Explanation: oral antifungal is considered to be the treatment of choice for tinea capitis , shampoo is being considered as an adjunct to oral treatment.

Explanation: Patients with cold Urticaria should learn to protect themselves from a rapid drop in body temperature. Regular antihistamines are not generally effective. The antihistamine cyproheptadine (Periactin) has been found to be a useful treatment. The tricyclic antidepressant doxepin has also been found to be an effective blocker of histamine release. Finally, a medication called ketotifen, which keeps mast cells from releasing histamine, has also been used with success.

 Explanation: Tineaversicolor (TIN-ee-uh vur-si-KUL-ur), also called pityriasis , is a common fungal infection of the skin. The fungus interferes with the normal pigmentation of the skin, resulting in small, discolored patches.
 

 Explanation: Jock itch (tineacruris) is a fungal infection that affects the skin of genitals, inner thighs and buttocks. Jock itch causes an itchy, red, often ring-shaped rash in these warm, moist areas of body.

Explanation: Symptoms typically include prodromal sensory phenomena along 1 or more skin dermatomes lasting 1-10 days (averaging 48 h), which usually are noted as pain or, rarely, paresthesias. Patchy erythema, occasionally accompanied by induration, appears in the dermatomal area of involvement.

 Explanation: Retinoid medications are derivatives of Vitamin A and the treatment of choice for comedonal acne, or whiteheads and blackheads. They work by increasing skin cell turnover promoting the extrusion of the plugged material in the follicle. They also prevent the formation of new comedones. All of the retinoids must be prescribed by a healthcare provider

 Treatment of comedones: Topical retinoid
 Treatment of papules or pustules: Topical benzoyl, peroxide plus topical antibiotics, mainly clindamycin or
erythromycin.
 In severe cases, intralesional steroid injection or oral antibiotics, such as tetracycline or erythromycin
may be added.

 Explanation: Antibiotics: Antibiotics can be effective in treating most inflammatory acne (papules and pustules). They work by decreasing inflammation caused by bacteria and other irritating chemicals present in the sebaceous follicle.
 Antibiotics may be combined with benzoyl peroxide, which is contained in over-the-counter medications, to form a topical solution that can be obtained with a doctor's prescription.

 Explanation: Cystic acne, or nodulocystic acne, is the most severe form of acne vulgaris. Deep, inflamed
breakouts develop on the face and/or other areas of the body. The blemishes themselves can become
large; some may measure up to several centimeters across. Some common treatments for nodulocystic
acne include:
1) Oral antibiotics
2) Isotretinoin
3) Oral contraceptives - for women
4) Surgical excision and drainage - A doctor makes a small incision in the skin and extracts the infected
material.
5) Intralesional corticosteroid injections - Medication is injected directly into the lesion to reduce
inflammation and shrink the blemish.

 Explanation: Milia are tiny white bumps or small cysts on the skin that are almost always seen in newborn babies. In children, no treatment is needed. 

 Explanation: Rosacea is a chronic skin condition that makes your face turn red and may cause swelling and skin sores that look like acne

Symptoms:
 Redness of the face
 Blushing or flushing easily
 A lot of spider-like blood vessels (telangiectasia) in the face
 Red nose (called a bulbous nose)
 Acne-like skin sores that may ooze or crust
 Burning or stinging feeling in the face
 Irritated, bloodshot, watery eyes.

 Explanation: Tinea corporis Symptoms may include itching. The rash begins as a small area of red, raised spots and pimples. The rash slowly becomes ring-shaped, with a red-colored, raised border and a clearer center. The border may look scaly. The rash may occur on the arms, legs, face, or other exposed body areas.

Explanation: They can commonly occur in body folds (axillae, groin, intergluteal space), genitals (vulva/vagina, penis), lips, and oral cavity. Candida lesions are red, tender, itchy, and have “satellite” lesions.

