DOCSLIB.ORG

Genital Lesions

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Genital Lesions Nick Van Wagoner, MD PhD Department of Infectious Diseases University of Alabama at Birmingham By the end of the lecture, the participant should be familiar with: Commonly used dermatological terms Common dermatological conditions seen in STD Clinics Dematology language Genital anatomy Categories of lesions Dermatological conditions seen in the STD clinic Not all individuals presenting to STD Clinics have STDs. Consider other causes for symptoms. History and examination are important in diagnosing non-STD genital findings. How long has it been present? What have you been doing to the skin in that area? Do you have any skin trouble anywhere else? Does this this look like an STD? Has this person been treated for STDs? Did it help? Know your limitations: Ask and Refer Symptoms perceived to be an STD Drips Discharge Dysuria Pain Redness Ulcers Bumps “I have spots on my head where hair won’t grow.” “I have a bump on my arm that hurts.” “I have painful sores on my back. I was told it was herpes.” History Exam Treat STD Reassure Not an STD Treat Refer Macule Patch area of color change area of color change <1.5cm, nonpalpable >1.5cm, nonpalpable From: www.acponline.org From: www.merck.com From: www.dermatology.cdlib.org From: www/missinglink.ucsf.edu From: www.visualdxhealth.com From: www.dermubc.ca From: www.dermubc.ca Papule Plaque area of elevation area of elevation <1.0cm, palpable >1.0cm, palpable elevated From: www.dermatology,about.com From: www.mycology.adelaide.edu/au/gallery From: www/missinglink.ucsf.edu www.dermatology.about.com CDC Susan Lindsey From: www.dermatology,about.com Nodule papule/plaque with deeper extension into the skin From: www.asnom.org Vesicle Pustule Bulla blister <1.0cm pus-filled vesicle blister >1.0cm From: www.meded.ucsd.edu From: www.afpmb.org From: www.ars.usda.gov From: www.missinglink.ucsf.edu From: www.acponline.org From: www.missinglink.ucsf.edu Erosion Ulcer shallow skin defect deep skin defect From: mdconsult.com From: www.missinglink.ucsf.edu From: www.missinglink.ucsf.edu Crust Scale amorphous accumulation of abnormal shedding or dried serum, blood or pus accumulation of cornified cells From: www.missinglink.ucsf.edu From: www.missinglink.ucsf.edu From: www.missinglink.ucsf.edu From www.glowm.com Michael Hughey, MD. 1. Testicles 2. Epididymis 3. Corpus cavernosa 4. Foreskin 5. Frenulum 6. Urethral opening 7. Glans penis 8. Corpus spongiosum 9. Penis/Shaft 10. Scrotum Red Plaques and Patches Red Papules and Nodules Yellow and Pustular Lesions Erosive and Vesiculobullous Diseases Ulcers White Lesions Skin-Colored Lesions Brown Lesions Atopic Dermatitis, Eczema, and Lichen Angiokeratoma Simplex Chronicus Cherry Angioma Irritant Contact Dermatitis Varicosity Allergic Contact Dermatitis Cutaneous Vulvar endometriosis Seborrheic Dermatitis Hematoma Psoriasis Hedradenoma Papilliferum Tinea Cruris Pyogenic Granuloma Erythrasma Kaposi’s Sarcoma Candidiasis Urethral Caruncle Perianal Streptococcal Disease Urethral Prolapse Lichen Planus Prurigo Nodularis (Picker’s Nodules) Plasma Cell Mucositis Pseudowarts Extramammary Page’s Disease Folliculitis and Furunculosis Bowen’s Disease Chigger Bites Vulvar Vistibulitis Nodules Scabies Dysesthetic Vulvodynia Inflamed Cysts Red Scrotum Syndrome Hydradenitis Suppurativa Crohn’s Disease Secondarily Red Skin-Colored Tumors Papulosquamous Diseases Lichen Planus Folliculitis Plasma cell (Zoon’s) vulvitis/balanitis Furunculosis Lichen Sclerosis Hidradenitis Suppurativa Reiter’s Disease Mucocutaneous Candidiasis Lichen Simplex Chronicus Pustular Psoriasis Necrolytic migratory erythema Reiter’s Syndrome Impetigo Sneddon-Wilson