#161 A Rash Approach to Rashes with Helena Pasieka MD

Tackle rashes with wisdom from Kashlak’s resident Skinternist (or Internist-Externist) Dr. Helena Pasieka (MedStar, Georgetown), board certified in both Internal Medicine and Dermatology. She offers “a rash approach to rashes” including: initial triage, ‘inside job’ vs ‘outside job’, differential diagnosis, a review of common culprits, basic management techniques, and how to determine if the reaction is life-threatening. Plus, Dr Pasieka teaches us how to handle family and friends asking, “Can you take a look at this rash?”. Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected]. Credits Written and Produced: Beth Garbitelli MS2 Infographic and Cover Art: Beth Garbitelli MS2 Hosts: Stuart Bringham MD, Matthew Watto MD, Paul Williams MD Editor: Matthew Watto MD Guest: Helena Pasieka MD Time Stamps 00:00 Intro, disclaimer, guest bio 04:10 Guest one-liner, book recommendations 09:56 Case of a rash; initial thought process (sick versus not sick); review of systems 18:05 Grouping rashes: inside job versus outside job 22:07 Terminology: Many people dont speak derm 26:03 Skin itching versus Skin pain; Morbilliform drug eruption 30:08 Urticaria (hives) vs morbilliform rash; Cotton tipped applicators and dermatographism 35:42 Itching is not all about histamine; Treatment of hives 38:26 Treatment of morbilliform rash 40:00 Case summary and review of concepts learned thus far 41:00 AGEP 45:14 SJS/TEN; Nikolsky’s sign 53:20 Complications of TEN - Ocular surface disease; Vulvar disease 58:02 DRESS (now DIHS) 66:30 Tips for asking about time course of meds and symptoms; Recap of DRESS (DISH) 70:00 How to handle family and friends ask for rash evaluation 76:20 Outro 78:00 Post-credits scene