DOCSLIB.ORG

Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2 Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2 DISCLOSURES •There are no financial relationships with Dermatology Conundrums: commercial interests to disclose Interesting Cases •Any unlabeled/unapproved uses of drugs or products referenced will be disclosed Peggy Vernon, RN, MA, CPNP, DCNP, FAANP ©PVernon2021 ©PVernon2021 RESTRICTIONS OBJECTIVES •Permission granted to the 2021 National Nurse • Name common contacts in phytophotodermatitis Practitioner Symposium and its attendees •All rights reserved. No part of this presentation • List a treatment of choice for Majocchi Granuloma may be reproduced, stored, or transmitted in any form or by any means without written permission of the author • Identify two symptoms of jellyfish sting •[email protected] ©PVernon2021 ©PVernon2021 56 Year Old Female Differential •Rash on trunk; started on back, spreading to • Drug eruption chest and abdomen • Tinea corporis •Only occasional itch • Tinea Versicolor •No history of allergies, • Pityriasis Rosea atopic dermatitis, • Nummular dermatitis psoriasis • Guttate psoriasis •No recent illness • Secondary syphilis •OTC HC no help Photo Courtesy Visual DX •OTC anti-fungal no help ©PVernon2021 ©PVernon2021 1 Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2 Pityriasis Rosea Diagnosis and Treatment •Herald patch: oval, salmon colored patch with fine collarette of • Biopsy if unclear scale; develops over 1-2 • Spontaneous remission weeks in 6-12 weeks • Smaller oval plaques • follow lines of Blashko Treat symptomatically: in “christmas tree” • Antihistamines for configuration itching •Usually confined to • Topical glucocorticoids trunk, proximal arms • UVB and legs, rarely on face; never on palms and ©PVernon2021 soles ©PVernon2021 43 Year Old Male Onychomadesis •Painless spontaneous •Separation of proximal nail plate on several separation of proximal fingernails nail plate •Toe nails not involved •Painless •Cosmetically bothersome © pvernon2015 © pvernon2015 ©PVernon2021 ©PVernon2021 Onychomadesis 30 Year Old Female A •Trauma (e.g. subungual •Areas of hair loss with hematoma) thick sticky yellow scale •Inflammation or infection (fever, HFM •Non-tender disease) •No adenopathy •Peripheral vascular •No one else in family disease with sx •Raynaud’s Photo courtesy •Familial trait Visual DX ©PVernon2021 ©PVernon2021 2 Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2 Pityriasis Amiantacea Differential Photos courtesy Visual DX • Distinct scalp disorder • Female predilection: young •Atopic dermatitis adults, adolescents, and •Psoriasis children • Clinical diagnosis: Adherent •Pityriasis Amiantacea thick silver, gray, or yellow •Seborrheic dermatitis scales which surround and bind down hair tufts. Scale •Tinea capitis attached to hair shaft and scalp • Fungal cultures usually negative Photo Courtesy Visual DX • Staph most common ©PVernon2021 ©PVernon2021 Pityriasis Amiantacia Treatment 10 Year Old Female •Keratolytic shampoos: 2% salicylic acid •Spontaneously shampoo developed lesion on •Urea 20% or 40% cream forearm •Topical steroids in oil •Rapidly increasing in base (flucinolone oil size 0.01%) •Frequently bleeds •Antibiotics if cultures • positive Non-tender ©PVernon2021 Photo Courtesy Visual DX ©PVernon2021 Differential Diagnosis Pyogenic Granuloma •Cherry Hemangioma •Rapidly growing •Aplastic Large Cell vascular lesion Lymphoma •Friable, prone to •Cutaneous bleeding Melanoma •Often as a result of •Pyogenic Granuloma trauma •BCC •Spitz Nevus ©PVernon2021 ©PVernon2021 3 Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2 Treatment Pyogenic Granuloma 23 Year Old Male •Small lesions may •Malodorous feet spontaneously •Works as chef regress •Feet moist, peeling, •Excision