Clinical Companions

Thieme Clinical Companions Dermatology

Bearbeitet von Wolfram Sterry, Ralf Paus, Walter Burgdorf

1. Auflage 2006. Buch. Hardcover ISBN 978 3 13 135911 7 Format (B x L): 11 x 18 cm

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Contents

Gray...... Section: Introduction and Diagnosis Contents 1 Introduction to Skin Biology ̈ 1 1.1 Overview ̈ 1 1.2 Functional Anatomy ̈ 1 1.3 Epidermis ̈ 5 1.4 Hair ̈ 7 1.5 Basement Membrane Zone ̈ 8 1.6 Dermis ̈ 9 1.7 Subcutis ̈ 10 1.8 Neuroendocrine-immune Networking ̈ 11 1.9 Outlook ̈ 12

2 Dermatologic Diagnosis ̈ 16 2.1 Components of the Dermatologic Evaluation ̈ 16 2.2 Description of Skin Findings ̈ 16 2.3 Primary and Secondary Lesions ̈ 17 2.4 Additional Descriptive Terms ̈ 18 2.5 Tools of the Trade ̈ 22 2.6 History ̈ 24 2.7 Histologic Diagnosis ̈ 25 2.8 Molecular Diagnostics ̈ 32 2.9 Mycologic Diagnosis ̈ 33 2.10 Diagnosis of Hair Disorders ̈ 34

3 Other Diagnostic Methods ̈ 39 3.1 Phlebologic Diagnosis ̈ 39 3.2 Allergy Testing ̈ 43 3.3 Light Testing ̈ 49 3.4 Ultrasonography ̈ 51

...... Blue Section: Dermatologic Diseases

4 Viral Diseases ̈ 53 4.1 Overview (Table 4.1) ̈ 53 4.2 Poxvirus Infections ̈ 54 4.3 Herpesvirus Infections ̈ 57 4.4 Picornavirus Infections ̈ 65 4.5 Cutaneous Manifestations of Hepatitis Virus Infections ̈ 66 4.6 Human Papillomaviruses ̈ 67

5 Bacterial Diseases ̈ 73 5.1 Introduction ̈ 73 5.2 Gram-positive Bacteria: Staphylococci ̈ 74 5.3 Gram-positive Bacteria: Streptococci ̈ 77 5.4 Gram-positive Bacteria: Corynebacteria ̈ 83 5.5 Gram-negative Bacterial Infections ̈ 85 5.6 Miscellaneous Bacterial Infections ̈ 88

. VII . Sterry, Paus, Burgdorf, Dermatology (ISBN 3131359110), ᮊ 2006 Georg Thieme Verlag . . Contents

5.7 Zoonotic Infections ̈ 89 5.8 Borreliosis ̈ 92 5.9 Mycobacterial Infections: Tuberculosis ̈ 96 5.10 Mycobacterial Infections: Leprosy ̈ 101 Contents 5.11 Atypical Mycobacterial Infections ̈ 103 5.12 Actinomycosis ̈ 104 5.13 Nocardiosis ̈ 105

6 Fungal Diseases ̈ 106 6.1 Nomenclature ̈ 106 6.2 Dermatophytes ̈ 106 6.3 Yeasts ̈ 112 6.4 Subcutaneous Mycoses ̈ 117 6.5 Systemic Mycoses ̈ 118

7 Other Infectious Diseases ̈ 122 7.1 Leishmaniasis ̈ 122 7.2 Other Protozoan Infections ̈ 125 7.3 Pediculosis ̈ 126 7.4 Scabies ̈ 127 7.5 Other Epizoonoses ̈ 130 7.6 Worms ̈ 131

8 Sexually Transmitted Diseases ̈ 134 8.1 Overview ̈ 134 8.2 Syphilis ̈ 135 8.3 Endemic Treponematoses ̈ 145 8.4 Gonorrhea ̈ 146 8.5 Other Sexually Transmitted Diseases ̈ 149

9 HIV Infection and AIDS ̈ 155 9.1 Overview ̈ 155 9.2 Cutaneous Manifestations ̈ 157 9.3 Extracutaneous Manifestations ̈ 161

10 Allergic Diseases ̈ 166 10.1 Basic Mechanisms ̈ 166 10.2 Urticaria ̈ 167 10.3 Angioedema ̈ 173 10.4 Food Allergies ̈ 174 10.5 Other Allergic Diseases ̈ 176 10.6 Hyposensitization ̈ 176

11 Drug Reactions ̈ 179 11.1 Overview ̈ 179 11.2 Common Reactions ̈ 182 11.3 Severe Skin Reactions ̈ 184 11.4 Uncommon Reactions ̈ 186 11.5 DrugPseudoallergies ̈ 188

12 ̈ 190 12.1 ̈ 190 12.2 Syndromes Associated with Atopic Dermatitis ̈ 194 . . VIII Sterry, Paus, Burgdorf, Dermatology (ISBN 3131359110), ᮊ 2006 Georg Thieme Verlag . Contents .

