Irritant Contact Dermatitis Versus ACD: Direct physical or chemical injury to the epidermis Tends to burn instead of itch Treatment: Remove offending agent Topical corticosteroids

Bullae Bullae (blisters) on legs frequently related to edema particularly if legs are swollen (think CHF patient) Bullae can develop in incapacitated individuals who are severely ill and immobile

Bullous Pemphigoid Autoimmune blistering condition Treatment: immunosuppression Topical corticosteroids Doxycycline and niacinamide Prednisone Not alone an indication for admission Look for mucosal involvement

Pemphigus vulgaris

Can occur in sun protected areas!!!

Skin Cancer Any new, changing, growing, symptomatic lesion Most commonly seen cutaneous malignancies: Melanoma is deadly Squamous cell is deadly Basal cell is locally destructive Please do not underestimate the potential morbidity and mortality of a skin cancer for your patient; prompt identification and treatment can be life-saving!

Tissue sparing + high cure rate + low complication rate + low cost