with pitted on weight- Pathology bearing surfaces •Cautery, electrodessiccation •Vascular laser for recurrent lesions ©PVernon2021 ©PVernon2021 Pitted Keratolysis Treatment • Superficial bacterial infection of the soles of the foot, lateral toes, occasionally palms • Remove environment, • Asymptomatic erythematous promote dryness plaques and circular shallow pits • 20% aluminum chloride on weight-bearing areas; occasionally painful (Drysol) BID • Often misdiagnosed as tinea • Alcohol-based benzoyl • Hyperhidrosis, moist socks, peroxide humid environment, occlusive • Topical erythromycin or shoes and prolonged immersion clindamycin in water are predisposing factors • OTC: Carpe ©PVernon2021 ©PVernon2021 31 YEAR OLD MALE DIFFERENTIAL DIAGNOSIS •Two day history pruritic, tender papules and vesicles •Rocky Mountain Spotted Fever •Recent camping trip •Recent fever, headache, •Lyme Disease lethargy, “flu symptoms” •Varicella •Developed rash on trunk day two •Day three increased lesions spreading to entire body with increased lethargy and fever ©PVernon2021 ©PVernon2021 4 Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2 Rocky Mountain Spotted Fever RMSF •Rash appears 2-5 days •2-4 days after after onset of symptoms infected tick bite •Macular, erythematous •Fever •Begins on extremities, •Headache spreads to trunk •Nausea, Vomiting •Petechiae appear on •Abdominal pain sixth day or later Photo Courtesy Visual DX •Muscle pain Photo Courtesy Visual DX ©PVernon2021 ©PVernon2021 Lyme Disease Varicella •Fever •Prodrome nausea, •Headache anorexia, myalgias, •Fatigue headache •Rash at site of tick bite •Vesicles and pustules • circular outwardly •Begins on head and expanding rash trunk, spreads to (erythema migrans) extremities • innermost portion dark red, indurated •Lesions at various (bull’s eye) stages of healing ©PVernon2021 Photo Courtesy Visual DX ©PVernon2021 58 Year Old Female VARICELLA TREATMENT •Annual Skin Exam •Valcyclovir(Valtrex) 1 gm TID x 7 days •Lesion on posterior L •Famcyclovir(Famvir) 500 mg q8h x 7 days shoulder, scapula, axilla, •Acyclovir(Zovirax) 800 mg qid x 5 days neck, extending to anterior L upper chest •Symptomatic care and L upper arm •IMMUNIZE •Present since early childhood •Increased slightly in size during teen years •No problems with lesion © pvernon2009 ©PVernon2021 ©PVernon2021 5 Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2 ILVEN ILVEN Differential Diagnosis •Inflammatory linear verrucous epidermal nevus (ILVEN) •Linear psoriasis •Erythematous, hyperkeratotic •Linear porokeratosis plaques following lines of • Blaschko Lichen striatus •ILVEN may represent mosaic •Warts inflammatory disorder similar to linear psoriasis and linear lichen planus © pvernon2009 •Usually appear in early childhood ©PVernon2021 ©PVernon2021 ILVEN Treatment 6 month old male •Difficult to manage •Large congenital lesion with topical therapy •Increasing in size with •CO2 laser growth •Full-thickness •Lesion crosses mid-line excision © pvernon2008 © pvernon2009 ©PVernon2021 ©PVernon2021 Congenital Hairy Nevus Lie in the distribution of a dermatome Vary in size to cover large areas Uneven pigment brownblack 95% have hairy component Numerous pigmented nevi co-exist in lesion Consult neurology if lesion is large or crosses the midline © pvernon2008 ©PVernon2021 ©PVernon2021 © pvernon2015 6 Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2 21 Year old Female •Nevus on dorsal foot •Tattoo in and around •Present since lesion 5 years ago childhood •Lesion has always •Recently increasing been cosmetically in size bothersome; patient thought tattoo •Developing red ring would help around lesion © pvernon2009 © pvernon2009 ©PVernon2021 ©PVernon2021 Dysplastic nevi Dysplastic Nevi Treatment • Clinically atypical with size, • Grading: symmetry, color, and/or borders –Mild: Observe, annual exam • Usually benign –Moderate: Conservative excision, annual exam • Appear in childhood through early adulthood –Severe: Excision 5 mm margins, annual exam • More common in Fitzpatrick I-III • Biopsy of changing nevi • Increased risk of melanoma in patients with multiple dysplastic • Annual Skin Exam nevi • Self Exams • Current evidence does not © pvernon2002 support dysplastic nevus as • Sunscreen premalignant lesion • Protective clothing ©PVernon2021 ©PVernon2021 10 year old female Differential Diagnosis •Developed blisters and •Atopic Dermatitis itching on legs and •Burns hands while on •Contact Dermatitis vacation •Child Abuse •Lesions have not spread •Phytophoto • Slight itching Dermatitis ©Pvernon 2009 ©Pvernon 2009 ©PVernon2021 ©PVernon2021 7 Dermatology Conundrums Peggy Vernon, RN, MA, CPNP, DCNP, FAANP Pre 2 Phytophoto Dermatitis Phytophoto Dermatitis Causes •Redness and blisters in bizarre shapes •Citrus and Lime found in drinks and food •Exposure to plants, • Figs especially those in celery, • Celery citrus, and grass family •Lemon and Lime oil •Plants produce psoralen •Queen Anne’s lace on the skin • Giant Russian hogweed • Exposure to sunlight • Bergapten produces photodermatitis with blister formation, • Component of bergamot oil followed by intense • Found in cosmetics, perfumes, lotions, stimulation of melanin sunscreens and household products ©PVernon2021 ©PVernon2021 Workup Treatment • Clinical suspicion •Remove offending substance •Photopatch test if photoallergy suspected: •No treatment necessary if asymptomatic • Occlusive application of test chemical(s) •Topical corticosteroids if pruritic • Irradiation with UV light at several intervals • Phototoxicity: controls positive •Analgesics • Photoallergy: controls negative •Sunscreen •Treat resulting PIH ©PVernon2021 ©PVernon2021 Differential Diagnosis 8 year old female •Herpes simplex •Developed red,
Load more

Recommended publications
  • Where Does Psoriasis Fit
    Dr Shan Edwards Dermatologist Dermatology Clinic, Christchurch 11:00 - 11:55 WS #86: Differential Diagnosis Based on Classic Location - Where Does Psoriasis Fit In? 12:05 - 13:00 WS #97: Differential Diagnosis Based on Classic Location - Where Does Psoriasis Fit In? (Repeated) Differential diagnosis based on classic location Where does psoriasis fit in? Dr Shan Edwards , dermatologist Christchurch 2016 2 Conflict statement . This talk sponsored by LEO Pharma Pty Ltd . I have no other association financial or otherwise with LEO Pharma Pty Ltd 3 Acknowedgement I wish to thank and acknowledge and thank A/Prof Amanda Oakley for providing a lot of the material and allowing me to use it in this talk I would also like to acknowledge Dermnet NZ as a source for most of my clinical slides 4 How do you diagnose red scaly skin ? Take a history (90% diagnosis made on history) . When did scaly rash first appear? . What do you think caused it? . What treatments used and their effects? . Personal history of skin problems ? . Family history of similar disorders? . Occupation, hobbies, other life events? . Symptoms: itch? Other eg fever, weightloss unwell Other medical problems?(co-morbidities) . Current medicines : how long, any new ? 7 When did scaly rash first appear? . Infancy: seborrhoeic dermatitis/eczema . Toddler: atopic dermatitis/eczema . Pre-schooler/primary school: tinea capitis/corporis . Primary school: head lice . Teenage/adult: seborrhoeic dermatitis/eczema, psoriasis . Adult/elderly: drug rash, lymphoma, other less common skin conditions(PRP,Lupus) . All age groups:scabies 8 Dear Shan Re: Miss EM age 7yrs I am completely puzzled by EM’s rash and particularly so since there now appear to be other areas of her body being affected by it.
