Related Therapeutic strategies

Herpes simplex virus (HSV) occurs in 2 common locations: orofacial (usually due to HSV-1) and genital (usually due to HSV-2).

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Seborrheic dermatitis can be limited to the scalp, but it also can involve the face and any hairy or intertriginous area and rarely can even progress to a generalized erythroderma.

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Chancroid

Timothy Berger Bruce Wintroub

Saturday, January 01, 2011

The diagnosis of chancroid is usually clinical, although improved culture techniques allow isolation of the causative organism H. ducreyi. The therapeutic strategy is to eliminate the pathogenic microorganism.

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Therapeutic Strategies

Pityriasis Rosea

Timothy Berger Bruce Wintroub

Wednesday, March 09, 2011

Overview

Pityriasis rosea (PR) is a papulosquamous eruption of unknown etiology. A viral pathogenesis has been proposed but is unproven. It resolves spontaneously, thus treatment usually is not required. Atypical cases may be caused by medications (PR-like drug eruption), especially gold. Secondary syphilis must be excluded.

First Steps

  1. As the condition is self-limited, the option of simple emollient therapy and antihistamines such as hydroxyzine
    10-50 mg nightly should be considered.
  2. Mid- to high-potency topical steroids applied twice daily may improve pruritus.
  3. For severe cases, erythromycin 250 mg 4 times daily for 7-10 days may lead to improvement.
  4. Narrowband UVB phototherapy can be effective for pruritus caused by PR.


Subsequent Steps

For severe cases of PR with pruritus uncontrolled by the above approaches, consider prednisone 1 mg/kg/day for 5-7 days, and taper over 2-3 weeks.

Pitfalls

Failing to diagnose secondary syphilis or a drug eruption resembling PR is of most concern.

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