Disease Pemphigus Bullous Impetigo Bullous pemphigoid Cicatricial pemphigoid Linear IgA Disease Epidermolysis bullosa acquisita Apthae Pemphigoid gestationis Behcet’s Disease Dermatitis herpetiformis Ulcus Vulvae Acutum Benign familial pemphigus Pyoderma Gangrenosum Erythema multiforme Crohn’s Diseas Fixed drug eruption Factitial Ulcerations Contact Dermatitis Diseases that secondarily ulcerate Basal cell carcinoma Lichen Planus Squamous cell carcinoma Tumor Vulvar intraepithelial neoplasia Hidradenitis Suppurativa Extramammary Paget’s disease Genital Warts Vitiligo Moluscum Cantagiosum Postinflammatory Hypopigmentation and Condyloma lata Depigmentation Cysts Lichen Sclerosus (Lichen Sclerosus et Atrophicus) Epidermal Cysts Lichen Planus Vestibular Cysts Lichen Simplex Chronicus Cyst of the Median Raphe Candidiasis Bartholin’s Gland Duct Cysts Intraeptithelial Neoplasia Acrochorda (Skin tag) White Spongy Nevus Intradrmal Nevi Epidermal Cysts and Milia Neurofibromas Verrucous Carcinoma (SCC) Lipomas Pearly Penile Papules Vestibular papillae Physiologic Nigricans Forcye’s spots (pilosebacious units) Post-Inflammatory Hyperpigmentation Tyson’s Glands Genital Melanosis Fox Fordyce Disease Melanocytic Nevus Keratosis Pilaris Atypical Nevus Hidradenoma Papilliferum Melanoma Lichen Nitidus Dermatofibroma Sclerosing Lymphangitis Seborrheic Keratosis Squamous Cell Carcinoma Pigmented Condylomata acuminata Squamous Intraepithelia Neoplasia Intraepithelial neoplasia (bowenoid Papulosis, Boweln’s Disease) Invasive Squamous Cell Carcinoma Basal Cell Carcinoma Kaposi’s Sarcoma Elephantiasis Nostra Verrucosa Angiokeratoma Recent sex with a new partner, “I thought he was the one.” No condoms Spermicide “I think he gave me an STD” Used feminine hygiene product Used depilatory agent Chlorox bath Contact Itching with Inflammation Stinging substance Erythema Irritant Allergic direct effects of irritating specific immunologic substance response (Type IV) Occurs days to weeks Occurs 2-4 days TCA Topical medications Liquid nitrogen Spermicide Extreme heat Personal hygiene products Bleach Nail polish Feces/Urine Sanitary napkins Water Condoms Deodorant Alcohol History of allergies Self- perpetuating Rubbing Atopic Dermatitis = Scratching Widespread Precipitant Lichen Simplex Chronicus = Irritant Localized Scaling plaques Allergen Itching Excoriations Chronic itching or Anxiety Drainage scratching Perspiration Lichenified lesions Urine overlying a thickened, well- circumscribed plaque Perpetuating Factors Predilection for scrotum Cleaning and vulva Scrubbing Creams Source: AAFP: O’Connell. AAFP 2008. Improvement Steroids Sitz baths Remove irritant Sedation Stop rubbing Avoid irritating substances Good History or scratching Gentle cleanser and Exam Hyperproliferation of the epidermis Red, sharply demarcated plaques with silver scale Preferentially affects Scalp Elbows Knees Gluteal cleft Umbilicus Diagnosis: History, Exam, Histology Treatment: Dermatologist www.dermatology.about.com www.psorialess.com Often precipitated by: Warmth Perspiration Urine Friction Genital location: Over the hair-bearing skin of the vulva Glans Shaft Scale may be inaparent because of the moisture of the genital area www.afp.com Dermatophyte fungal Infection Occurs on drier keratinized skin www.dermimages.med.jhmi.edu Scaling well-demarcated plaques Does not affect scrotum or penis Unless immunocompromised Look for fungal elements Topical Antifungals www.womenshealthapta.org Characteristics Small Purplish Sharply demarcated papules Cutaneous blood vessels Genetically predisposed May have innumerable lesions Reassurance Characteristics Small Bright red Sharply demarcated papules Very common in older white persons Usually over trunk, but can