​Dermatology - Roseola 
Exanthem subitum, often known as roseola, is a medical condition.
Infections caused by the primary human herpesvirus-6 (HHV-6) and HHV-7 result in a condition known as exanthema subitum (roseola infantum). This condition is marked by a high fever in a healthy infant, which lasts for three days and is then followed by a sudden appearance of a rash.

The newborn experiences a prodrome characterized by a continuously high fever ranging from 38.9°–40.6°C, with temporary relief in the morning. This fever persists until the fourth day when it abruptly returns to normal, coinciding with the emergence of a rash.
Abnormalities
The exanthema is characterized by tiny, pink macules and papules on the neck and trunk. These lesions are 1-5 mm in diameter and can either remain separate or merge together. Anatomical distribution: mostly located in the trunk and neck regions.

The diagnosis is typically established based on clinical observations.

Exanthem subitum is a condition that often resolves on its own without the need for treatment, and complications are uncommon.
Antivirals should be administered to patients with weakened immune systems.

Dermatology - Irritant contact dermatitis (ICD)
ICD is a result of chemical irritants and can happen after either a one-time or repeated exposure. It is influenced by the concentration of the irritants and happens once the exposure beyond a specific threshold.
Allergic contact dermatitis, on the other hand, relies on the process of sensitization. ICD is primarily occupational, although exposure can potentially occur in any setting. The predominant agents include abrasives, cleaning compounds, oxidizing agents, reducing agents, plant and animal enzymes, desiccants, dust, soil, and excessive water.


The symptoms of ICD manifest in the specific area of the body that has been exposed, resulting in a sensation of burning, stinging, and itching that can start between seconds to hours after the exposure. Short-term exposure to severe irritants can lead to a reaction, but most cases are caused by long-term cumulative exposure.
Abnormalities
The observed erythema and superficial edema have distinct boundaries and do not extend beyond their current location, indicating exposure.
In severe situations, vesicles and blisters may develop and progress to erosions or complete necrosis.
The lesion's pattern frequently exhibits an irregular or linear nature, resembling an external influence, which corresponds to the contact pattern. The duration of lesions in acute ICD ranges from a few days to a few weeks. Chronic ICD is characterized by persistent redness, itching, and burning, which result in prolonged rubbing and the development of thickened skin with scales, indistinct borders, and lichenification that can last for months to years.

The diagnosis is determined by the patient's medical history and a thorough clinical examination. Allergic contact dermatitis is the primary differential diagnosis of utmost significance. The differential diagnosis for skin conditions on the palms and soles includes palmoplantar psoriasis and photoallergic contact dermatitis in areas that are exposed to sunlight.

Determine and eliminate the causative agent, followed by the application of moist dressings soaked in Burow's solution, to be changed at intervals of 2-3 hours. Empty the bigger vesicles, while leaving the caps intact. Counsel patients on the use of preventive measures such as the use of protective clothes, barrier creams, and considering a change in occupation to minimize exposure.
Manage lesions by applying topical glucocorticoids such as betamethasone dipropionate or clobetasol propionate. Additionally, ensure sufficient lubrication, which should be sustained throughout the healing process while progressively reducing the use of glucocorticoids.

