(BQ) Part 1 book Manual of dermatologic therapeutics presents the following contents: Acne, alopecia areata, androgenetic alopecia, aphthous stomatitis, bacterial skin infections, bites and stings, corns and calluses, diaper dermatitis, dry skin and ichthyosis vulgaris, erythema nodosum, fungal infections,...
(c) 2015 Wolters Kluwer All Rights Reserved C2 V-2 C2 V-3 Left side: Relaxed skin tension lines Right side: Dermatome chart—sensory root fields Note: The illustrations on the inside covers and facing front cover, dermatome charts and relaxed skin tension lines (RSTLs), represent approximations, since there is much overlap and individual variation Denervation of one posterior root will not produce complete anesthesia within the corresponding dermatome The direction of the RSTLs should always be assessed before making an ellipsoidal incision parallel to, or a punch biopsy with skin stretched perpendicular to, these lines (see Fig 48-1, p 370) In areas of flexion creases, flex and note the direction of the majority of “wrinkle” lines, that is, the direction of the RSTL In nonflexion areas, the RSTL is determined by picking up skin folds between the thumb and index finger and pinching, proceeding in a clockwise direction, until it is clear in which direction wrinkle lines are most numerous, straight, and parallel to one another In certain areas it is difficult or impossible to find the RSTL In that situation, make a small circular incision or “punch” to see in which direction the ellipse forms (c) 2015 Wolters Kluwer All Rights Reserved MANUAL OF DERMATOLOGIC THERAPEUTICS Eighth Edition Kenneth A Arndt, MD Ashish C Bhatia, Jeffrey T.S Hsu, Suneel Chilukuri, MD Director of Mohs and Dermatological Surgery Bellaire Dermatology Associates Associate Clinical Professor Baylor College of Medicine Chief of Dermatology and Dermatologic Surgery Memorial Hermann Family Practice Residency Program Houston, Texas Associate Clinical Professor Columbia University College of Surgeons & Physicians New York, New York President SkinCare Physicians Chestnut Hill, Massachusetts Clinical Professor of Dermatology, Emeritus Harvard Medical School Boston, Massachusetts Adjunct Professor Department of Surgery The Geisel School of Medicine at Dartmouth Hanover, New Hampshire Adjunct Professor of Dermatology Brown University Providence, Rhode Island MD Co-Director of Dermatologic Laser and Cosmetic Surgery The Dermatology Institute DuPage Medical Group Naperville, Illinois Adjunct Assistant Professor Department of Surgery The Geisel School of Medicine at Dartmouth Hanover, New Hampshire Murad Alam, MD Professor of Dermatology, Otolaryngology, and Surgery Chief, Section of Cutaneous and Aesthetic Surgery Department of Dermatology Feinberg School of Medicine Northwestern University Chicago, Illinois MD, FAAD Assistant Professor of Clinical Dermatology Department of Dermatology Northwestern University - Feinberg School of Medicine Chicago, Illinois Medical Director for Dermatologic Research Department of Clinical Research, Co-Director of Dermatologic, Laser and Cosmetic Surgery The Dermatology Institute DuPage Medical Group Naperville, Illinois (c) 2015 Wolters Kluwer All Rights Reserved Executive Editor: Rebecca Gaertner Product Development Editor: Kristina Oberle Developmental Editor: Rebeca Baroso Production Project Manager: Alicia Jackson Senior Manufacturing Manager: Beth Welsh Marketing Manager: Stephanie Manzo Designer: Terry Mallon Production Services: Integra Software Services Pvt Ltd © 2014 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business 2001 Market Street Philadelphia, PA 19106 USA LWW.com 7th edition, © 2007 Lippincott Williams & Wilkins 6th edition, © 2002 Lippincott Williams & Wilkins 5th edition, © 1995 Lippincott Williams & Wilkins 4th edition, © 1988 Lippincott Williams & Wilkins 3rd edition, © 1983 Little Brown and Company 2nd edition, © 1978 Little Brown and Company 1st edition, © 1974 Little Brown and Company All rights reserved This book is protected by copyright No part of this book may be reproduced in any form or by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews Materials appearing in this book prepared by individuals as part of their official duties as U.S government employees are not covered by the above-mentioned copyright Printed in China Library of Congress Cataloging-in-Publication Data Manual of dermatologic therapeutics / [edited by] Kenneth A Arndt, Jeffrey T.S Hsu, Murad Alam, Ashish Bhatia, Suneel Chilikuri — Eighth edition p ; cm Preceded by Manual of dermatologic therapeutics / Kenneth A Arndt, Jeffrey T.S Hsu 7th ed c2007 Includes bibliographical references and index ISBN 978-1-4511-7634-6 I Arndt, Kenneth A., 1936- editor of compilation II Hsu, Jeffrey T S., editor of compilation III Alam, Murad, editor of