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138 Cards in this Set
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Primary skin lesions (2) |
Initial lesion Unaltered by trauma, manipulation or natural regression over time |
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Secondary skin lesion (2) |
Lesions created by manipulation (scratching/rubbing/infxn) Or natural evolution from primary lesions |
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Macule (3) |
Circumscribed change in colour of skin Niether raised nor depressed |
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Pustule (3) |
Pus filled raised area |
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Papule |
Elevated solid area 5mm/less across |
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Lichenification (3) |
Focal area of thickened skin Dt chronic scratching or rubbing Markings accentuated, resembling a washboard |
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Koebner phenomenon (3) |
Trauma to epidermis in pt with pre-existing skin dx --> same skin dx to form at site of trauma Eg. Lichen planus, psoriasis |
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Annular lesions (3) |
Ring shaped lesions Eg. Tinea corporis |
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Staph presentation of impetigo (2) |
First watery vesicles which develop into bullae with depressed center Cloudy contents or layering of pus Enlarge then dry and form light-yellow crusts or scabs Blisters |
BLISTAPHLOCOCCAL |
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Strep presentation of impetigo (2) |
Honey-coloured crusts Stuck onn appearance Red surface if removed Commomly face No blisters |
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Ant Crud Impetigo Indications (5) Generals (2) Mentals (2) |
● Face and corners of mouth Sores become crusted, cracked then thickened Oozes discharge: this, smelly/honey-like Burning >open air <heat, bathing ● Fat and over eat Tongue coated thick Desires acids and pickles ●Capricious, sulky Cannot bear to be touched or looked at |
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Ant crud mentals compare (2) |
Chamomilla Cina |
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Ant crud & Graph compare (4) (1) |
Thick crusts Honey like discharges, offensive Corners of mouth, face <heat Ant crud: burning, mental picture Graph: itching |
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2 polychrests impetigo |
Sulphur Graphites |
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2 non polycrests impetigo |
Ant crud Cicuta |
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Arum triphyllum impetigo Indications (4) Other uses (2) |
●Mouth and lips with cracked skin Irritating, prickling Picking at lesion Acrid, excoriating discharges --> skin around nosrils red Worries lips with teeth constantly ●Boring into nose, biting finger nails Scarlatina Horseness with lacl of contol of vocal cords |
Acridity |
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Cicuta impetigo |
Thick, lemon coloured scabs, on scalp Seizures ffg milk crust suppression |
Brain, nerves, skin |
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Mezerum impetigo |
Thick leathery scabs with pus that oozes underneath Hands, feet, scalp Cracking (geometrical) Itch <night |
Maddening itch |
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Cracking impetigo (5) |
Graphites Petroleum Nit-ac Mez Ant crud |
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Croton tig impetigo |
Itching amd stinging Pustular eruption on inflamed base Eat amd immediately get diarrhoea |
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Skin + digestive (2) |
Iris Croton tig (eat and immediately get diarrhoea) |
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Furuncle definition |
Acute, tender, perifollicular inflammatory nodules resulting from infxn by staphylococci |
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Furuncle pathophysiology |
Initial nodule --> pustule 5-30mm --> central necrosis, discharging a core of necrotic tissue and sanguineous purulent exudates Erythematous, painful, deep-seated follicular abscess Microbes enter --> changes --> cell death = foreign body --> inflammation --> pus at summit --> rupture Mild constitutional symptoms in severe cases |
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Diff bt carbuncle and furuncle |
Carbuncle = cluster of furuncles - spread of infxn subcut Carbuncle more likely to develop into cellulitis or septicaemia Carbuncle frequently on nape of neck, develop more slowly Carbuncle accompanied by fever and prostration |
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Organism responsible for furuncles and carbuncle |
Staphylococcus |
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Calc sulph suppurative |
Creamy yellow discharge Linked to fistula linked to deeper abscess Continue to discharge for weeks to months after opening |
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Hepar sulph suppurative (5) |
Extremely painful and sensitive Swollen, tender axillary LN - keeps arm elevated to prevent pressure on painful area Chilly, hypersensitive >wrapped up warmly Early stage of pus formation Every skin lesion suppurates Offensive discharge like old cheese |
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Silicea suppurative (5) |
Slowly developing abscesses Develop around foreign bodies Disposition to constipation and boils Chilly, lacks vital heat > warmth, local heat Offensive, bloody, purulent discharge Location: tear ducts, axilla, LN, posterior thigh |