occur in the perineum Reassurance From: www2.kumc.edu/coa/Education/ AMED900/Dermatology.htm Folliculitis Furunculosis Inflammation around the Deeper, perifollicular abscess hair follicle Characteristics Itch Painful Erythematous papules/nodules Location Hair bearing areas /www.skininfection.com/image S aureus Treatment: Antibacterial cleansers Topical antibiotics Oral antibiotics missinglink.ucsf.edu/.../folliculitis.html www.atlasdermatologico.com Can occur in Epidermal cysts Median raphe cysts Vestibular cysts Bartholins duct cysts Characteristics Red Tender www.meridiamedical.com/images Nodular Caused by Friction Trauma Occasionally infection Antibiotics Steroid Injection Drainage with a catheter Marsupialization Cystic Acne Not infection Apocrine and pilosebacious units with follicles distended by keratin/apocrine secretions Location Axillae www.mayoclinic.com/health/medica Genital Area Doesn’t remit after teenage years www.derm101.com Characteristics Comedones and nodules Painful as they enlarge May rupture Can form tracts draining to the surface 18 year old male MSM Recently became sexually active “My boyfriend told me I have warts.” Caused by HPV Usually asymptomatic Number and size dependent on host immune status Many shapes and sizes Round Acuminate (pointed) Filiform (long and slender) Raised Flat Images Courtesy of the CDC Characteristics Skin-colored Monomorphous Dome-shaped In rows around the corona Most common in uncircumcised men Asymptomatic Reassurance Characteristics Soft Monomorphous Discrete base Occur in patches or lines Bilaterally symmetrical Rounded tips (rather than acuminate) Occur at the introitus and medial labia minora Present in ~1/2 of premenopausal women Reassurance Pin-point yellowish papules Occur over labia minora/mucosal surfaces Enlarged sebaceous glands Reassurance Characteristics 2-5 mm Flesh-colored Smooth Domed Centrally
Load more

Recommended publications
  • The Use of Biologic Agents in the Treatment of Oral Lesions Due to Pemphigus and Behçet's Disease: a Systematic Review
    Davis GE, Sarandev G, Vaughan AT, Al-Eryani K, Enciso R. The Use of Biologic Agents in the Treatment of Oral Lesions due to Pemphigus and Behçet’s Disease: A Systematic Review. J Anesthesiol & Pain Therapy. 2020;1(1):14-23 Systematic Review Open Access The Use of Biologic Agents in the Treatment of Oral Lesions due to Pemphigus and Behçet’s Disease: A Systematic Review Gerald E. Davis II1,2, George Sarandev1, Alexander T. Vaughan1, Kamal Al-Eryani3, Reyes Enciso4* 1Advanced graduate, Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA 2Assistant Dean of Academic Affairs, Assistant Professor, Restorative Dentistry, Meharry Medical College, School of Dentistry, Nashville, Tennessee, USA 3Assistant Professor of Clinical Dentistry, Division of Periodontology, Dental Hygiene & Diagnostic Sciences, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA 4Associate Professor (Instructional), Division of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA Article Info Abstract Article Notes Background: Current treatments for pemphigus and Behçet’s disease, such Received: : March 11, 2019 as corticosteroids, have long-term serious adverse effects. Accepted: : April 29, 2020 Objective: The objective of this systematic review was to evaluate the *Correspondence: efficacy of biologic agents (biopharmaceuticals manufactured via a biological *Dr. Reyes Enciso, Associate Professor (Instructional), Division source) on the treatment of intraoral lesions associated with pemphigus and of Dental Public Health and Pediatric Dentistry, Herman Ostrow Behçet’s disease compared to glucocorticoids or placebo. School of Dentistry of USC, Los Angeles, California, USA; Email: [email protected].