compilation IV Bhatia, Ashish, editor of compilation V Chilikuri, Suneel, editor of compilation VI Arndt, Kenneth A., 1936- Manual of dermatologic therapeutics Preceded by (work): [DNLM: Skin Diseases—therapy—Handbooks. Skin Diseases—diagnosis—Handbooks. Skin Diseases—physiopathology—Handbooks WR 39] RL74 616.5—dc23 2013043802 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication Application of this information in a particular situation remains the professional responsibility of the practitioner The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions This is particularly important when the recommended agent is a new or infrequently employed drug Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings It is the responsibility of the health-care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320 International customers should call (301) 223-2300 Visit Lippincott Williams & Wilkins on the Internet at LWW.com Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST 10 9 8 7 6 5 4 3 2 1 (c) 2015 Wolters Kluwer All Rights Reserved To my family, with love Kenneth A Arndt To Mom, who teaches me to always good To Anita, who challenges me to always better Jeffrey Hsu Many thanks to all those that inspire and support me: my Mom & Dad, teachers, my loving family, my dear friends, my entire team at the office, my brilliant partners in practice—Jeff & Kelly, and my ever patient wife Tania Ashish C Bhatia To my parents, Rahat and Rehana; my sister, Nigar; my nephew, Ali; my niece, Noor; MP and BT, and Dr Arndt, who always made us feel worthy and inspired us to be better Murad Alam Thank you, Mom & Dad, for giving me the tools to succeed Thank you Susan, Sonia, and Sage for your patience and allowing me to use these tools With love Suneel Chilukuri (c) 2015 Wolters Kluwer All Rights Reserved Contributors Murad Alam, MD Ashish C Bhatia, MD, FAAD Professor of Dermatology, Otolaryngology, and Surgery Chief Section of Cutaneous and Aesthetic Surgery Department of Dermatology Feinberg School of Medicine Northwestern University Chicago, Illinois Assistant Professor of Clinical Dermatology Department of Dermatology Northwestern University - Feinberg School of Medicine Chicago, Illinois Medical Director for Dermatologic Research Department of Clinical Research, Co-Director of Dermatologic, Laser and Cosmetic Surgery The Dermatology Institute DuPage Medical Group Naperville, Illinois Lauren Alberta-Wszolek, MD Dermatology Associates of Concord Concord, Massachusetts Ajay N Amarnani, MD Summa Health System/NEOMED Akron, Ohio Danielle S Applebaum, BS Baylor College of Medicine Houston, Texas Kenneth A Arndt, MD President SkinCare Physicians Chestnut Hill, Massachusetts Clinical Professor of Dermatology Emeritus Harvard Medical School Boston, Massachusetts Adjunct Professor Department of Surgery The Geisel School of Medicine at Dartmouth Hanover, New Hampshire Adjunct Professor of Dermatology Brown University Providence, Rhode Island Yoon-Soo Cindy Bae-Harboe, MD Dermatology Resident Department of Dermatology Boston University Boston, Massachusetts Emily Bahram-ahi, MD Candidate, B.S Chemical Engineering B.S Biological Sciences Baylor College of Medicine Houston, Texas Adriane M Boyle, MD, MA Resident Physician Division of Dermatology University of California San Diego San Diego, California Nathan H Brewer, MD Department of Dermatology Yale University School of Medicine New Haven, Connecticut Kathryn Buikema, DO, MPH U.S Navy, General Medical Officer Ft Meade, Maryland Christopher G Bunick, MD, PhD Instructor of Dermatology Department of Dermatology Yale University New Haven, Connecticut Joanna Busquets, MD Department of Dermatology and Cutaneous Biology Thomas Jefferson University Hospital Philadelphia, Pennsylvania Katherine L Caretti, MD Department of Dermatology Wayne State University Detroit, Michigan vii (c) 2015 Wolters Kluwer All Rights Reserved viii CONTRIBUTORS Gunilla Carlsson Thorn, MD Edward P Conrad, MD Resident Physician Department of Dermatology Northwestern University Chicago, Illinois Department of Dermatology DuPage Medical Group Wheaton, Illinois Chung-Yin Stanley Chan, MD Department of Dermatology The Permanente Medical Group Elk Grove, California Dermatology Resident Department of Dermatology Northwestern University Chicago, Illinois Alix J Charles MD Kristy F Fleming, MD Tracy Lynn Donahue, MD The Dermatology Institute of DuPage Medical Group Hinsdale, Illinois Division of Dermatology University of California Los Angeles, California Pamela Chayavichitsilp, MD Sumul A Gandhi, MD Assistant Clinical Professor Division of Dermatology University of California San Diego San Diego, California Jessica M Gjede, MD Michael C Chen, PhD Medical Sciences Galderma Laboratories, L.P Fort Worth, Texas Suneel Chilukuri, MD Director of Mohs & Dermatological Surgery Bellaire Dermatology Associates Associate Clinical Professor Baylor College of Medicine Chief of Dermatology & Dermatologic Surgery Memorial Hermann Family Practice Residency Program Houston, Texas Associate Clinical Professor Columbia University College of Surgeons & Physicians New York, New York Resident John H Stroger, Jr Hospital of Cook County Chicago, Illinois Resident in Dermatology Department of Dermatology Boston University Medical Center Boston, Massachusetts Allison L Goddard, MD Fellow, Cutaneous Oncology Department of Dermatology Brigham and Women’s Hospital and Dana-Farber Cancer Institute Boston, Massachusetts Jacqueline A Guidry, MD Baylor College of Medicine Houston, Texas Nilanthi Gunawardane, MD Resident Physician Department of Dermatology Northwestern University Chicago, Illinois Michelle T Chevalier, MD, PGY-4 Elena Hadjicharalambous, BS Division of Dermatology John H Stroger, Jr Hospital of Cook County Chicago, Illinois Department of Dermatology Wayne State School of Medicine Detroit, Michigan (c) 2015 Wolters Kluwer All Rights Reserved CONTRIBUTORS ix Sarah J Harvey, MD Maria Kashat, BS University of Minnesota Minneapolis, Minnesota Biological Science, Medical Student, Dermatology Wayne State University School of Medicine Detroit, Michigan James J Herrmann, MD Associate Clinical Professor of Dermatology Northwestern University of Medical School Chicago, Illinois Partner of DuPage Medical Group Wheaton, Illinois Julia M Kasprzak MD Division of Dermatology John H Stroger Jr Hospital of Cook County Chicago, Illinois Paul M Hoesly, BS Leonard Yale Kerwin, MD Senior Medical Student Department of Dermatology Northwestern University Chicago, Illinois Department of Dermatology Wayne State University Dearborn, Michigan Jeffrey T.S Hsu, MD USAF, MSC Co-Director of Dermatologic Laser and Cosmetic Surgery The Dermatology Institute of DuPage Medical Group Naperville, Illinois Adjunct Assistant Professor Department of Medicine The Geisel School of Medicine at Dartmouth Hanover, New Hampshire Abel D Jarell, MD Assistant Professor of Dermatology and Dermatopathology Department of Dermatology Uniformed Services University Walter Reed National Military Medical Center Bethesda, Maryland Shang I Brian Jiang, MD Clinical Professor of Dermatology/ Medicine University of California San Diego San Diego, California Jessica Ann Kado, MD Assistant Professor Department of Dermatology Wayne State University School of Medicine Detroit, Michigan Dominic C Kim, MS, 2d Lt, Uniformed Services University School of Medicine Class of 2015 Bethesda, Maryland Jessica S Kim, MD Division of Dermatology University of California San Diego Health System San Diego, California Silvia Soohyun Kim, BA Medical Student Division of Dermatology University of California San Diego La Jolla, California Lacey L Kruse, MD Pediatric Dermatology Fellow Ann & Robert H Lurie Children’s Hospital of Chicago Chicago, Illinois Chao Li, MD Resident, Division of Dermatology University of California San Diego San Diego, California Jeffrey M Melancon, MD, PhD Division of Dermatology University of California San Diego San Diego, California (c) 2015 Wolters Kluwer All Rights Reserved x CONTRIBUTORS Laurel M Morton, MD Nazanin Saedi, MD Resident Physician Department of Dermatology Skin care Physicians Chestnut Hill, Massachusetts Assistant Professor, Director, Laser Surgery and Cosmetic Dermatology Thomas Jefferson University Philadelphia, Pennsylvania Emily Newsom, MD Kevin Shih, BA Department of Dermatology Wayne State University School of Medicine Detroit, Michigan Quynh-Giao Ly Nguyen, ScB Medical Student Baylor College of Medicine Houston, Texas David C Reid, MD Attending Physician Department of Dermatology John H Stroger, Jr Hospital of Cook County Assistant Professor Department of Dermatology Rush University Chicago, Illinois Medical Student, Research Assistant Department of Dermatology Northwestern University Feinberg School of Medicine Chicago, Illinois Vidya D.M Shivakumar, MD Dermatology Resident Cook County Hospital Chicago, Illinois Fareesa Shuja, MD Department of Dermatology Baylor College of Medicine Houston, Texas Kelly J Stankiewicz, MD The Dermatology Institute of DuPage Medical Group Naperville, Illinois Robert Stavert, MD, MBA Vicky Ren, BS Baylor College of Medicine Houston, Texas Kerri L Robbins, MD Department of Dermatology Baylor College of Medicine Houston, Texas Giselle Rodriguez, BA Research Assistant Department of Dermatology Northwestern University Feinberg School of Medicine Chicago, Illinois Donna R Sadowski, MD Division of Dermatology John H Stroger, Jr Hospital of Cook County Chicago, Illinois Resident Yale School of Medicine Department of Dermatology New Haven, Connecticut Aimee M Two, MD Post-doctoral Fellow Division of Dermatology