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Sulphur suppurative |
Recurring boils Buttocks Yellow, offensive discharges with air bubbles |
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Anthracinum (5) |
Severe burning sensation (violent) Cerebral sx: blood poisoning Large, tense, carbuncles Black or purplish Fowl smelling pus Trapezius/over scapula, lip Prostration |
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Arnica Montana |
Small, symmetrical lesions Soreness of whole region affected |
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Arsenicum album suppurative (4) |
Marked burning Diabetics Prostration, restlessness, thirst in small amounts <night >external warm applications Abscesses thay don't mature Internal abscesses, glands, parotid |
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Calc carb suppurative |
Deep abscesses in muscles, glands and deeper organs Glandular swellings Reapsorption Boils with cramps in the arms |
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Crotalus horridus suppurative (4) |
Purplish Violent burning Swelling and pitting oeema surrounding lesion Oozing of dark blood Dark fluid that does not clot Foul smelling |
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Heckla Lava suppurative (3) |
Gumboil with underlying abscess in lower right jawline Submandibular LN painfully enlarged Treatof osteomyelitis Huge swelling Hard or rubbery swelling with scant pus Bone necrosis, tumors in general, difficult teething |
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Pyrogenium suppurative (4) |
Associated feverViolent burningRecurrent abscessesDisecting or internal abscessesRestlessPulse disproportioned to state |
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Tarentula cubensis suppurative (4) |
Severely burning and inflamed abscess Black discolouration or black core Burning, stinging pains: carbuncles, gangrene, septic boils Painful and inflamed abscesses with associated pqinful, swollen, neighboring glands Febrile, weak, restless Prostration |
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Carbolicum acidum suppurative |
Diabetics Pus discharge from several openings Foul odour |
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Black discharges (4) |
Anthracinum Crotalus Tarent c Ars Lach |
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Bad odour of discharges (7) |
Anthracinum Pyrogen Hepar sulph Tellirium Carbolicum acidum Silicea Sulph |
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Calc sulph compare (5) |
Discharges- thick, lumpy, yellow - puls Calendula and silicea similar Hepar sulph: < open air - calc s: >open air, desires Both <change in weather Calc s not as sensitive |
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Burning boils (3) |
Tarent c Ars Anthracinum Pyrogen |
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Restless with boils (3) |
Ars Anthracinum Pyrogen |
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Restless with boils (3) |
Ars Anthracinum Pyrogen |
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Septic states with boils (4) |
Anthracinum Pyrogen Tarent c Crotalus |
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Keloid rx (5) |
Silicea Graphites Calc flour Thiosinaminum Thuja |
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Petroleum cracking (5) |
Dry, dirty look, fingertips <winter Deep, painful, bloody Avoids bending hands fearing to rip open skin Labourers or repeated exposure to chemicals Hands and fingers |
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Graphites cracking (4) |
Honey like discharge Thick/calloused skin Junction of mm and skin <hands, fingertips, bends of elbows and knees, behind ears, lips |
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Ant crud cracking |
Hyperkeratosis with fissuring Palm, heals |
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Nit ac cracking (5) |
Bloody, deep, surrounding yellow Thorn-like splinter/sharp Tendency to bleeding base Clear cut edges <cold Hands, borders or skin and mm (graph) Anal fissures, cracks of lips, genitalia |
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Sarsaparilla cracking (3) |
Runs against normal direction of skin folds Recurring cystitis Burning, painful Skin thick and leathery (mez) |
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Sepia crackimg (1) |
Fissuring on top of psoriatic plaque, haemorrhagic Cracks <winter/spring <washing |
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Cellulitis no1 |
Sulphur |
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Apis cellulitis |
Oedema marked |
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Bufo cellulitis |
Lymphangitis tracking with cellulitis Red streaks under skin Effects blood and circulation |
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Cellulitis bursting (2) |
Lachesis Vipera |
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Pyrogenium cellulitis |
Streaking and pale area From wounds, abscesses, bedsores Septic Offensive discharge Fever |
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Staph cellulitis |
From incision or laceration |
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Hepar sulph cellulitis |
Always hypersensitivity and pain |
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Ledum cellulitis |
From puncture wound Coldness of affected part |
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Cellulitis streakimg (2) |
Bufo Pyrogenium |
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Vipera cellulitis |