    [Show full text]
  • Il-23, a Novel Marker in the Diagnosis of Psoriasis
    IL-23, A NOVEL MARKER IN THE DIAGNOSIS OF PSORIASIS Dissertation submitted to The Tamilnadu Dr.MGR Medical University In partial fulfillment of the regulations for the award of the degree of M.D.BIOCHEMISTRY Branch XIII DEPARTMENT OF BIOCHEMISTRY KILPAUK MEDICAL COLLEGE CHENNAI - 600010. THE TAMILNADU DR.MGR MEDICAL UNIVERSITY CHENNAI-600032 APRIL-2017 CERTIFICATE This to certify that the dissertation entitled “IL-23, A NOVEL MARKER IN THE DIAGNOSIS OF PSORIASIS”- A CASE CONTROL STUDY is the bonafide original work done by DR.G.EZHIL, Post graduate in Biochemistry under overall supervision and guidance in the Department of Biochemistry, Kilpauk Medical College, Chennai, in partial fulfillment of the regulations of The Tamilnadu Dr. M.G.R . Medical University for the award of M.D. Degree in Biochemistry (Branch XIII) Dr. NARAYANA BABU., M.D.DCH Dr . V. MEERA,M.D DEAN, PROFESSOR & HEAD, Kilpauk Medical College, Department of Biochemistry, Chennai – 600010. Kilpauk Medical College, Chennai – 600010 Date : Date: Station: Station: DECLARATION I solemnly declare that this dissertation entitled “IL-23, A NOVEL MARKER IN THE DIAGNOSIS OF PSORIASIS”- A CASE CONTROL STUDY was written by me in the Department of Biochemistry, Kilpauk Medical College, Chennai, under the guidance and supervision of Prof. DR.V.MEERA,M.D., Professor & HOD, Department of Biochemistry & Kilpauk Medical College, Chennai – 600010. This dissertation is submitted to THE TAMILNADU Dr.M.G.R MEDICAL UNIVERSITY Chennai, in partial fulfillment of the university regulations for the award of DEGREE OF M.DBIOCHEMISTRY(BRANCH - XIII) examinations to be held in APRIL – 2017. Date : Place : Chennai Dr.G.EZHIL ACKNOWLEDGEMENT “Gratitude is the humble gift, I can give to my beloved Teachers”.
    [Show full text]
  • General Dermatology an Atlas of Diagnosis and Management 2007
    An Atlas of Diagnosis and Management GENERAL DERMATOLOGY John SC English, FRCP Department of Dermatology Queen's Medical Centre Nottingham University Hospitals NHS Trust Nottingham, UK CLINICAL PUBLISHING OXFORD Clinical Publishing An imprint of Atlas Medical Publishing Ltd Oxford Centre for Innovation Mill Street, Oxford OX2 0JX, UK tel: +44 1865 811116 fax: +44 1865 251550 email: [email protected] web: www.clinicalpublishing.co.uk Distributed in USA and Canada by: Clinical Publishing 30 Amberwood Parkway Ashland OH 44805 USA tel: 800-247-6553 (toll free within US and Canada) fax: 419-281-6883 email: [email protected] Distributed in UK and Rest of World by: Marston Book Services Ltd PO Box 269 Abingdon Oxon OX14 4YN UK tel: +44 1235 465500 fax: +44 1235 465555 email: [email protected] © Atlas Medical Publishing Ltd 2007 First published 2007 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Clinical Publishing or Atlas Medical Publishing Ltd. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. A catalogue record of this book is available from the British Library ISBN-13 978 1 904392 76 7 Electronic ISBN 978 1 84692 568 9 The publisher makes no representation, express or implied, that the dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations.