Explanation: Urticarial lesions are polymorphic, round, or irregularly shaped pruritic wheals that range in size from a few millimeters to several centimeters

Angioedema, which can occur alone or with urticaria, is characterized by nonpitting, non-pruritic, well defined, edematous swelling that involves subcutaneous tissues (e.g., face, hands, buttocks, genitals), abdominal organs, or the upper airway (i.e., larynx).
Chronic urticaria: if more than 6 weeks Solar urticaria: due to sunlight

Cholinergic urticariae: due to a brief increase in body temperature.
Cold urticaria: due to exposure to cold.

 Explanation: Impetigo A single or possibly many blisters filled with pus; easy to pop and -- when broken -- leave a reddish raw-looking base (in infants)Itching blister: Filled with yellow or honey-colored fluid oozing and crusting over. A culture of the skin or lesion usually grows the bacteria streptococcus or staphylococcus. The culture can help determine if MRSA is the cause because specific antibiotics are used to treat this infection

 Explanation: The main symptom of erythema toxicumneonatorum is a rash of small, yellow-to-white colored papules surrounded by red skin. There may be a few or several papules. They usually appear on the face and middle of the body, but may also be seen on the upper arms and thighs. The rash can change rapidly, appearing and disappearing in different areas over hours to days.

 Explanation: Chronic hives, also known as urticaria, are batches of raised, red or white itchy welts (wheals) of various sizes that appear and disappear. While most cases of hives go away within a few weeks or less, for some people they are a long-term problem. Chronic hives are defined as hives that last more than six weeks or hives that go away but recur frequently.

 Explanation: With postherpetic neuralgia, a complication of herpes zoster, pain may persist well after the resolution of the rash and can be highly debilitating. Herpes zoster is usually treated with orally administered acyclovir. Other antiviral medications include famciclovir and valacyclovir. The antiviral medications are most effective when started within 72 hours after the onset of the rash. The addition of an orally administered corticosteroid can provide modest benefits in reducing the pain of herpes zoster and the incidence of postherpetic neuralgia.

 Medicines used to treat mouth sores include:
Acyclovir, Famciclovir & Valacyclovir.

 Explanation: Permethrin cream and Malathion lotion are the two most widely used treatments for scabies.

 Explanation: Oral acyclovir (5 times/d) has been shown to shorten the duration of signs and symptoms,
as well as to reduce the incidence and severity of HZO complications. The use of oral corticosteroids has
been shown to reduce the duration of pain during the acute phase of the disease and to increase the
rate of cutaneous healing; Corticosteroids are recommended for HZO only for use in combination with
antiviral agents.

While corticosteroids can sometimes be used in conjunction with antivirals for Herpes Zoster to reduce inflammation and pain, steroids alone do not prevent post-herpetic neuralgia and should be used cautiously, especially in patients with immunocompromised states.

 The described progression of the rash is characteristic of Chickenpox (Varicella), which is caused by the Varicella-zoster virus (VZV). The sequence of the rash beginning with papules, progressing to vesicles (fluid-filled blisters), and eventually forming crusts is a hallmark feature of chickenpox.

 Explanation: The classical keratoacanthoma has a raised margin and a central keratin-filled crater

 In its most common form, androgenetic hair loss starts with an enlargement of the middle parting and the hair thinning out. The top of the head then gradually lights up, as part of a process that is irreversible if the person is not treated.

 Explanation: The tumors most often appear as bluish-red or purple bumps on the skin. They are reddish-purple because they are rich in blood vessels. The lesions may first appear on the feet or ankles, thighs, arms, hands, face, or any other part of the body. They also can appear on sites inside the body. Other symptoms may include: Bloody sputum &Shortness of breath.

