Common Dermatologic Conditions

The Medical clinics of North America (Impact Factor: 2.61). 05/2014; 98(3):445-485. DOI: 10.1016/j.mcna.2014.01.005
Source: PubMed


This review discusses common dermatologic presentations as they would appear in a primary care office, exploring the differential diagnoses for each. Tips are provided on choosing an appropriate topical drug and vehicle and advising patients on its use. Etiology, differential diagnosis, and treatment options are discussed for the following: alopecias including androgenetic alopecia, female pattern hair loss, alopecia areata, and telogen effluvium; facial rashes including acne vulgaris, acne rosacea, periorificial dermatitis, seborrheic dermatitis, erysipelas/cellulitis, and systemic lupus erythematosus; intertriginous rashes including infections, intertrigo, and inverse psoriasis; and the inflamed leg including cellulitis and erysipelas, stasis dermatitis, and contact dermatitis.

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    ABSTRACT: Alopecia areata (AA) is a common, non-scarring dermatologic condition regularly distinguished by patches of hair loss on the scalp also manifesting in other, severe forms, including alopecia totalis (total loss of hair on the scalp) and alopecia universalis (complete loss of hair on the scalp and body). AA is a clinically heterogeneous disease with greatly varying yet typical symptoms, but the etiology for AA remains an enigma. However, clinical and experimental studies have pointed to autoimmune involvement, specifically regarding immune privilege sites of the hair follicles and the infiltration of CD4 + and CD8 + T cells and a predominant Th1 cytokine profile. Environmental insults, such as viral infections, trauma and genetic predisposition are also believed to contribute to the disease process. Multiple treatment options including the use of broad acting corticosteroids appear to be relative effective in mild cases, however the clinical management of more severe forms of AA is much more difficult. Recent studies suggest that intervention of the JAK pathway may have a potential therapeutic efficacy for AA.
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