University of California San Diego San Diego, California Zena W Zoghbi, MD Dermatology Resident Columbia University New York-Presbyterian Hospital New York, New York Amanda E Zubek, MD, PhD Department of Dermatology Yale University New Haven, Connecticut (c) 2015 Wolters Kluwer All Rights Reserved Preface When the first edition of the Manual was published in 1974, I could not have imagined how this set of guidelines to the treatment of common skin disorders would evolve into its current form With the 2014 edition, the Manual is reframed and it is now a bigger, enhanced, and more colorful print and electronic publication My original goal in creating the Manual was to present rational and practical therapeutic guidelines that would be useful for physicians and other health-care personnel The original publication and the subsequent editions were greeted with enthusiasm and they became widely used in the United States and throughout the world through Spanish, Portuguese, Italian, Indonesian, French, and Chinese versions The understanding of the causes, course, and therapy of cutaneous disorders has changed dramatically over the past four decades, as has the whole field of dermatology and the biology of skin disease The procedural aspects of the specialty have broadened enormously as has the expertise and interest in dermatologic surgery As knowledge about the pathophysiology of the skin and the basis of cutaneous disorders has become better understood, sophisticated and highly effective therapies for many disorders have become available, such as the biologic agents in the treatment of psoriasis The specialty has become bigger, broader, and better, and so has this Manual The structure and style of this edition were conceptualized together with my colleagues and coeditors Murad Alam, Ashish Bhatia, Suneel Chilikuri, and Jeffrey T.S Hsu Jeff Hsu assumed the yeoman task of pulling this all together and has been the driving force behind the successful completion of this edition The book has been enlarged and enhanced with discussion of all common and many less common disorders affecting the skin Each chapter has been edited, rewritten, or newly written by authors from around the country, particularly from the Departments of Dermatology at the University of Chicago, Northwestern, Baylor, and Yale Universities, and was then reviewed by several of the coeditors, Dr Hsu and myself For each entity, the Background is first discussed, followed by sections on the Clinical Presentation, Workup, Treatment, References, and Suggested Readings Included are tables listing treatment choices and differential diagnosis and numerous color illustrations As in previous editions, there are sections on Operative Procedures, Diagnostic and Therapeutic Techniques, and Treatment Principles We hope that the eighth edition of the Manual is as helpful and educational a guide to rational therapeutics and disease management as the previous seven editions have been Kenneth A Arndt xi (c) 2015 Wolters Kluwer All Rights Reserved 202 MANUAL OF DERMATOLOGIC THERAPEUTICS Figure 23-7. Scabies Pruritic papules and nodules are present on the penis and scrotum (With permission from Goodheart HP Goodheart’s Photoguide of Common Skin Disorders 2nd ed Philadelphia, PA: Lippincott Williams & Wilkins; 2003.) Figure 23-8. Norwegian scabies This child with Down syndrome has verrucous plaques on his hands and thickened dystrophic nails The lesions are teeming with mites (With permission from Goodheart HP Goodheart’s Photoguide of Common Skin Disorders 2nd ed Philadelphia, PA: Lippincott Williams & Wilkins; 2003.) (c) 2015 Wolters Kluwer All Rights Reserved Chapter 23 • Infestations 203 scabies is highly contagious Patients with HIV disease may present with scabies as their first AIDS defining illness III WORKUP The diagnosis of scabies is primarily clinical and can be a dif- ficult conclusion at which to arrive Characteristic burrow may be visualized as multiple straight or S-shaped ridges or dotted lines, to 20 mm long Mites are also in papules and vesicles, the most common lesions The diagnosis of scabies can also be made by demonstrating the presence of the organisms, the eggs, or the oval, brown-black fecal concretions (called scybala) by light microscopy (Fig 23-9) A superficial epidermal scraping of a burrow or papule is the best method for obtaining a specimen Apply a thin layer of mineral oil to the burrow or papule, then gently scrape with a no 15 blade Place the material recovered on a glass slide, cover with immersion oil, and examine under scanning power IV TREATMENT (Table 23-2) A Permethrin is a synthetic pyrethroid that interferes with the influx of sodium through cell membranes, leading to neurologic paralysis and death of the mite There is minimal percutaneous absorption (