Typical presentation of secondary syphilis with a rash on the palms of the hands Reddish papules and nodules over much of the body due to secondary syphilis. Secondary syphilis occurs approximately four to ten weeks after the primary infection. While secondary disease is known for the many different ways it can manifest, symptoms most commonly involve the skin, mucous membranes, and lymph nodes. There may be a symmetrical, reddish-pink, non-itchy rash on the trunk and extremities, including the palms and soles

 Explanation: Leprosy is a disease that has been known since biblical times. It causes skin sores, nerve damage, and muscle weakness that gets worse over time.
 Symptoms include:
 Skin lesions that are lighter than your normal skin color.
 Lesions have decreased sensation to touch, heat, or pain.
 Lesions do not heal after several weeks to months.
 Muscle weakness.
 Numbness or lack of feeling in the hands, arms, feet, and legs.

For severe cystic acne with scarring, oral isotretinoin is the most effective treatment. It should be considered after other treatments (topical antibiotics, oral antibiotics, or topical retinoids) have failed.

 Explanation: Acanthosis nigricans can be seen with obesity, PCOS, and other disorders associated with insulin resistance, a precursor to diabetes.

Shingles (Herpes Zoster) is a common condition in older adults, particularly after steroid use or other immunosuppressive treatments. It typically presents with pain followed by a vesicular rash that follows a dermatomal distribution. Early antiviral treatment can help reduce symptoms and prevent complications like post-herpetic neuralgia.

Explanation: Pellagra is a condition of having too little niacin in the body and affects the normal the function of the nerves, digestive system, and skin. Pellagra may result in a number of symptoms. The symptoms can vary in intensity from person to person. Common symptoms of pellagra: You may experience pellagra symptoms daily or just once in a while. At times any of these common symptoms can be severe:
 Abdominal cramping
 Confused or delusional thinking
 Depression
 Diarrhea
 Difficulty with memory, thinking, talking, comprehension, writing or reading
 Headache
 Loss of appetite, Weakness (loss of strength)
 Malaise or lethargy
 Mucus membrane inflammation
 Nausea with or without vomiting
 Skin lesions that are scaly and sore

 Explanation: The cause of dermatomyositis is unknown. Experts think it may be due to a viral infection of the muscles or a problem with the body's immune system. It can also sometimes occur in patients who have cancer of the abdomen, lung, or other body area.

 Symptoms including:
1) Difficulty swallowing
2) Muscle weakness, stiffness, or soreness
3) Purple or violet colored upper eyelids
4) Purple-red skin rash
5) Shortness of breath

Explanation: Mouth. Painful mouth sores, identical to canker sores, are the most common sign of Behcet's disease.
Skin: Some people may develop acne-like sores on their bodies. Others may develop red, raised and
tender nodules on their skin, especially on the lower legs.
Genitalia sores
Eyes. Behcet's disease may cause inflammation in the eye — a condition called uveitis (u-ve-I-tis).
Joints. Joint swelling and pain often affect the knees in people with Behcet's disease. The ankles,
elbows, or wrists also may be involved. Signs and symptoms may last one to three weeks and go away
on their own.
Vascular system (Vasculitis).
Digestive system. Behcet's disease may cause a variety of signs and symptoms that affect the digestive
system, including abdominal pain, diarrhea, or bleeding.
Brain.. Behcet's disease may cause inflammation in the brain and nervous system that leads to
headache, fever, disorientation, poor balance, or stroke.

Explanation: most COMMON side effects persist or become bothersome when using:  

Valproic Acid: Constipation, diarrhea, dizziness, drowsiness, headache, increased or decreased appetite, mild hair loss; nausea; sore throat; stomach pain or upset; trouble sleeping; vomiting; weakness; weight gain.  

Phenytoin: gingival hyperplasia, hirsutism, ataxia.

Carbamazepine: agranulocytosis, hepatotoxicity, aplastic anemia.

Na Valproate: transient hair loss.

The clinical scenario described strongly suggests Kawasaki Disease. Key features pointing to this diagnosis are:

• Desquamation of hands and feet: This is a classic feature of Kawasaki Disease and occurs after the acute phase, typically between 2-3 weeks into the illness.
• High blood pressure (170/110): Although Kawasaki Disease is primarily known for coronary artery inflammation and mucocutaneous involvement, hypertension can occur due to coronary artery involvement or kidney issues in severe cases.
• Symptoms of infection: Kawasaki Disease can present with fever and generalized signs of inflammation that may be confused with an infection.