Cannot bare to have affected limb not elevated Fullness sensation as if limb would burst <letting limb hang down |
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Thick crusts rx (5) |
Graphites Ant crud Mez Cicuta Jugulans |
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Acne vulgaris definition |
Common inflammatory pilosebaceos dx Comodones, papules, pustules, inflamed nodules, superficial pus-filled cysts Extreme cases canalising and deep, inflamed, purulent sacks Puberty |
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Oral isotretinion side fx |
Used if antibiotics are unsuccessful Teratogenic - must be on contraceptive 1 month before, during and 1 month after Liver toxic Raised triglyceride levels |
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Oral contraceptive effects on acne |
Oestrogen dominant: improve Progestin containing with androginic activity may aggravate acne |
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Rosacea definition and s&s |
Middle age or later Flushing, telangiectasia, erythema, papules, and pustules Central areas of face, trunk, extremeties Comodones never present Erthrosis of face Associatedblepharitis, conjunctivitis, and keratitis Convex areas of face only, nose, cheeks, forehead and chin |
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Calc sulph acne |
Same location for weeks Ooze yellow, creamy pus day after day |
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Kali brom acne (5) |
Aggressive, beginning in teens, never ceasing Universal for simple acne Large, bluish red pimples Discoloured, depressed scars Burning and prickling and much itching Depressed centre Forehead, especially centre of forhead, above nose amd eyebrows |
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Lachesis acne rosacea (2) |
Large number of large pimples over face Cirrhosis and menopause (aetiology) Localised: rhinophyma Excessive alcohol Purplish scar Without pitting |
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Pitted scar acne (3) |
Silicea Kali brom Ant tart |
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Thuja acne |
Very oily Shame out of proportion to appearance |
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Arnica rosacea (2) |
Very sore Symmetrical lesions |
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Aurum met acne |
Rhinophyma Excessive alcohol Large cysts rarely erupt |
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Causticum acne |
Pustules and comedones with black centers Nose, especially tip Ears |
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Graphites acne |
Very itchy pimples <night, before menses Oozing |
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Puls acne |
Pale individual with menstrual problems Right sided headache and digestive upsets from fatty foods |
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Sanguinaria rosacea (2) |
During menopause or scanty menses Burning and stinging <exposure to heat Circumscribed redness of cheeks |
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Sanguinaria complementary (2) |
Sulphur Lachesis |
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Selenium acne |
Comedones Black heads Oily skin Exhaustion |
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Oily skin (3) |
Selenium Thuja Sulphur |
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Ant tart acne |
Bluish, smallpox-like scars Purplish red craters |
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Itching acne (2) |
Calc sil Kali brom |
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Psoriasis aetiology (5) |
Onset bt 10 and 40 Common family hx Associated with deeper problems Precipitated by: koebner phenomina, sunburn, various drugs chloroquine, lithium, beta blockers, topocal drugs etc |
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Psoriasis sites (3) |
Extensor surfaces Back and buttocks Scalp, behind ears Nails, eyebrows, axillae, umbilicus/anogenital Occasionally generalised |
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Psoriasis progresssion (2) |
Papules coalesce into large plaques with bizarre annular (rig shaped) and gyrate (spiral shaped) patterns |
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Guattate psoriasis |
Crops of small, drop-like psoriasis papules and plaques |
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Nummular Psoriasis |
Lesions discrete and discoid |
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Punctata psoriasis |
Individual lesions are papules Each red and tipped with single white scale |
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Inverse psoriasis (2) |
Intertriginous areas as opposed to extensor surfaces Often don't have silvery scales Sharply demarcated red plaques |
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Nail psoriasis vs tinea unguium (4) |
●Tinea: Usually toenail, rarely fingernails Nails become thickened, lustreless Debris accumulates under free edge Nail plate separated, nail , may be destroyed No pitting ●Psoriasis: Pitting, discolouration, oncholysis, subungal kyperkeratosis Thinning and brittleness Distal edge separated from nail bed Ridges or grooves or deformity may be seen |
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Psoriasis treatment |
Lubricants, keratolytics, topical corticosteroids Sunlight recommended (no excess) Systemic antimetabolites eg. Methotrexate in severe cases, skin and joints Lubricating applications after bathing |
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Ars alb psoriasis |