    [Show full text]
  • Scaly Scalp in Different Dermatological Diseases: a Scanning and Transmission Electron Microscopical Study
    N ature and Science 2010;8(12) Nature and Science 2010;8(12) Scaly Scalp in Different Dermatological Diseases: A Scanning and Transmission Electron Microscopical study. Amr A. Rateb1, Wafaa E. Abdel-Aal2, Nermeen M. Shaffie2,. Sobhi RM1 and Faisal N. Mohammed3 1- Dermatology Department, Kasr El-Einy, Faculty of Medicine, Cairo University, Egypt. 2- Pathology Department, Medical Research Division, National Research Center, Cairo, Egypt 3- Dermatology Department, Medical Research Division, National Research Center, Cairo, 12622, Egypt. [email protected] Abstract: Scanning electron microscope (SEM) and Transmission electron microscope (TEM) examination of the scales in different scaly scalp disorders reveal the importance of alteration in the stratum corneum in the diagnosis of these disorders. Each disease has its own characteristic scale features that are distinguished from other scaly disorders. Specimens from 20 patients with different scaly scalp conditions were randomly taken and examined by both SEM and TEM. Each scaly scalp disorder expressed its characteristic SEM and TEM findings. These findings may pave the way for further understanding of the differences between scaly scalp disorders that may look alike or slightly different in their clinical presentation. [Nature and Science 2010;8(12):61-69] (ISSN: 1545-0740). Key words: scanning EM – transmission EM – epidermis – corneum – psoriasis – seborrheic dermatitis – tinea capitis – dandruff – pityriasis rubra pylaris. 1. Introduction: and pathogenic hypotheses in the dermatoses of the Scales are dry or greasy laminated masses of scalp. keratin. The body is constantly shedding In scalp psoriasis, lesions are often discrete imperceptible tiny thin fragments of stratum corneum. nummular plaques that may be thickened and pruritic.
    [Show full text]
  • Pityriasis Amiantacea : a Reaction Pattern of the Scalp in Psoriatic Patient
    Case Report Northern International Medical College Journal Pityriasis amiantacea : A reaction pattern of the scalp in psoriatic patient I Bhuiyan1, M S Hossain2, M M Rahman3, Y Joarder4 Introduction Case Report Tinea amiantacea or pityriasis amiantacea In 21th April, 2015, a 27 years old, unmarried, (asbestos- like tinea) is a disease of scalp with hotelboy, working at Maldives presented to the heavy scales extend on to the hairs and Department of Dermatology and Venereology, separate and bind together their proximal Shaheed Suhrawardi Medical College Hospital, portions.1 The process may be only slightly Dhaka, Bangladesh with 3 months history of inflammatory with dry silvery, micaceous scales, thick, slightly foul smelly, adherent scales that overlying like the tiles on a roof1,2, adhere to the surround and bound down the tufts of hair scalp or markedly inflammatory with admixture involving the entire scalp. Patient also complaints of crusts.1 of numerous well circumscribed,dry, silvery, thick scaly plaques of various size and shapes situated 1 According to the Alibert, inventor of the name of Dr. Ishrat Bhuiyan over the extensor aspects of lower extremities the condition, there is an early moist stage, MBBS, DDV, FCPS and back for last 9 months. This patient was also followed by drier one.1 Removal of this scales Assistant Professor suffering from fine powdery scaly, slightly pruritic Dept. of Dermatology & Venereology reveals erythematous, edematous epidermis.1,2 lesions on the scalp for last 6 months. Shaheed Suhrawardi Medical The disease may be localized or diffuse.1,2,3 It is College and Hospital He stated that he was in Maldives for last 3 a chronic condition, but curable.1 2 years.
    [Show full text]
  • Pityriasis Amiantacea: a Study of Seven Cases*
    COMMUNICATION 694 s Pityriasis amiantacea: a study of seven cases* Gustavo Moreira Amorim1 Nurimar Conceição Fernandes1 DOI: http://dx.doi.org/10.1590/abd1806-4841.20164951 Abstract: Pityriasis amiantacea was first described in 1832. The disease may be secondary to any skin condition that primarily affects the scalp, including seborrheic dermatitis. Its pathogenesis remains uncertain. We aim to analyze the epidemiological and clinical profiles of patients with pityriasis amiantacea to better understand treatment responses. We identified seven cases of pityriasis amiantacea and a female predominance in a sample of 63 pediatric patients with seborrheic dermatitis followed for an average of 20.4 months. We reported a mean age of 5.9 years. Five patients were female, with a mean age of 9 years. All patients were successfully treated with topic ketoconazole. Keywords: Dermatitis, seborrheic; Pityriasis; Tinea Pityriasis amiantacea (PA) can be described as an exagger- obtained through a review of medical records. Inclusion criteria for ated inflammatory response pattern that affects the scalp, secondary seborrheic dermatitis were: erythema and scaling of the scalp, with to any dermatitis that may affect that region. It was first described or without advancement to the retroauricular regions; presence or by Alibert in 1832 as a condition characterized by thick silvery or absence of erythematous scaly lesions in other seborrheic areas; and yellowish scales, resembling asbestos fibers, strongly adhered to absence of atopic eczematous lesions or psoriasis. Inclusion criteria tufts of hair.1 Frequency data for the disease are scarce in the lit- for pityriasis amiantacea were silvery or yellowish scales encircling erature and its etiopathogenesis remains unclear.