Most eye doctors will prescribe long-acting tetracyclines such as doxycycline, which can be taken once or twice a day. Furthermore, doxycycline, unlike traditional tetracycline, can be taken with food and milk products without preventing absorption in the body

 Explanation: Treatment; Hot, moist compresses may promote drainage of the affected follicles. Treatment may include antibiotics applied to the skin (mupirocin) or taken by mouth (dicloxacillin), or antifungal medications to control the infection

 Explanation: This occurs due to insulin spillover (from excessive production due to obesity or insulin resistance) into the skin which results in abnormal growth being observed.
 The most common cause would be insulin resistance, usually from type 2 diabetes mellitus. 

Explanation: The patient is having a malignant melanoma and the treatment is by excision.

Explanation: this patient has sickle cell anemia.

Bullous Pemphigoid (BP) presents with tense, subepidermal bullae, often in older adults, and is characterized by IgG deposition at the dermoepidermal junction.

 Cradle cap (seborrheic dermatitis) is the most common diagnosis for scaling lesions on the scalp and forehead in infants, especially within the first few months of life.

 Explanation: Henoch-Schönleinpurpura is a small-vessel vasculitis in which complexes of immunoglobulin A (IgA) and complement component 3 (C3) are deposited on arterioles, capillaries, and venules. 

Explanation: it is not always due to deposition of immune complex in the skin (right :due to increase permeability of capillaries).

 Explanation: Erythema toxicum may appear in 50 percent or more of all normal newborn infants. It usually appears in term infants between the ages of 3 days and 2 weeks. Its causes are unknown. The condition may be present in the first few hours of life, generally appears after the first day, and may last for several days. Although the condition is harmless, it can be of great concern to the new parent. Symptoms: The main symptom is a rash of small, yellow-to-white colored papules surrounded by red skin. There may be a few or several papules. They usually appear on the face and middle of the body, but may also be seen on the upper arms and thighs. The rash can change rapidly, appearing and disappearing in different areas over hours to days

 Explanation: treatment --> selenium sulfide or zinc pyrithione shampoos for the scalp, and topical antifungals and/or topical corticosteroids for other areas.
 

 Etiology: Varicella-zoster virus (dormant in dorsal root ganglion after childhood chickenpox).
 

 Erythema multiforme: is an acute, self-limiting, inflammatory skin eruption. The rash is made of spots that are red, sometimes with blistered areas in the center. so named because of the "multiple forms" it appears in; Divided into two overlapping subgroups (EM minor and Stevens-Johnson syndrome “most often results from a medication like penicillin’s and sulfa drugs”)
 Eczema herpiticum: A febrile condition caused by cutaneous dissemination of herpes virus type 1, occurring most commonly in children, consisting of a widespread eruption of vesicles rapidly becoming umbilicated pustules. Skin reactions are the most common adverse reactions to sulfa medications, ranging from various benign rashes to life-threatening Stevens-Johnson syndrome and toxic epidermal necrolysis.
 Erythema nodosum: the formation of tender, red nodules on the front of the legs.

 Explanation: Scabies are caused by the mite S scabieivarhominis, an arthropod.
 Humans can be affected by animal scabies. Transient pruritic papular or vesicular erythemic lesions may occur after 24 hours of exposure to an infested animal. The immediate itching protective mechanism can prevent the mite from burrowing  Treatment options include either topical or total medications. Topical options include permethrin
cream, lindane, benzyl benzoate, crotamiton lotion, and cream, sulfur, and Tea tree oil. Oral options include ivermectin

 Dysplastic nevi, also known as atypical moles, are unusual benign moles that may resemble melanoma.
 