    [Show full text]
  • Immunohistochemical Analysis of S100-Positive Epidermal
    An Bras Dermatol. 2020;95(5):627---630 Anais Brasileiros de Dermatologia www.anaisdedermatologia.org.br DERMATOPATHOLOGY Immunohistochemical analysis of S100-positive ଝ,ଝଝ epidermal Langerhans cells in dermatofibroma Mahmoud Rezk Abdelwhaed Hussein Department of Pathology, Assuit University Hospital, Assuit, Egypt Received 3 February 2020; accepted 12 April 2020 Available online 12 July 2020 Abstract Dermatofibroma is a dermal fibrohistiocytic neoplasm. The Langerhans cells are the KEYWORDS immunocompetent cells of the epidermis, and they represent the first defense barrier of the Histiocytoma, benign immune system towards the environment. The objective was to immunohistologically compare fibrous; the densities of S100-positive Langerhans cells in the healthy peritumoral epidermis against Skin neoplasms; those in the epidermis overlying dermatofibroma (20 cases), using antibodies against the S100 S100 Proteins molecule (the immunophenotypic hallmark of Langerhans cells). The control group (normal, healthy skin) included ten healthy age and sex-matched individuals who underwent skin biopsies for benign skin lesions. A significantly high density of Langerhans cells was observed both in the epidermis of the healthy skin (6.00 ± 0.29) and the peritumoral epidermis (6.44 ± 0.41) vs. those in the epidermis overlying the tumor (1.44 ± 0.33, p < 0.05). The quantitative deficit of Langerhans cells in the epidermis overlying dermatofibroma may be a possible factor in its development. © 2020 Sociedade Brasileira de Dermatologia. Published by Elsevier Espana,˜ S.L.U. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Langerhans cells (LCs) are the exclusive antigen-presenting tions stained with hematoxylin and eosin as ‘‘clear cells’’ cells of the normal human epidermis.
    [Show full text]
  • Storiform Collagenoma: Case Report Colagenoma Estoriforme: Relato De Caso
    CASE REPORT Storiform collagenoma: case report Colagenoma estoriforme: relato de caso Guilherme Flosi Stocchero1 ABSTRACT INTRODUCTION Storiform collagenoma is a rare tumor, which originates from the Storiform collagenoma or sclerotic fibroma is a rare proliferation of fibroblasts that show increased production of type-I benign skin tumor that usually affects young adults collagen. It is usually found in the face, neck and extremities, but and middle-age individuals of both sexes. This tumor is it can also appear in the trunk, scalp and, less frequently, in the slightly predominant in women. Storiform collagenoma oral mucosa and the nail bed. It affects both sexes, with a slight female predominance. It may be solitary or multiple, the latter being appears as a small papule or solid fibrous nodule. an important marker for Cowden syndrome. It presents as a painless, It is well-circumscribed, pink, whitish or skin color, solid nodular tumor that is slow-growing. It must be considered in the painless and of slow-growing. This tumor is often differential diagnosis of other well-circumscribed skin lesions, such as found in face and limbs, but it can also appears in dermatofibroma, pleomorphic fibroma, sclerotic lipoma, fibrolipoma, the chest, scalp and, rarely, in oral mucosa and nail giant cell collagenoma, benign fibrous histiocytoma, intradermal Spitz bed. Storiform collagenoma often appears as single nevus and giant cell angiohistiocytoma. tumor, and the occurrence of multiple tumors is an important indication of Cowden syndrome, which is Keywords: Collagen; Hamartoma; Skin neoplasms; Fibroma; Skin; Case a heritage genodermatosis of autosomal dominant reports condition.(1-4) Storiform collagenoma has as differential diagnosis other well-circumscribed skin tumors such RESUMO as dermatofibroma, pleomorphic fibroma, sclerotic O colagenoma estoriforme é um tumor raro originado a partir da lipoma, fibrolipoma, giant cell collagenoma, benign proliferação de fibroblastos com produção aumentada de colágeno tipo I.