Dermatology - Exfoliative Erythroderma Syndrome
Exfoliative erythroderma is a severe and potentially life-threatening response pattern marked by a consistent redness, infiltration, and scaling. Typically found in individuals aged 50 and over, while in youngsters, it commonly arises from atopic dermatitis, pityriasis rubra pilaris, or atopic dermatitis. Males are more frequently impacted than females.
Exfoliative erythroderma is characterized by the presence of fever, malaise, shivering, and widespread lymphadenopathy.
There are two distinct stages, namely acute and chronic, that seamlessly transition into one another. The acute phase can manifest swiftly, typically in response to a medication reaction, cancer, eczema, or psoriasis.
During the initial acute phase, it is still feasible to detect the prior skin condition. The individual is experiencing symptoms such as fever, pruritus, weariness, weakness, anorexia, weight loss, malaise, feeling cold, and chills.
Abnormalities
The skin appears red, thickened, and covered with scales. The dermatitis is evenly distributed across the entire body, with the exception of pityriasis rubra pilaris, when distinct regions of unaffected skin are present.
Thickening of the skin results in the formation of prominent skin folds. This can be accompanied by either subtle or more pronounced scaling, ranging from small to big flakes measuring up to 0.5 cm, appearing in layers. In conditions such as pityriasis rubra pilaris, Sézary syndrome, and psoriasis, the palms and soles are typically affected, exhibiting significant thickening of the skin and the presence of deep cracks. Scalp and body hair may be lost, and the nails may grow thicker and detached from the nail bed (a condition known as onycholysis). Hyperpigmentation or hypopigmentation may occur, particularly in people with darker skin.Diagnosing the condition is challenging, and the previous history of the skin disorder may be the sole indication.
Despite undergoing treatment, patients may die from infections or, if they have cardiac issues, from cardiac failure (specifically "high-output" failure), or from the consequences of extended glucocorticoid therapy.
The patient should be admitted to a private room in the hospital, maintaining a warm environment, and receiving topical water baths infused with bath oils. This should be followed by the use of mild moisturizers. Systemic oral glucocorticoids can bring about a state of remission, but they should not be employed for long-term maintenance. Administer appropriate supportive care and administer systemic and topical medication as needed for the underlying problem.

​Symptoms and Signs – Differential Diagnosis of Cardioembolism
• Valvular heart disease (e.g., rheumatic mitral valve disease, mitral valve prolapse)
• Sick sinus syndrome and cardiac arrhythmias
• Prosthetic heart valves
• Patent foramen ovale
• Other: VVI pacing, ventricular support devices, heart transplantation, intracardiac defects with paradoxical embolism
• Nonbacterial thrombotic endocarditis
• Left ventricular aneurysm
• Infective endocarditis
• Dilated cardiomyopathy
• Cyanotic heart disease
• Coronary artery bypass grafting
• Cardioversion for atrial fibrillation
• Balloon angioplasty
• Atrial septal defect
• Atrial septal aneurysm
• Atrial myxoma and other intracardiac tumors
• Atrial fibrillation
• Aneurysms of sinus of Valsalva
• Acute MI

​Symptoms and Signs – Differential Diagnosis of Bursitis
• Tendinitis (sometimes occurs in conjunction with bursitis)
• Infectious arthritis
• Degenerative joint disease
• Cellulitis (if bursitis is septic)

​Symptoms and Signs – Differential Diagnosis of Café au Lait Macule
• Lentigo
• Multiple lentigines syndrome
• Nevi
• Seborrheic keratosis

​Symptoms and Signs – Differential Diagnosis of Calcification on Chest Radiograph
• Tuberculosis
• Silicosis
• Secondary hyperparathyroidism
• Mitral stenosis (end stage)
• Lung neoplasm (primary or metastatic)
• Idiopathic pulmonary fibrosis
• Histoplasmosis
• Disseminated varicella infection

Symptoms and Signs – Differential Diagnosis of Cutaneous Calcifications
•Calcification, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome
• Chronic renal failure
• Dermatomyositis
• Hyperparathyroidism
• Hypervitaminosis D
• Iatrogenic (e.g., application of calcium alginate dressing to skin)
• Idiopathic
• Leukemia
• Lymphoma
• Milk-alkali syndrome
• Multiple myeloma
• Pancreatitis or pancreatic cancer
• Panniculitis
• Parasitic infections
• Sarcoidosis
• Trauma

​Symptoms and Signs – Differential Diagnosis of Calcium Stones
• Thyrotoxicosis
• Sarcoidosis
• Renal tubular acidosis
• Prolonged immobilization
• Primary hyperparathyroidism
• Milk-alkali syndrome
• Medications (e.g., antacids, loop diuretics, vitamin D, acetazolamide, glucocorticoids)
• Hypocitraturia (e.g., metabolic acidosis, hypomagnesemia, hypokalemia)
• Hyperuricosuria (e.g., hyperuricemia, excessive dietary purine, allopurinol, probenecid)
• Hyperoxaluria (e.g., Crohn’s disease, celiac disease, chronic pancreatitis)
• Hypercalcemia from malignant disease

​Symptoms and Signs – Differential Diagnosis of Candidiasis
• Cellulitis
• Eczema
• Psoriasis
• Seborrheic dermatitis
• Tinea