12.3 Contact Dermatitis ̈ 195 12.4 Other Forms of Dermatitis ̈ 200

13 Collagen–Vascular Disorders ̈ 203 13.1 Classification and Overview ̈ 203 Contents 13.2 Lupus Erythematosus (LE) ̈ 204 13.3 Dermatomyositis and Polymyositis ̈ 213 13.4 Morphea ̈ 216 13.5 ̈ 217 13.6 Systemic Sclerosis ̈ 219 13.7 Pseudoscleroderma ̈ 222 13.8 Mixed Collagen–Vascular Disease ̈ 223 13.9 Other Rheumatoid Diseases ̈ 224 13.10 Raynaud Syndrome ̈ 226 13.11 Graft-Versus-Host Disease (GVHD) ̈ 227

14 Autoimmune Bullous Diseases ̈ 229 14.1 Classification ̈ 229 14.2 Pemphigus Group ̈ 229 14.3 Pemphigoid Group ̈ 235 14.4 Subepidermal IgA-mediated Disorders ̈ 240 14.5 Dermatitis Herpetiformis ̈ 241 14.6 Overview of Diagnostic Approach ̈ 243

15 Purpura and Vasculitis ̈ 245 15.1 Overview ̈ 245 15.2 Purpura ̈ 245 15.3 Cutaneous Vasculitis ̈ 247 15.4 Variants of Cutaneous Vasculitis ̈ 249 15.5 Systemic Vasculitis ̈ 252 15.6 Livedo ̈ 258 15.7 Vessel Occlusion and Cutaneous Necrosis ̈ 260

16 Papulosquamous Disorders ̈ 262 16.1 ̈ 262 16.2 ̈ 273 16.3 Reiter Syndrome ̈ 275 16.4 Seborrheic Dermatitis ̈ 276 16.5 Amiantacea ̈ 277 16.6 ̈ 278 16.7 ̈ 279 16.8 Small-Patch ̈ 280 16.9 Erythema Multiforme ̈ 281 16.10 ̈ 282 16.11 Figurate Erythemas ̈ 285 16.12 Lichenoid Dermatitis ̈ 286

17 Granulomatous and Necrobiotic Disorders ̈ 290 17.1 Granulomatous Disorders ̈ 290 17.2 Necrobiotic Disorders ̈ 292

18 DermatosesCausedbyPhysicalandChemicalAgents̈ 295 18.1 Photodermatoses ̈ 295 . IX . Sterry, Paus, Burgdorf, Dermatology (ISBN 3131359110), ᮊ 2006 Georg Thieme Verlag . . Contents

18.2 Light-induced Aging and Photocarcinogenesis ̈ 303 18.3 Photosensitive Genodermatoses ̈ 304 18.4 Diseases Caused by Cryoproteins ̈ 307 18.5 Disease Caused by Cold ̈ 309 Contents

19 Metabolic Diseases ̈ 310 19.1 Porphyrias ̈ 310 19.2 Disorders of Lipid Metabolism ̈ 314 19.3 Disorders of Amino Acid Metabolism ̈ 315 19.4 Disorders of Mineral Metabolism ̈ 316 19.5 Endocrine Disorders ̈ 317 19.6 Mucinoses ̈ 320 19.7 Cutaneous Signs of Monoclonal Gammopathy ̈ 321 19.8 Gout ̈ 322 19.9 Amyloidosis ̈ 322 19.10 Smokingand the Skin ̈ 326

20 Pruritus and Prurigo ̈ 328 20.1 Pruritus ̈ 328 20.2 Prurigo ̈ 329

21 Genodermatoses ̈ 332 21.1 MIM Code ̈ 332 21.2 The Ichthyoses ̈ 332 21.3 Other Keratinization Disorders ̈ 340 21.4 Palmoplantar Keratoderma ̈ 345 21.5 Linear or Striped Lesions ̈ 348 21.6 Ectodermal Dysplasias ̈ 351 21.7 Epidermolysis Bullosa (EB) ̈ 351 21.8 Diseases of Connective Tissue ̈ 354 21.9 PerforatingDermatoses ̈ 359 21.10 Poikiloderma ̈ 360 21.11 Neurofibromatoses ̈ 361 21.12 Tuberous Sclerosis ̈ 365 21.13 Cancer-associated Genodermatoses ̈ 366