    [Show full text]
  • Benign Tumors and Tumor-Like Lesions of the Vulva
    Please do not remove this page Benign Tumors and Tumor-like Lesions of the Vulva Heller, Debra https://scholarship.libraries.rutgers.edu/discovery/delivery/01RUT_INST:ResearchRepository/12643402930004646?l#13643525330004646 Heller, D. (2015). Benign Tumors and Tumor-like Lesions of the Vulva. In Clinical Obstetrics & Gynecology (Vol. 58, Issue 3, pp. 526–535). Rutgers University. https://doi.org/10.7282/T3RN3B2N This work is protected by copyright. You are free to use this resource, with proper attribution, for research and educational purposes. Other uses, such as reproduction or publication, may require the permission of the copyright holder. Downloaded On 2021/09/23 14:56:57 -0400 Heller DS Benign Tumors and Tumor-like lesions of the Vulva Debra S. Heller, MD From the Department of Pathology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, NJ Address Correspondence to: Debra S. Heller, MD Dept of Pathology-UH/E158 Rutgers-New Jersey Medical School 185 South Orange Ave Newark, NJ, 07103 Tel 973-972-0751 Fax 973-972-5724 [email protected] Funding: None Disclosures: None 1 Heller DS Abstract: A variety of mass lesions may affect the vulva. These may be non-neoplastic, or represent benign or malignant neoplasms. A review of benign mass lesions and neoplasms of the vulva is presented. Key words: Vulvar neoplasms, vulvar diseases, vulva 2 Heller DS Introduction: A variety of mass lesions may affect the vulva. These may be non-neoplastic, or represent benign or malignant neoplasms. Often an excision is required for both diagnosis and therapy. A review of the more commonly encountered non-neoplastic mass lesions and benign neoplasms of the vulva is presented.
    [Show full text]
  • Detail Report
    Supplemental Update Report CR Number: 2012319113 Implementation Date: 16-Jan-19 Related CR: 2012319113 MedDRA Change Requested Add a new SMQ Final Disposition Final Placement Code # Proposed SMQ Infusion related reactions Rejected After Suspension MSSO The proposal to add a new SMQ Infusion related reactions is not approved after suspension. The ICH Advisory Panel did approve this SMQ topic to go into the development phase and it Comment: underwent testing in three databases (two regulatory authorities and one company). However, there were numerous challenges encountered in testing and the consensus decision of the CIOMS SMQ Implementation Working Group was that the topic could not be developed to go into production as an SMQ. Most notably, in contrast to other SMQs, this query could not be tested using negative control compounds because it was not possible to identify suitable compounds administered via infusion that were not associated with some type of reaction. In addition, there is no internationally agreed definition of an infusion related reaction and the range of potential reactions associated with the large variety of compounds given by infusion is very broad and heterogenous. Testing was conducted on a set of around 500 terms, the majority of which was already included in Anaphylactic reaction (SMQ), Angioedema (SMQ), and Hypersensitivity (SMQ). It proved difficult to identify potential cases of infusion related reactions in post-marketing databases where the temporal relationship of the event to the infusion is typically not available. In clinical trial databases where this information is more easily available, users are encouraged to provide more specificity about the event, e.g., by reporting “Anaphylactic reaction” when it is known that this event is temporally associated with the infusion.