Psoralens should not be used by: Children under age 12, because the UV light therapy may cause cataracts, People who have diseases that make their skin more sensitive to sunlight (such as lupus), and Fertile men and women who do not use birth control. There is a small risk of birth defects., Pregnant women, because of possible effects on developing fetuses Side effects (short-term): Skin redness & itching, headache, nausea & Burns.The spread of psoriasis to skin that was not affected before (Koebner's response).
 Side effects (long-term): Squamous cell carcinoma & Melanoma.

Chronic urticaria: if more than 6 months
Solar urticaria: due to sunlight
Cholinergic urticaria: due to a brief increase in body temperature.
Cold urticaria: due to exposure to cold

The side effects of retinoids are:
1) Dry skin, eyes, lips, hair & genitalia.
2) Sun sensitivity.
3) body ache&joint pain
4) decreased night vision
5) increased triglyceride levels
6) liver and kidney toxicity
7) Pseudo tumor cerebri

Syphilis Is a sexually transmitted disease, & it is one of the infectious diseases, that has dermatological
manifestation: painless papule develops and soon breaks down to form a clean-based ulcer (chancre with
raised, indurated margins.
Erythema multiforme: most cases are related to drug ingestion and the majority of cases pertaining to antibiotics
(penicillin, sulfonamides), anticonvulsants (phenytoin, carbamazepine, Phenobarbital, lamotrigine), NSAID,
allopurinol, a minority of cases may be infection-related (mycoplasma pneumonia, herpes simplex) and involve
skin including perineum and genitals, and mucous membranes ( eyes, mouth, pharynx) It varies from a mild,
self-limited rash (E. multiforme minor) to a severe, life-threatening form (E. multiform major, or Stevens-
Johnson syndrome) that also involves mucous membranes. The skin form of E. multiforme, far more
common than the severe form, usually presents with mildly itchy, pink-red blotches, symmetrically
arranged and starting on the extremities

Erythema nodosum (red nodules) is an inflammation of the fat cells under the skin (panniculitis). It occurs
3-6 weeks after an event, either internal or external to the body initiates a hypersensitivity reaction in
subcutaneous fat and is frequently associated with fever, malaise, and joint pain and inflammation. It
presents as tender red nodules on the shins that are smooth and shiny.
Fixed drug eruptions are more common on the limbs than the trunk; the hands and feet “not necessarily
palms and soles”. Lesions may occur around the mouth or the eyes. The genitals or inside the mouth may
be involved in association with skin lesions or on their own, Can be caused by: acetaminophen,
sulfonamide antibiotics, tetracycline, Phenobarbital, and phenolphthalein.
Pityriasis rosea most often affects teenagers or young adults. In most cases, there are no other symptoms,
but in some cases, the rash follows a few days after an upper respiratory viral infection. Herpes viruses 6 and
7 have sometimes been associated with pityriasisrosea. It begins with one large (2-5cm), oval herald patch,
and smaller secondary multiple lesions appear within 1-2 weeks.

 Explanation: The ABCDEs of melanoma are asymmetric, Irregular Border, Irregular Color, Diameter > 6 mm,
Evolution: changing or new lesion.

Lesions usually develop on flexural surfaces of the limbs, such as the wrists (see the image below). After a week or more, a generalized eruption develops with maximal spreading within 2-16 weeks.

The described rash, located on the scalp, nose, and retroauricular area, is consistent with seborrheic dermatitis, a common inflammatory condition characterized by scaly, fine papules, often seen in areas rich in sebaceous glands. Topical corticosteroids are commonly used to treat seborrheic dermatitis due to their anti-inflammatory properties.

Explanation: They are usually soft plaques that are located in the dermis at the inner aspect of the upper eyelid.

 TREATMENT: Prophylactic measures include use of nondrying soaps, application of moisturizers, and avoidance of known triggers.
 Treat with topical corticosteroids (avoid systemic steroids in light of their side effect profile), PUVA, and topical immunomodulators (e.g., tacrolimus, pimecrolimus).
 Topical corticosteroids should not be used for longer than 2–3 weeks

 Explanation: if mention tetracycline choose it.
 Treatment of Rosacea :
1) Oral tetracyclines& topical metronidazole or topical erythromycin or topical clindamycin.
2) For severe case: isotretinoin, surgical treatment for rhinophyma

A biopsy should be done, and the lesion surgically excised if pre-cancerous changes or cancer is detected.