    [Show full text]
  • A Deep Learning System for Differential Diagnosis of Skin Diseases
    A deep learning system for differential diagnosis of skin diseases 1 1 1 1 1 1,2 † Yuan Liu ,​ Ayush Jain ,​ Clara Eng ,​ David H. Way ,​ Kang Lee ,​ Peggy Bui ,​ Kimberly Kanada ,​ ​ ​ ‡ ​ 1​ ​ 1 ​ 1 ​ Guilherme de Oliveira Marinho ,​ Jessica Gallegos ,​ Sara Gabriele ,​ Vishakha Gupta ,​ Nalini 1,3,§ 1 ​ ​ 4 ​ 1 ​ ​ 1 Singh ,​ Vivek Natarajan ,​ Rainer Hofmann-Wellenhof ,​ Greg S. Corrado ,​ Lily H. Peng ,​ Dale ​ ​ 1 1 ​ † 1, ​ 1, ​ 1, ​ R. Webster ,​ Dennis Ai ,​ Susan Huang ,​ Yun Liu *​ , R. Carter Dunn *​ *, David Coz *​ * ​ ​ ​ ​ ​ ​ Affiliations: 1 G​ oogle Health, Palo Alto, CA, USA 2 U​ niversity of California, San Francisco, CA, USA 3 M​ assachusetts Institute of Technology, Cambridge, MA, USA 4 M​ edical University of Graz, Graz, Austria † W​ ork done at Google Health via Advanced Clinical. ‡ W​ ork done at Google Health via Adecco Staffing. § W​ ork done at Google Health. *Corresponding author: [email protected] **These authors contributed equally to this work. Abstract Skin and subcutaneous conditions affect an estimated 1.9 billion people at any given time and remain the fourth leading cause of non-fatal disease burden worldwide. Access to dermatology care is limited due to a shortage of dermatologists, causing long wait times and leading patients to seek dermatologic care from general practitioners. However, the diagnostic accuracy of general practitioners has been reported to be only 0.24-0.70 (compared to 0.77-0.96 for dermatologists), resulting in over- and ​ ​ ​ ​ ​ ​ ​ under-referrals, delays in care, and errors in diagnosis and treatment. In this paper, we developed a deep learning system (DLS) to provide a differential diagnosis of skin conditions for clinical cases (skin photographs and associated medical histories).