    [Show full text]
  • Dermatofibrosarcoma Protuberans and Dermatofibroma: Dermal Dendrocytomas? a Ultrastructural Study
    Dermatofibrosarcoma Protuberans and Dermatofibroma: Dermal Dendrocytomas? A Ultrastructural Study Hugo Dominguez-Malagon, M.D., Ana Maria Cano-Valdez, M.D. Department of Pathology, Instituto Nacional de Cancerología, Mexico. ABSTRACT population of plump spindled cells devoid of cell processes, these cells contained intracytoplasmic lipid droplets and rare Dermatofibroma (DF) and Dermatofibrosarcoma subplasmalemmal densities but lacked MVB. Protuberans (DFSP) are dermal tumors whose histogenesis has not been well defined to date. The differential diagnosis in most With the ultrastructural characteristics and the constant cases is established in routine H/E sections and may be confirmed expression of CD34 in DFSP, a probable origin in dermal by immunohistochemistry; however there are atypical variants dendrocytes is postulated. The histogenesis of DF remains of DF with less clear histological differences and non-conclusive obscure. immunohistochemical results. In such cases electron microscopy studies may be useful to establish the diagnosis. INTRODUCTION In the present paper the ultrastructural characteristics of 38 The histogenesis or differentiation of cases of DFSP and 10 cases of DF are described in detail, the Dermatofibrosarcoma Protuberans (DFSP) and objective was to identify some features potentially useful for Dermatofibroma (DF) is controversial in the literature. For differential diagnosis, and to identify the possible histogenesis of DFSP diverse origins such as fibroblastic,1 fibro-histiocytic2 both neoplasms. Schwannian,3 myofibroblastic,4 perineurial,5,6 and endoneurial (7) have been postulated. DFSP in all cases was formed by stellate or spindled cells with long, slender, ramified cell processes joined by primitive junctions, Regarding DF, most authors are in agreement of a subplasmalemmal densities were frequently seen in the processes.
    [Show full text]
  • Genital Dermatology
    GENITAL DERMATOLOGY BARRY D. GOLDMAN, M.D. 150 Broadway, Suite 1110 NEW YORK, NY 10038 E-MAIL [email protected] INTRODUCTION Genital dermatology encompasses a wide variety of lesions and skin rashes that affect the genital area. Some are found only on the genitals while other usually occur elsewhere and may take on an atypical appearance on the genitals. The genitals are covered by thin skin that is usually moist, hence the dry scaliness associated with skin rashes on other parts of the body may not be present. In addition, genital skin may be more sensitive to cleansers and medications than elsewhere, emphasizing the necessity of taking a good history. The physical examination often requires a thorough skin evaluation to determine the presence or lack of similar lesions on the body which may aid diagnosis. Discussion of genital dermatology can be divided according to morphology or location. This article divides disease entities according to etiology. The clinician must determine whether a genital eruption is related to a sexually transmitted disease, a dermatoses limited to the genitals, or part of a widespread eruption. SEXUALLY TRANSMITTED INFECTIONS AFFECTING THE GENITAL SKIN Genital warts (condyloma) have become widespread. The human papillomavirus (HPV) which causes genital warts can be found on the genitals in at least 10-15% of the population. One study of college students found a prevalence of 44% using polymerase chain reactions on cervical lavages at some point during their enrollment. Most of these infection spontaneously resolved. Only a minority of patients with HPV develop genital warts. Most genital warts are associated with low risk HPV types 6 and 11 which rarely cause cervical cancer.
    [Show full text]
  • Surgical Excision of Eyelid Lesions Reference Number: CP.VP.75 Coding Implications Last Review Date: 12/2020 Revision Log
    Clinical Policy: Surgical Excision of Eyelid Lesions Reference Number: CP.VP.75 Coding Implications Last Review Date: 12/2020 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description: The majority of eyelid lesions are benign, ranging from innocuous cysts and chalazion/hordeolum to nevi and papillomas. Key features that should prompt further investigation include gradual enlargement, central ulceration or induration, irregular borders, eyelid margin destruction or loss of lashes, and telangiectasia. This policy describes the medical necessity requirements for surgical excision of eyelid lesions. Policy/Criteria I. It is the policy of health plans affiliated with Centene Corporation® (Centene) that surgical excision and repair of eyelid or conjunctiva due to lesion or cyst or eyelid foreign body removal is medically necessary for any of the following indications: A. Lesion with one or more of the following characteristics: 1. Bleeding; 2. Persistent or intense itching; 3. Pain; 4. Inflammation; 5. Restricts vision or eyelid function; 6. Misdirects eyelashes or eyelid; 7. Displaces lacrimal puncta or interferes with tear flow; 8. Touches globe; 9. Unknown etiology with potential for malignancy; B. Lesions classified as one of the following: 1. Malignant; 2. Benign; 3. Cutaneous papilloma; 4. Cysts; 5. Embedded foreign bodies; C. Periocular warts associated with chronic conjunctivitis. Background The majority of eyelid lesions are benign, ranging from innocuous cysts and chalazion/hordeolum to nevi and papillomas. Key features that should prompt further investigation include gradual enlargement, central ulceration or induration, irregular borders, eyelid margin destruction or loss of lashes, and telangiectasia. Benign tumors, even though benign, often require removal and therefore must be examined carefully and the differential diagnosis of a malignant eyelid tumor considered and the method of removal planned.