The patient's history of prolonged, unprotected sun exposure makes him susceptible to actinic keratosis (AK), which is a precancerous skin lesion often caused by chronic sun exposure. Macular lesions are typical for AK, and they are usually painless. They are more common in areas exposed to sunlight, such as the face, neck, ears, scalp, and backs of the hands

 Explanation: Black hairy tongue: Defective desquamation of the filiform papillae that results from a variety of precipitating factors (poor oral hygiene, use of medications e.g. broad-spectrum Abx& therapeutic radiation of the head & neck). All cases are characterized by hypertrophy and elongation of filiform papillae with a lack of desquamation. Seen more in those: tobacco use, heavy coffee or tea drinkers, HIV +ve. Rarely symptomatic. Rx: In many cases, simply BRUSHING THE TONGUE with a toothbrush or tongue scraper is sufficient. Medication: if due to candidiasis: Antifungal (Nystatin), Keratolytic agents (but irritant).

The patient is most likely presenting with psoriasis, a chronic skin condition characterized by scaly, hyperkeratotic lesions that commonly occur on the extensor surfaces of the body, such as the knees and elbows. The best way to avoid exacerbation of psoriasis is to focus on regular moisturizing to reduce dryness and prevent scaling. Emollients help to restore the skin's barrier, prevent excessive dryness, and reduce irritation, which can trigger flare-ups.

“Don’t choose milia or cavernous haemangioma”.

The patient likely has intertrigo complicated by a Candida (fungal) infection, which is common in moist, warm areas like under the breasts. The presence of moisture and maceration suggests an overgrowth of Candida.

This case is "herpes zoster”. Treatment of herpes zoster is antiviral and analgesic, Antiviral are (systemic) and includes: acyclovir, famciclovir.

The diagnosis: scarlet fever: The cutaneous rash, lasts for 4-5 days, followed by fine desquamation, one of the most distinctive features of scarlet fever. The desquamation phase begins 7-10 days after the resolution of the rash, with flakes peeling from the face. Peeling from the palms and around the fingers occurs about a week later and can last up to a month or longer. The extent and duration of this phaseare directly related to the severity of the eruption Antibiotic therapy is the treatment of choice for scarlet fever: Penicillin remains the drug of choice (documented cases of penicillin-resistant group A streptococcal infections still do not exist). A first-generation cephalosporin may be an effective alternative, as long as the patient does not have any documented anaphylactic reactions to penicillin. If this is the case, erythromycin may be considered as an alternative.

 Eczema: the earliest lesion affects anti-cubital and popliteal foss
Lesions are ill-defined as erythematous, scaly, patches and plaques

 A patchy brown or dark brown skin discoloration, that usually occurs on the face and may result from hormonal changes, generally found in sun-exposed areas.

The presentation is suggestive of Tinea Versicolor (Pityriasis Versicolor), caused by Malassezia species, a superficial fungal infection.

Trichotillomania (compulsive hair pulling) causes:

• Irregular patches of hair loss
• Hairs of varying lengths
• No signs of infection or inflammation
• Microscopy: broken, frayed, or attenuated (thin) hair shafts

DOC of Tinea Capitis.

Trichotillomania is a hair pulling disorder, that falls under anxiety spectrum. Patients have developed this habit of pulling hair all the time.

In Alopecia, eye lashes are usually not affected. If eye lashes are absent, it means patient is pulling them out.

The scaly lesions around the mouth and ear are suggestive of seborrheic dermatitis, a chronic inflammatory condition involving areas rich in sebaceous glands (e.g., scalp, nasolabial folds, and ears).

The pattern of hair loss described—starting from the temporal and occipital areas, then spreading to the frontal region—suggests alopecia areata, an autoimmune disorder in which the immune system attacks the hair follicles, causing hair loss.