Derm&Path Halcomb.Pptx

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Dermatology/Pathology

S. Eliza Halcomb, MD

http://en.wikipedia.org/wiki/Black_tongue

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http://en.wikipedia.org/wiki/Gingival_enlargement

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Oral Discoloration

Tongue • Brown • Bromine, bismuth, arsenic, phenolpthalein, doxrubicin, quinacrine, tobacco • Vanadium • Green

• Black, Hairy • Cefoxitin, corticosteroids,lansoprazole, penicillin, sodium perborate, sodium peroxide, tetracycline • White • Chlorhexidine, phenol, caustic acids, hydrogen peroxide • Methylene blue • Blue • Bismuth, lead, mercury, copper salts, • Blue Gray Gums thallium, zinc

Fecal Discoloration

• Acetazolamide, aluminum hydroxide, • Black aminophylline,amphotericin b,barium, benzene,bismuth, bromides, charcoal,chloramphenical,chlorpropamide,clindamycin,co rticosteroids,cyclophosphamide,digitalis,feroous salts,fluoruracil,formaldehyde,halides,halothane, metals (Ag,As, Cu,Hg,Mn,Pb,Tl),hydralazine,methotrexetae,methylene blue, nitrates,NSAIDs, tetracycline,theophylline,warfarin

• Blue • Boric acid, chloramphenical, maganese dioxide, methylene blue • Yellow-green • Mercurous chloride, yellow phosphorus • Orange-red • Phenazopyridine, rifampin • Pink • Manganese dioxide, phenolthalein

Teratogens

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Teratogens

• Coumadin • Quinine: – Midface hypoplasia – Hypoplasia 8th CN • Bromides • Retinoids – Polydactyly, clubfoot – Craniofacial abnormalities • Ethanol – Absent ears – FAS • SMZ/TMP • Danazol – Neural tube defects – Pseudo-hermaphrodism • Valproate • Lithium – Spina bifida – Ebstein’s anaomaly • Mycophenolate – Cleft lip/palate – Distal limb anomalies

http://en.wikipedia.org/wiki/Fetal_alcohol_syndrome

Buehler BA et al. N Engl J Med 1990;322:1567-1572.

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http://en.wikipedia.org/wiki

http://en.wikipedia.org/wiki/ Phocomelia#mediaviewer/ File:Ears_of_phocomelia_patients. jpg

Adverse Drug Reactions – Cutaneous Manifestations

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http://en.wikipedia.org/wiki/Stevens–Johnson_syndrome

http://en.wikipedia.org/wiki/Toxic_epidermal_necrolysis

An. Bras. Dermatol. vol.87 no.4 Rio de Janeiro July/Aug. 2012

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Neurology November 10, 2009 vol. 73 no. 19 e94-e95

http://en.wikipedia.org/wiki/Coumadin_necrosis

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http://en.wikipedia.org/wiki/Mees'_lines

http://www.medicinenet.com/image-collection/melasma_picture/picture.html

http://drugline.org/img/term/gray-baby-syndrome-6642_2.jpg

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Cutaneous Manifestations

• Red Man Syndrome - Vancomycin • Grey Baby Syndrome - Chloramphenical • Blue (MetHgb): Sulfonamides, Dapsone, Primaquine, chloroquine, nitrofurans • Yellow: Dinitrophenol • Stevens-Johnson: PNC, Cephalosporins, Sulfa, nevirapine • TEN: PNC, Sulfas, nevirapine • Vesiculobullous: PNC, Rifampin, Sulfonamides, Griseofulvin • Vasculitis: Levamisole • Acute Hypersensitivity Syndrome: Sulfas, Bacitracin, Clindamycin, Lincomycin, Nitrofurazone, nevirapine • Alopecia: Selenium Sulfide