    [Show full text]
  • Fundamentals of Dermatology Describing Rashes and Lesions
    Dermatology for the Non-Dermatologist May 30 – June 3, 2018 - 1 - Fundamentals of Dermatology Describing Rashes and Lesions History remains ESSENTIAL to establish diagnosis – duration, treatments, prior history of skin conditions, drug use, systemic illness, etc., etc. Historical characteristics of lesions and rashes are also key elements of the description. Painful vs. painless? Pruritic? Burning sensation? Key descriptive elements – 1- definition and morphology of the lesion, 2- location and the extent of the disease. DEFINITIONS: Atrophy: Thinning of the epidermis and/or dermis causing a shiny appearance or fine wrinkling and/or depression of the skin (common causes: steroids, sudden weight gain, “stretch marks”) Bulla: Circumscribed superficial collection of fluid below or within the epidermis > 5mm (if <5mm vesicle), may be formed by the coalescence of vesicles (blister) Burrow: A linear, “threadlike” elevation of the skin, typically a few millimeters long. (scabies) Comedo: A plugged sebaceous follicle, such as closed (whitehead) & open comedones (blackhead) in acne Crust: Dried residue of serum, blood or pus (scab) Cyst: A circumscribed, usually slightly compressible, round, walled lesion, below the epidermis, may be filled with fluid or semi-solid material (sebaceous cyst, cystic acne) Dermatitis: nonspecific term for inflammation of the skin (many possible causes); may be a specific condition, e.g. atopic dermatitis Eczema: a generic term for acute or chronic inflammatory conditions of the skin. Typically appears erythematous,
    [Show full text]
  • Hair Loss in Infancy
    SCIENCE CITATIONINDEXINDEXED MEDICUS INDEX BY (MEDLINE) EXPANDED (ISI) OFFICIAL JOURNAL OF THE SOCIETÀ ITALIANA DI DERMATOLOGIA MEDICA, CHIRURGICA, ESTETICA E DELLE MALATTIE SESSUALMENTE TRASMESSE (SIDeMaST) VOLUME 149 - No. 1 - FEBRUARY 2014 Anno: 2014 Lavoro: 4731-MD Mese: Febraury titolo breve: Hair loss in infancy Volume: 149 primo autore: MORENO-ROMERO No: 1 pagine: 55-78 Rivista: GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA Cod Rivista: G ITAL DERMATOL VENEREOL G ITAL DERMATOL VENEREOL 2014;149:55-78 Hair loss in infancy J. A. MORENO-ROMERO 1, R. GRIMALT 2 Hair diseases represent a signifcant portion of cases seen 1Department of Dermatology by pediatric dermatologists although hair has always been Hospital General de Catalunya, Barcelona, Spain a secondary aspect in pediatricians and dermatologists 2Universitat de Barcelona training, on the erroneous basis that there is not much in- Universitat Internacional de Catalunya, Barcelona, Spain formation extractable from it. Dermatologists are in the enviable situation of being able to study many disorders with simple diagnostic techniques. The hair is easily ac- cessible to examination but, paradoxically, this approach is often disregarded by non-dermatologist. This paper has Embryology and normal hair development been written on the purpose of trying to serve in the diag- nostic process of daily practice, and trying to help, for ex- ample, to distinguish between certain acquired and some The full complement of hair follicles is present genetically determined hair diseases. We will focus on all at birth and no new hair follicles develop thereafter. the data that can be obtained from our patients’ hair and Each follicle is capable of producing three different try to help on using the messages given by hair for each types of hair: lanugo, vellus and terminal.
