#ClinicalPearls: Dermatology for the Internist

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