Today Dr. Heather Wickless from the Department of Dermatology at UT Southwestern gave a great, interactive lecture on skin conditions that internists should know about and how to evaluate and treat them. Below are takeaway points from her lecture:
- Tinea versicolor is characterized by well-demarcated, tan, salmon, or hypopigmented patches, occurring most commonly on the trunk. KOH confirms the diagnosis.
- Tinea pedis can be interdigital, moccasin, and vesiculobullous.
- Candida intertrigo classically has satellite macules and papules or pustules around patches of erythema
- If it scales, scrape it! KOH examination is the easiest and most cost effective method used to evaluate for fungal and yeast infections of the skin; culture can also aid in diagnosis.
- Topical treatment is usually appropriate as a first-line agent for tinea pedis, tinea corporis, tinea versicolor, seborrheic dermatitis and candidal intertrigo, however oral medications are called for when involvement is extensive
- Perioral dermatitis is an analogue of rosacea, and topical steroids may perpetuate the eruption.
- When first line treatments fail, consider alternate diagnoses
“Shared decision making” is a term we often hear and referred to in health care as patients have become more educated about their health and want to be informed when making medical decisions. With recent spotlight in the media and medical literature on utility of tests and treatments, patients have even more questions for their providers. There is a resource for patients who want to know more about tests and treatments from the Informed Medical Decisions Foundation. This website provides links and articles that help guide a patient through clinic visits and what questions they may want to ask their provider. Also, there are links to online tools such as the cardiovascular disease risk calculator that patients can use. Thanks to Dr. Ethan Halm from the division of General Internal Medicine at UT Southwestern for the reference!
Informed Medical Decisions Foundation – Patient Resources
STRAIGHT FROM THE HOUSESTAFF – the April 2015 UT Southwestern Internal Medicine Journal Watch! They have summarized important issues in clinical practice, from alcoholic hepatitis to which medications to use for stroke prevention in afib. Make sure to take the EKG challenge at the end! You will have to view this post on our website to access the PDF. There is a quick run down of the topics below:
- Extended report: Prediction of cardiovascular risk in rheumatoid arthritis: performance of original and adapted SCORE algorithms. Dr. Brian Skaug reviewing Arts, et al. Ann Rheum Dis. 2015 Feb 17. pii: annrheumdis-2014-206879. doi: 10.1136/annrheumdis-2014-206879
- Trial of Early, Goal-Directed Resuscitation for Septic Shock [The Protocolised Management in Sepsis (ProMISe) Trial]. Dr. James Galloway reviewing Mouncey PR et al. N Engl J Med. 2015;372(14):1301-11.
- A Randomized Trial of Icatibant in ACE-Inhibitor-Induced Angioedema. Dr. James Galloway reviewing Bas M, et al. N Engl J Med. 2015;372(5):418-25.
All of the work above comes from the IMJW Editorial Board: Jan Petrasek, Brian Skaug, Ben Galloway, Natalia Rocha, Doug Darden, and Jeanney Lew!