelock with white patches of skin Location: face (chin), trunk, + distal extremities Pigmentary Demarcation Line Etiology: Define: abrupt transition between areas of darker and lighter pigmentation At risk: darker skin tones Pigmented DFSP (Bednar tumor) Etiology: At risk: AA Pigmented Purpuric Dermatosis (PPD) Etiology: Appearance: reddish-brown patches and spots Etiology: results from capillary inflammation and leakage of red blood cells, leading to hemosiderin deposits Location: lower legs Tx: topical corticosteroids, compression stockings Pilar Cyst / Trichilemmal Cyst Etiology: Cause: keratin-filled cyst that originates from the outer hair root sheath; typically running in families (AD) Description: one or more firm, mobile, subcutaneous nodules measuring 0.5 to 5 cm in diameter and without a central punctum Location: typically scalp Pilomatricoma Etiology: Define: benign (non-cancerous) skin tumor that arises from hair follicle cells Appearance: small, hard, and slow-growing lump Location: head or neck Pityriasis Alba Etiology: Cause: unknown; coexists with dry skin and atopic dermatitis Description: hypopigmented patches that are round or irregular in shape and up to 5 cm in diameter Locations: typically appear on face, especially cheeks and chin Pityriasis Lichenoids Et Varioliformis (PLEVA) Etiology: Pityriasis Rosea Etiology : not clear; some suggest HHV-6 or 7 At risk : older children + young adults Appearance: begins with a single "herald patch" or "mother patch" which is a salmon colored oval plaque, usually on neck, back or chest. Patch becomes scaly and develops central clearing, forming "collarettes of scale." Then numerous similar but smaller patches. appear on trunk + extremities following skin tension lines (Christmas tree distribution). Tx : only topical CS to relieve pruritus Pityriasis (Tinea) Versicolor Etiology : Malassezia furfur or Malassezia globosa Appearance : hyper or hypo pigmented or salmon colored scaly patches Location : sebum rich areas Tx : selenium sulfide, ketoconazole shampoo, topical or oral azoles Pitysporum Folliculitis Etiology: Dermatoscope: spores grouped together in hair follicle POEMS Syndrome Etiology: Description: hyperpigmentation, hemangiomas, hypertrichosis, and scleroderma-like skin thickening Polyarteritis Nodosa (PAN) Etiology: Cause: Medium vessel vasculitis Description: lace like rash (livedo reticularis) + ischemic digits Associated with: HBV, acute mesenteric ischemia Polymorphic Eruption of Pregnancy (PEP) / Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) Etiology: Sx: onset of late 3rd trimester Location: starts within abdominal striae with periumbilical sparing RF: primigravid preg, multiple gestation preg Does not affect development Tx: topical steroids, non-sedating oral antihistamines, oral pred Polymorphous Light Eruption (PMLE) Etiology: Appearance: erythematous papules, vesicles, plaque on sun exposed skin only Tx: antihistamines (Zyrtec and Benadryl), steroid injection in office Cause: stretching of the skin elicits an immune response due to connective tissue damage Description: itchy, bumpy rash that starts in the stretch marks of the abdomen Porphyria Cutanea Tarda Etiology: Cause: AD mutation in UROD gene = affecting uroporphyrinogen decarboxylase = accumulates uroporphyrin Description: blistering cutaneous photosensitivity and pigmentation Port-wine stain / Nevus flammeus Etiology : vascular malformation of capillaries and post capillary venules in dermis Appearance : pink, red, or violaceous sharply demarcated patches that darken + thicken overtime Location : face, unilateral Tx : PDL Prog : persist throughout life + grow proportionally with child Pretibial myxedema / thyroid dermopathy Etiology: Cause: dermal fibroblasts Description: plaques of thick, scaly skin and swelling Location: lower legs Associated with: Graves disease (hyperthyroidism); if not at pretibial region = related to hypothyroidism Primary Cutaneous Anaplastic Large Cell Lymphoma (ALCL) Etiology: Cause: t(2;5)(p23;q35) translocation resulting in a fusion gene product of receptor tyrosine kinase ALK with nucleophosmin Description: rapidly-growing single nodule or plaque that typically is red to violaceous, at least 2 cm in diameter, and often ulcerates Location: upper half of the body is most commonly involved At risk: 50+ yo males Proteus syndrome Etiology : mosaic non inherited mutation in AKT1 gene Appearance : port wine stains Location : limbs, digit, skull Prog : at risk for developing DVTs, PEs Prurigo Nodularis Etiology: Sx: intensely itchy, firm nodules; can be extremely uncomfortable, impacting sleep and potentially leading to anxiety and depression Tx: JAK-I, ILK Pseudofolliculitis Barbae / Razor Bumps Etiology: Cause: shaving, which lead to ingrown hair Description: firm, hyperpigmented papules and pustules that are painful and pruritic Location: face + neck At risk: Black males Psoriasis Etiology: Appearance: well demarcated pink erythematous plaque with silver scale Nail changes: pitting, onycholysis, subungal hyperkeratosis, oil drop sign (yellow-orange discoloration) Tx: localized: high potency steroid +/- topical vitamin D other options: tazarotene, calcineurin inhibitors, Taltz, Otezla (apremilast) Cause: T cells triggered (stress, skin injury, infection, cold, dry weather, tobacco) to attack skin cells Description: dry, raised skin patches (plaques) covered with gray or silver scales Location: hairline, elbows, knees (extensor surfaces) Purpura Etiology: Description: 4 - 10 mm in diameter, flat, and red, purple in color Pustular Psoriasis Etiology: Sx: presents in 3rd trimester Appearamce: symmetric erythematous plaques with pustules that start in flexural areas and spread centrifugally Location: trunk and extremities Ass sx: fever, malaise, nausea, vomiting, anorexia Tx: CCS, low dose cyclosporine, infliximab Prog: increased risk to fetus Cause: triggers from infections, stress, corticosteroid treatment withdrawal, and pregnancy Description: pus-filled blisters on plaques, which are patches of scaly, flaky skin Pyoderma Gangrenosum Etiology: Description: painful, symmetrical necrotic base that progresses over 1 month Location: legs Associated with: IBD Pyogenic granuloma / Capillary lobular hemangioma Etiology : mutation in BRAF plays a key role; medications (retinoids, TK inhibitors), trauma, laser therapy At risk : 20-30 yo Appearance : small red papule that grows over several weeks into a nodule Location : hands, lower lip, gingiva Tx : full thickness excision or shave excision for pedunculated lesions A B C D E F G H I J K L M N O P Q R S T U V W X Y Z