    [Show full text]
  • 86A1bedb377096cf412d7e5f593
    Contents Gray..................................................................................... Section: Introduction and Diagnosis 1 Introduction to Skin Biology ̈ 1 2 Dermatologic Diagnosis ̈ 16 3 Other Diagnostic Methods ̈ 39 .....................................................................................Blue Section: Dermatologic Diseases 4 Viral Diseases ̈ 53 5 Bacterial Diseases ̈ 73 6 Fungal Diseases ̈ 106 7 Other Infectious Diseases ̈ 122 8 Sexually Transmitted Diseases ̈ 134 9 HIV Infection and AIDS ̈ 155 10 Allergic Diseases ̈ 166 11 Drug Reactions ̈ 179 12 Dermatitis ̈ 190 13 Collagen–Vascular Disorders ̈ 203 14 Autoimmune Bullous Diseases ̈ 229 15 Purpura and Vasculitis ̈ 245 16 Papulosquamous Disorders ̈ 262 17 Granulomatous and Necrobiotic Disorders ̈ 290 18 Dermatoses Caused by Physical and Chemical Agents ̈ 295 19 Metabolic Diseases ̈ 310 20 Pruritus and Prurigo ̈ 328 21 Genodermatoses ̈ 332 22 Disorders of Pigmentation ̈ 371 23 Melanocytic Tumors ̈ 384 24 Cysts and Epidermal Tumors ̈ 407 25 Adnexal Tumors ̈ 424 26 Soft Tissue Tumors ̈ 438 27 Other Cutaneous Tumors ̈ 465 28 Cutaneous Lymphomas and Leukemia ̈ 471 29 Paraneoplastic Disorders ̈ 485 30 Diseases of the Lips and Oral Mucosa ̈ 489 31 Diseases of the Hairs and Scalp ̈ 495 32 Diseases of the Nails ̈ 518 33 Disorders of Sweat Glands ̈ 528 34 Diseases of Sebaceous Glands ̈ 530 35 Diseases of Subcutaneous Fat ̈ 538 36 Anogenital Diseases ̈ 543 37 Phlebology ̈ 552 38 Occupational Dermatoses ̈ 565 39 Skin Diseases in Different Age Groups ̈ 569 40 Psychodermatology
    [Show full text]
  • Annotation Psoriasis in Childhood
    Archives ofDisease in Childhood 1992; 67: 75-76 75 Annotation Arch Dis Child: first published as 10.1136/adc.67.1.75 on 1 January 1992. Downloaded from Psoriasis in childhood Psoriasis is a common probably polygenically determined or coal tar solution 2% in emulsifying ointment are papulosquamous skin disorder of unknown cause. An recommended for guttate psoriasis. Coal tar preparations association has been found with the HLA antigen HLA- are useful for psoriasis vulgaris and scalp psoriasis. Sunlight CW6. The risk for first degree relatives of an isolated case is and ultraviolet light B have a beneficial effect in chronic at least 10% but children of two psoriatic parents have psoriasis in most individuals but are contraindicated in around a 50% risk ofbeing affected.' It affects approximately acute guttate or other acute psoriasis. 2% of the population of Europe and North America and is A common time honoured regimen for plaque psoriasis is more common in white people. In childhood it is more a tar bath followed by exposure to ultraviolet light B and common in girls. In a 1988 survey I found 31% of adult then application of dithranol in Lassar's zinc paste with psoriatic patient remembered an onset before the age of 16 salicylic acid. Dithranol may irritate the skin and treatment but in Scandinavia the figure is 45%.2 Ten per cent ofa large should start with a low concentration. Patients/parents American sample had an onset before the age of 10 years.3 should be informed of the temporary brown skin staining Farber et al re-examined nine children with psoriasis in dithranol produces.
    [Show full text]
  • Topographic Differential Diagnosis of Chronic Plaque Psoriasis
    Journal of Clinical Medicine Review Topographic Differential Diagnosis of Chronic Plaque Psoriasis: Challenges and Tricks Paolo Gisondi * , Francesco Bellinato and Giampiero Girolomoni Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37129 Verona, Italy; [email protected] (F.B.); [email protected] (G.G.) * Correspondence: [email protected] Received: 29 September 2020; Accepted: 5 November 2020; Published: 8 November 2020 Abstract: Background: Psoriasis is an inflammatory skin disease presenting with erythematous and desquamative plaques with sharply demarcated margins, usually localized on extensor surface areas. Objective: To describe the common differential diagnosis of plaque psoriasis classified according to its topography in the scalp, trunk, extremities, folds (i.e., inverse), genital, palmoplantar, nail, and erythrodermic psoriasis. Methods: A narrative review based on an electronic database was performed including reviews and original articles published until 1 September 2020, assessing the clinical presentations and differential diagnosis for psoriasis. Results: Several differential diagnoses could be considered with other inflammatory, infectious, and/or neoplastic disorders. Topographical differential diagnosis may include seborrheic dermatitis, tinea capitis, lichen planopilaris in the scalp; lupus erythematosus, dermatomyositis, cutaneous T-cell lymphomas, atopic dermatitis, syphilis, tinea corporis, pityriasis rubra pilaris in the trunk and arms; infectious intertrigo in the inguinal and intergluteal folds and eczema and palmoplantar keratoderma in the palms and soles. Conclusions: Diagnosis of psoriasis is usually straightforward but may at times be difficult and challenging. Skin cultures for dermatophytes and/or skin biopsy for histological examination could be required for diagnostic confirmation of plaque psoriasis. Keywords: psoriasis; plaque psoriasis; differential diagnosis; diagnosis; papulosquamous lesions 1.
