Common Derma OPD cases

Stethogram
1. Acne Vulgaris
Diagnose
  • Comedones, papules, pustules on face, chest, or back.
Treatment
  • Topical: Benzoyl Peroxide 2.5–5% + Adapalene 0.1% gel
  • Oral: Doxycycline 100 mg OD–BD
Side Effects
  • Dryness, irritation, photosensitivity, gastritis
2. Tinea (Corporis/Cruris/Pedis)
Diagnose
  • Annular, scaly, itchy patches on body (corporis), groin (cruris), or feet (pedis).
Treatment
  • Terbinafine 250 mg OD
  • Topical: Terbinafine tablets + Clotrimazole cream
Side Effects
  • GI upset, headache, ↑ LFT
3. Pityriasis Versicolor
Diagnose
  • Hypopigmented or hyperpigmented scaly patches on trunk.
Treatment
  • Shampoo: Ketoconazole 2% shampoo
  • Fluconazole 300 mg once weekly
Side Effects
  • Skin irritation, nausea, hepatotoxicity
4. Scabies
Diagnose
  • Intense itching, worse at night.
  • Burrows in web spaces, wrists, belt line.
Treatment
  • Permethrin 5% cream: Apply overnight
  • Ivermectin: 200 mcg/kg
Side Effects
  • Mild burning, itching, dizziness, nausea
5. Seborrheic Dermatitis
Diagnose
  • Greasy scales and redness on scalp, face (eyebrows, nasolabial folds), or chest.
Treatment
  • Ketoconazole 2% shampoo (twice weekly)
Side Effects
  • Local irritation
6. Psoriasis
Diagnose
  • Well-demarcated, erythematous plaques with silvery scales.
Treatment
  • Topical Steroid + Calcipotriol
  • Oral Methotrexate (if severe): 7.5–25 mg weekly
Side Effects
  • Skin atrophy, irritation, hepatotoxicity, marrow suppression
7. Atopic Dermatitis (Eczema)
Diagnose
  • Dry, itchy, eczematous patches, often in flexures.
Treatment
  • Moisturizers + Topical Steroid (Hydrocortisone 1%)
  • Or Tacrolimus 0.1%
Side Effects
  • Skin atrophy, burning sensation
8. Urticaria
Diagnose
  • Transient, itchy wheals (hives) that appear and disappear.
Treatment
  • Cetirizine 10 mg OD
Side Effects
  • Drowsiness, dry mouth
9. Melasma
Diagnose
  • Symmetrical brown patches on cheeks, forehead, upper lip.
Treatment
  • Hydroquinone 2–4% cream
  • Sunscreen SPF 30+
Side Effects
  • Irritation, ochronosis (rare)
10. Vitiligo
Diagnose
  • Well-defined depigmented patches.
Treatment
  • Topical Tacrolimus 0.1%
  • Topical Corticosteroids
Side Effects
  • Burning sensation, skin atrophy
11. Impetigo
Diagnose
  • Honey-colored crusted lesions, usually around mouth and nose.
Treatment
  • Mupirocin 2% ointment
  • Cephalexin 500 mg QID
Side Effects
  • Local irritation, GI upset
12. Herpes Zoster
Diagnose
  • Painful grouped vesicles in a dermatomal distribution.
Treatment
  • Acyclovir 800 mg five times daily
Side Effects
  • Nausea, headache, renal toxicity
13. Alopecia Areata
Diagnose
  • Sudden patchy non-scarring hair loss.
Treatment
  • Topical Corticosteroids
  • Intralesional Triamcinolone
Side Effects
  • Skin atrophy, irritation
14. Telogen Effluvium
Diagnose
  • Diffuse hair shedding following stress, illness, or pregnancy.
Treatment
  • Reassurance
  • Iron supplementation if deficient
Side Effects
  • GI upset with iron supplements
15. Lichen Planus
Diagnose
  • Purple, polygonal, pruritic papules with Wickham striae.
Treatment
  • Topical Corticosteroids
  • Antihistamines for itching
Side Effects
  • Skin atrophy, drowsiness
16. Viral Warts
Diagnose
  • Hyperkeratotic papules caused by HPV.
Treatment
  • Salicylic Acid 17–40%
  • Cryotherapy
Side Effects
  • Skin irritation, blistering
17. Drug Eruption (Fixed)
Diagnose
  • Sudden rash after starting a drug, often symmetric and itchy.
Treatment
  • Stop offending drug + Topical steroid (BD)
Side Effects
  • Skin thinning, irritation
18. Paronychia
Diagnose
  • Redness, swelling, pain around nail fold, may have pus.
Treatment
  • Warm soaks + Mupirocin (Topical)
  • Or Cephalexin 500 mg QID (Oral)
Side Effects
  • Local irritation, diarrhea
19. Onychomycosis
Diagnose
  • Thickened, discolored, brittle nails, often with debris.
Treatment
  • Terbinafine 250 mg OD
Side Effects
  • GI upset, ↑ LFT
20. Herpes Simplex
Diagnose
  • Recurrent painful blisters or sores, usually on lips or around mouth.
Treatment
  • Acyclovir 400mg TDS
Side Effects
  • Nausea, headache
21. Androgenic Alopecia (Male)
Diagnose
  • Gradual thinning of hair on scalp, recession of hairline.
Treatment
  • Minoxidil 5% + Finasteride 1 mg OD
Side Effects
  • Scalp irritation, ↓ libido, ED
22. Cellulitis
Diagnose
  • Red, warm, swollen, tender skin, often with fever.
Treatment
  • Amoxicillin-Clavulanate 625mg TDS
Side Effects
  • Diarrhea, nausea, vomiting.
23. Tinea Cruris (Jock Itch)
Diagnose
  • Itchy, red scaly rash in groin and inner thighs.
Treatment
  • Terbinafine 250 mg OD
  • Topical: Terbinafine cream BD
Side Effects
  • GI upset, headache, ↑ LFT
24. Tinea Pedis (Athlete's Foot)
Diagnose
  • Scaling, macerated papules, fissures and burrows on feet.
Treatment
  • Terbinafine 250 mg OD
  • Topical: Terbinafine cream BD
Side Effects
  • GI upset, headache, ↑ LFT
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