    [Show full text]
  • Basal Cell Carcinoma Associated with Non-Neoplastic Cutaneous Conditions: a Comprehensive Review
    Volume 27 Number 2| February 2021 Dermatology Online Journal || Review 27(2):1 Basal cell carcinoma associated with non-neoplastic cutaneous conditions: a comprehensive review Philip R Cohen MD1,2 Affiliations: 1San Diego Family Dermatology, National City, California, USA, 2Touro University California College of Osteopathic Medicine, Vallejo, California, USA Corresponding Author: Philip R Cohen, 10991 Twinleaf Court, San Diego, CA 92131-3643, Email: [email protected] pathogenesis of BCC is associated with the Abstract hedgehog signaling pathway and mutations in the Basal cell carcinoma (BCC) can be a component of a patched homologue 1 (PCTH-1) transmembrane collision tumor in which the skin cancer is present at tumor-suppressing protein [2-4]. Several potential the same cutaneous site as either a benign tumor or risk factors influence the development of BCC a malignant neoplasm. However, BCC can also concurrently occur at the same skin location as a non- including exposure to ultraviolet radiation, genetic neoplastic cutaneous condition. These include predisposition, genodermatoses, immunosuppression, autoimmune diseases (vitiligo), cutaneous disorders and trauma [5]. (Darier disease), dermal conditions (granuloma Basal cell carcinoma usually presents as an isolated faciale), dermal depositions (amyloid, calcinosis cutis, cutaneous focal mucinosis, osteoma cutis, and tumor on sun-exposed skin [6-9]. However, they can tattoo), dermatitis, miscellaneous conditions occur as collision tumors—referred to as BCC- (rhinophyma, sarcoidal reaction, and varicose veins), associated multiple skin neoplasms at one site scars, surgical sites, systemic diseases (sarcoidosis), (MUSK IN A NEST)—in which either a benign and/or systemic infections (leischmaniasis, leprosy and malignant neoplasm is associated with the BCC at lupus vulgaris), and ulcers.
    [Show full text]
  • 2016 Essentials of Dermatopathology Slide Library Handout Book
    2016 Essentials of Dermatopathology Slide Library Handout Book April 8-10, 2016 JW Marriott Houston Downtown Houston, TX USA CASE #01 -- SLIDE #01 Diagnosis: Nodular fasciitis Case Summary: 12 year old male with a rapidly growing temple mass. Present for 4 weeks. Nodular fasciitis is a self-limited pseudosarcomatous proliferation that may cause clinical alarm due to its rapid growth. It is most common in young adults but occurs across a wide age range. This lesion is typically 3-5 cm and composed of bland fibroblasts and myofibroblasts without significant cytologic atypia arranged in a loose storiform pattern with areas of extravasated red blood cells. Mitoses may be numerous, but atypical mitotic figures are absent. Nodular fasciitis is a benign process, and recurrence is very rare (1%). Recent work has shown that the MYH9-USP6 gene fusion is present in approximately 90% of cases, and molecular techniques to show USP6 gene rearrangement may be a helpful ancillary tool in difficult cases or on small biopsy samples. Weiss SW, Goldblum JR. Enzinger and Weiss’s Soft Tissue Tumors, 5th edition. Mosby Elsevier. 2008. Erickson-Johnson MR, Chou MM, Evers BR, Roth CW, Seys AR, Jin L, Ye Y, Lau AW, Wang X, Oliveira AM. Nodular fasciitis: a novel model of transient neoplasia induced by MYH9-USP6 gene fusion. Lab Invest. 2011 Oct;91(10):1427-33. Amary MF, Ye H, Berisha F, Tirabosco R, Presneau N, Flanagan AM. Detection of USP6 gene rearrangement in nodular fasciitis: an important diagnostic tool. Virchows Arch. 2013 Jul;463(1):97-8. CONTRIBUTED BY KAREN FRITCHIE, MD 1 CASE #02 -- SLIDE #02 Diagnosis: Cellular fibrous histiocytoma Case Summary: 12 year old female with wrist mass.
    [Show full text]