    [Show full text]
  • Mallory Prelims 27/1/05 1:16 Pm Page I
    Mallory Prelims 27/1/05 1:16 pm Page i Illustrated Manual of Pediatric Dermatology Mallory Prelims 27/1/05 1:16 pm Page ii Mallory Prelims 27/1/05 1:16 pm Page iii Illustrated Manual of Pediatric Dermatology Diagnosis and Management Susan Bayliss Mallory MD Professor of Internal Medicine/Division of Dermatology and Department of Pediatrics Washington University School of Medicine Director, Pediatric Dermatology St. Louis Children’s Hospital St. Louis, Missouri, USA Alanna Bree MD St. Louis University Director, Pediatric Dermatology Cardinal Glennon Children’s Hospital St. Louis, Missouri, USA Peggy Chern MD Department of Internal Medicine/Division of Dermatology and Department of Pediatrics Washington University School of Medicine St. Louis, Missouri, USA Mallory Prelims 27/1/05 1:16 pm Page iv © 2005 Taylor & Francis, an imprint of the Taylor & Francis Group First published in the United Kingdom in 2005 by Taylor & Francis, an imprint of the Taylor & Francis Group, 2 Park Square, Milton Park Abingdon, Oxon OX14 4RN, UK Tel: +44 (0) 20 7017 6000 Fax: +44 (0) 20 7017 6699 Website: www.tandf.co.uk All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention.
    [Show full text]
  • Scales on the Scalp Jamil A, Muthupalaniappen L Jamil A, Muthupalaniappen L
    TEST YOUR KNOWLEDGE Scales on the scalp Jamil A, Muthupalaniappen L Jamil A, Muthupalaniappen L. Scales on the scalp. Malaysian Family Physician 2013;8(1):48-9 Keywords: Case History pityriasis amiantacea, psoriasis, tinea capitis, seborrhoeic A five-year-old boy presented with a six-week history of scales, flaking and crusting of the scalp. He dermatitis. had mild pruritus but no pain. He did not have a history of atopy and there were no pets at home. Examination of the scalp showed thick, yellowish dry crusts on the vertex and parietal areas and Authors: the hair was adhered to the scalp in clumps. There was non-scarring alopecia and mild erythema Adawiyah Jamil, (Figure 1 & 2). There was no cervical or occipital lymphadenopathy. The patient’s nails and skin in AdvMDerm other parts of the body were normal. (Corresponding author) Medical Department, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Question Tel: +60391456074 Fax: +60391456679 Email: adda_jamil@ 1. What is the most likely diagnosis? yahoo.com Leelavathi 2. What are the associated conditions? Muthupalaniappen, MMed 3. What investigations are indicated? Department of Family Medicine Universiti Kebangsaan 4. What is the treatment for this condition? Malaysia Medical Center, Kuala Lumpur, Malaysia Figure 1 Answer 1. Tinea amiantacea. 2. Scalp psoriasis, seborrhoeic dermatitis, tinea capitis, pyogenic infections and lichen planus. 3. Wood’s lamp examination, potassium hydroxide examination and culture of hair with crust to exclude fungal infection. Figure 2 4. Keratolytics for isolated tinea amiantacea, Figure 1 & 2. topical steroids in patients with associated Thick scales on the scalp which are adherent to the proximal part of the hair shaft and binding tufts of hair.
    [Show full text]