Fine powdery desquamation, parchment-like dry skin Nummular psoriasis, raised red spots Debilitated Itches violently, burns on scratching Relief when skin is raw --> heals --> itch >warmth, warm applications <midnight |
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Graphites psoriasis (6) |
Children Thick and whitish, hard skin, cracked May ooze thick serum Bland eruptions, without itching <night, before menses Nails thick and pitted or split Head and scalp, behind ears, genitalia, back of hand Associated obesity |
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Petroleum psoriasis (6) |
Dryness Sites of old scars (graph) <winter, cold dry weather Hands cracked and painful, impossible to work with Hands, between fingers, fingertips, palms, scrotum, heels, Fissures, sore, red scaled, deep bleeding cracks |
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Ars iod psoriasis |
Thick crusts, inflamed underneath Marked exfoliation Emaciated and weak Large scales, raw bleeding skin underneath >cold/cold application Lichenification Fine squams- powdery |
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Iris psoriasis |
Associated migraines Shiny scales Raised, irregular, cracked Right, elbow, knee Burning (throughout git) Digestive derangement |
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Kali arsenicosum psoriasis |
Inverterate Numerous patches Forearms Burning and itching <undressing, warmth, after hot bath Asthma <1-3am Anxiety, del: going to have heart attack |
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Manganum psoriasis |
Thickening and suppuration in folds of skin Folds of skin, elbows, knees Thickened becomes fissued Shiny, hard, scales <winter |
Similar to petroleum Not fingertips Modality? |
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Mezerum psoriasis (6) |
Fine white scales covering large areas Scalp, back, palm Moist or oozing Dry, fine plaques Thick crusts with pus underneath, ulcerating plaques Itching <heat, after scratching, undressing >exposure to open/cold air |
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Mezerum psoriasis (6) |
Fine white scales covering large areas Scalp, back, palm Moist or oozing Dry, fine plaques Thick crusts with pus underneath, ulcerating plaques Itching <heat, after scratching, undressing >exposure to open/cold air |
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Nit ac psoriasis |
Offensive Scaly spots with deep cracks Painful stitches/stabs <night, winter |
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Oleander psoriasis (4) |
Scalp <acidic foods Dry, large, flakes from scalp Itching and burning <Night and cold air |
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Rad brom psoriasis (6) |
Inflamed, red spots Painful Penis and scrotum Arms, waist, diffuse Circular Itching and burning |
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Sarsaparilla psoriasis |
Cracking against flow of skin folds Palms, dorsum of hands, feet Thickened Easily suppurating Burning UTI at last drops |
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Lichen planus cf (5) |
Recurrent, pruritic, inflammatory eruption Small papules coalesce into rough, scaly patches Accompanied by oral lesions Symmetrical distribution Koebner phenomenon |
Plentiful Pruritic Polygonal Polished Purple Papular Planar |
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Tenia pedis presentation (3) |
Trichophytum mentagrophytes Begins at 3rd and 4th inter-digital spaces --> planter surface of arch Nails become thick amd distorted Acute flareups with vesicles and bullae in warm weather T.rubrum: Scaling and thickening of soles, extends just beyond plantar surface Scaling and thickening of soles, extends just beyond plantar surfaceItching, pain, inflammation, or vesiculation - slight to severeSecondary bacrerial infxn Itching, pain, inflammation, or vesiculation - slight to severe Secondary bacrerial infxn bacrerial infxn |
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Sepia fungal (5) |
No1 Round scaly patches Dry, mild itch, whitish Yellowish patches on face <open air, cold washing >warmth Itch not relieved by scratching Face, mouth (lower lip), head, scalp |
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Bacillinum Derm (4) Generals (6) |
●Fine white scales Falling of hair in spots on scalp and face Itching Face, scalp, beard ●Weakness Drowsy during day, restless at night Talks in sleep, grinds teeth Appetite poor Indurated, palpable glands everywhere Excessive sweats |
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Rad brom fungal |
Ringworm Lesions very red Burning Perfectly round patches on skin or scalp |
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Tellurium (3) |
Circular (ring shaped) May cover whole body or single parts Barbers itch: hair falling in spots Offensive garlic or fish brine odors |
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Tinea versocolor (2) |
Noticed in summer Lesions do not tan, remain pale White 'sun spots' |
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Intertrigo (2) |
Superficial pustules Erythema Creamy exudates withing skin folds |
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Thrush (2) |
White, adherent, cottage cheese-like plaques on oral mucosa |
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Perleche (2) |
Erythema Fissuring Creamy exudates at angles of mouth |
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Paronchia (2) |
Tender Erythematous Indurated proximal nail fold With or without purulent discharge |
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Contact dermatitis locations and causes (5) |
