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Most popular medical Questions
What disorder can present as "freckles" associated with hives?Urticaria pigmentosa (mastocytosis). Presenting at birth or during early infancy, multiple mastocytomas appear as brown macules, papules, or plaques (vesicle formation can also occur) and are often mistaken for freckles or melanocytic nevi. Lesions are usually only cutaneous but infrequently they may affect other organ systems (e.g., lungs, kidney, gastrointestinal tract, central nervous system). The Darier sign is a key feature of diagnosis.
What is impetigo?
Impetigo is a superficial skin infection that is caused by Staphylococcus aureus or group A streptococcus. Historically, streptococcus was the most prevalent agent. However, over the last few decades, S. aureus appears to be the predominant organism, although mixed infections may also occur. Bullous impetigo is usually caused by S. aureus.
Is topical or systemic therapy better for impetigo?
Treatment usually requires an antibiotic that is active against both streptococci and staphylococci. Topical antibiotics (mupirocin) can be used in localized disease. Systemic antibiotics are usually indicated for extensive involvement; outbreaks among household contacts, schools, or athletic teams; or if topical therapy has failed. Cephalosporins (e.g., cephalexin, cefadroxil), amoxicillin-clavulanate, and dicloxacillin are most effective. Erythromycin is unlikely to be useful because increasing numbers of staphylococci are resistant; local resistance patterns should determine its usage.
What dermatologic sign starts from a scratch?
Dermographism occurs when the skin is stroked firmly with a pointed object. The result is a red line that is followed by an erythematous flare, which is eventually followed by a wheal. This "triple response of Lewis" usually occurs within 1-3 minutes. Dermographism (or skin writing) is an exaggerated triple response of Lewis and is seen in patients with urticaria. The tendency to be dermographic can appear at any age and may last for months to years. The cause is often unknown. White dermographism is seen in patients with an atopic diathesis, in whom the red line is replaced by a white line without a subsequent flare and wheal.
What diseases are associated with a strawberry tongue?
Scarlet fever caused by group A beta hemolytic streptococcus and Kawasaki disease are the most common disorders associated with a strawberry tongue. The "strawberry-like" surface characteristics are caused by prominent lingual papillae. A white strawberry tongue is caused by fibrinous exudate overlying the tongue. Red strawberry tongues lack the fibrinous exudate.
What is the difference between eczema and atopic dermatitis?
The term eczema derives from the Greek word exzein, which means to erupt: ex (out) plus zein (to boil). To most physicians, eczema is synonymous with atopic dermatitis, a chronic skin disease manifested by intermittent skin eruption. Eczema is primarily a morphologic term used to describe an erythematous, scaling, inflammatory eruption with itching, edema, papules, vesicles, and crusts. There are other "eczematous eruptions" (nummular eczema, allergic contact dermatitis), but "garden variety" eczema is certainly the most common.
Atopic dermatitis is a broader allergic tendency with multiple dermal manifestations that are mostly secondary to pruritus. Atopic dermatitis has been called an "itch that rashes, not a rash that itches." Its manifestations are dry skin, chronic and recurrent dermatitis, low threshold to pruritus, hyperlinear palms, eyelid pleats (Dennie-Morgan folds), pityriasis alba, and keratosis pilaris, among others.
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