Eyelids: nail polish, eye makeup, airborne allergen Earlobes/neck: metal jewellery Forhead, scalp margins: hair dyes Face: cosmetics, fragrances, airborne allergens Waistband: elastic Dorsal feet: shoes |
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Diagnosis of atopic dermatitis |
3/4: Pruritis Topical morphology and distribution for age Chronic or relapsing Personal or family hx of asthma, allergic rhinitis, atopic derm |
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Psoriasis vs eczema cf (10) |
Psoriasis Extensors Joint involvmemt Non pruritic Nail involvement Dry, well circumscribed, silvery, scaling papules and plaques Eczema Flexor surfaces No joint involvement Pruritic Erythema, lichenification, weeping Secondary bacterial infxn Erythema, lichenification, weepingSecondary bacterial infxn<wool, emotional stress, weather changes, bacterial skin infxns <wool, emotional stress, weather changes, bacterial skin infxns |
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Seborrheic derm cf (6) |
Inflammatory scaling dx of scalp, face Gradual onset in adults: dry or greasy, diffuse scaling with variable itching No hair loss Yellow-red scaling papules along hairline, behing ears, in external auditory canals, on eyebrows, bridge of nose, naso-labial folds and over sternum Inflamed scalp covered with greasy scales Neonates: <1month - thick yellow, crusted scalp lesion (cradle cap), fissuring and yellow scaling behind ears and red facial papules Older children: thick, tenacious, scaly plaquss in scalp 1-2cm |
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Housewives eczema (3) |
Hand dermatitis Amongst wet workers Chronic exposure to abrasive detergents |
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Pompholyx (3) |
Aka dishydrosis Deep seeted itchy vesicles On palms, sides of fingers, soles and toes. Scaling, redness and oozing ffg vesiculation Nat mur Crops <stress |
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Candidates for aggravation (5) |
Beginning early childhood Deeper health problems: asthma, emotional problems etc Poorly controlled with topical steroids Highly controlled/emotionally suppressed patients Strong family hx |
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Steroid reduction (4) |
Remove oral steroids, keep topical Once rx has acted, gradually withdraw as tolerable by pt If maximum topical steroids fail, then try treating on systemic steroids Never cease abruptly - taper by 20% each week Antihistamines for itch (quercetin) |
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Therapeutic tips skin (3) |
Prescription based on skin sx, risk bad aggravation without amelioration Start low 6c, 9c, 12c daily or at most one 30c or LM Aggravation= Immediate cessation of remedy until settles, LM--> LM2 settles, LM--> LM2 |
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Sulphur eczema (5) |
Moist Voluptuous itch Scratch until raw, oozing or bleeding <night, heated bed, wool >cold application Dirty, unclean appearance Rotten odor Hairline, anticubital and popliteal fossae, groin, feet |
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Graph eczema (3) |
Dry with thick or honey like discharge Deep cracks (furrows) <nighy, heated becoming Hard, thick skin, dry and rough, workers skin Suppressed eczema, alternates wiyh deep disorders like asthma or peptic ulcers |
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Mez eczema (7) |
Maddening itch, intolerable Scalp with thick, white flakes, pus from under scabs <nighy, heat, touch, hot fire, hot bathing >cold air Cracked, geometric pattern Stocking glove, head and scalp Hairline, face, eyebrows, around eyes Chilly |
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Petroleum eczema |
Dry Work with hands Scratches until bleeds Coldness in raw spot <winter, cold weather Small vesicles break open and crust over Skin dirty look Fingertips Hands, corners of mouth and skin folds, nipples, groin |
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Calc sulph eczema |
Easy infection Week to months to heal Yellow crusty |
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Cicuta virosa eczema (4) |
Eczema without itching Burning on hands from slightest touch Lemon coloured, yellow, thick crusts in patches Scalp, hands, between fingers Neurological disorders from suppressed eruptions |
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Manganum eczema |
Scratches until raw <perspiration, sea bathing, menses, menopause >scratching, warmth |
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Eczema associated with menstrual cycle, sea bathing and vesicles (2) |
Manganum Nat mur |
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Eczema associated with menstrual cycle, sea bathing and vesicles (2) |
Manganum Nat mur |
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Medorrhinum eczema |
Eczema and asthma since birth Hx of severe diaper rash |
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Oleander eczema |
Head, scalp Scabs ooze when lifted Scratches until raw <oranges, tomatoes, acids Huge flakes Chapped or cracked face Chronic diarrhea |
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Scalp distribution (3) |
Mez Cicuta Oleander |
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Sulph vs psor |
Similarities Itch- scratch until bleeds <night, heat of bed, bathing, wool Dirty appearance Foul odor Moist Sulph Voluptuous itch >cold applications Rotten egg smell Hot Psor <cold, undressing, winter >warmth Fetid odor Cold Can be dry |
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