22 Disorders of Pigmentation ̈ 371 22.1 Overview ̈ 371 22.2 Hypopigmentation ̈ 372 22.3 Brown Hyperpigmentation ̈ 378 22.4 Blue and Gray Hyperpigmentation ̈ 380 22.5 Reticular Hyperpigmentation and Dyschromatosis ̈ 383

23 Melanocytic Tumors ̈ 384 23.1 Benign Melanocytic Tumors ̈ 384 23.2 Lentigenes ̈ 384 23.3 Melanocytic Nevi ̈ 385 23.4 Malignant Melanoma ̈ 393

24 Cysts and Epidermal Tumors ̈ 407 24.1 Cysts ̈ 407 24.2 Epidermal and Organoid Nevi ̈ 410 24.3 Benign Epidermal Tumors ̈ 414 . . X Sterry, Paus, Burgdorf, Dermatology (ISBN 3131359110), ᮊ 2006 Georg Thieme Verlag . Contents .

24.4 Carcinoma in situ ̈ 417 24.5 Malignant Epidermal Tumors ̈ 419

25 Adnexal Tumors ̈ 424 25.1 Overview ̈ 424 Contents 25.2 Benign Tumors with Eccrine Differentiation ̈ 424 25.3 Benign Tumors with Apocrine Differentiation ̈ 427 25.4 Benign Tumors with Sebaceous Differentiation ̈ 429 25.5 Benign Tumors with Hair Follicle Differentiation ̈ 430 25.6 Malignant Adnexal Tumors ̈ 433

26 Soft Tissue Tumors ̈ 438 26.1 Connective Tissue Tumors ̈ 438 26.2 Smooth Muscle Tumors ̈ 445 26.3 Tumors of Fat ̈ 446 26.4 Vascular Malformations and Tumors ̈ 448 26.5 Neural Tumors ̈ 461

27 Other Cutaneous Tumors ̈ 465 27.1 Mast Cell Disorders ̈ 465 27.2 Histiocytoses ̈ 467

28 Cutaneous Lymphomas and Leukemia ̈ 471 28.1 Benign Lymphocytic Infiltrates ̈ 471 28.2 Primary Cutaneous Lymphomas ̈ 472 28.3 Primary Cutaneous T-cell Lymphomas ̈ 474 28.4 Primary Cutaneous B-cell Lymphomas ̈ 480 28.5 Leukemia and the Skin ̈ 483

29 Paraneoplastic Disorders ̈ 485

30 Diseases of the Lips and Oral Mucosa ̈ 489 30.1 Inflammation and Leukoplakia ̈ 489 30.2 Leukoplakia ̈ 490 30.3 Lesions of Tongue ̈ 492 30.4 Epulis ̈ 494 30.5 Aphthous Stomatitis ̈ 494

31 Diseases of the Hairs and Scalp ̈ 495 31.1 Alopecia: Overview ̈ 496 31.2 Congenital Alopecia and Hypotrichosis ̈ 498 31.3 Diffuse NonscarringAlopecia ̈ 498 31.4 Localized NonscarringAlopecia ̈ 503 31.5 ScarringAlopecia ̈ 506 31.6 Hair Shaft Anomalies ̈ 510 31.7 ̈ 513 31.8 ̈ 514 31.9 Diseases of the Scalp ̈ 516

32 Diseases of the Nails ̈ 518 32.1 Introduction ̈ 518 32.2 Congenital Nail Anomalies ̈ 519 32.3 Nail Apparatus Infections ̈ 520 32.4 Acquired Nail Changes ̈ 523 . XI . Sterry, Paus, Burgdorf, Dermatology (ISBN 3131359110), ᮊ 2006 Georg Thieme Verlag . . Contents

33 Disorders of Sweat Glands ̈ 528

34 Diseases of Sebaceous Glands ̈ 530 34.1 ̈ 530 Contents 34.2 ̈ 535 34.3 ̈ 537

35 Diseases of Subcutaneous Fat ̈ 538 35.1 Lipodystrophy and Lipoatrophy ̈ 538 35.2 Panniculitis ̈ 539

36 Anogenital Diseases ̈ 543 36.1 Anal and Perianal Diseases ̈ 543 36.2 Diseases of Male Genitalia ̈ 546 36.3 Diseases of Female Genitalia ̈ 549

37 Phlebology ̈ 552 37.1 Anatomy and Function of LegVeins ̈ 552 37.2 Varicose Veins ̈ 553 37.3 Inflammation of Veins ̈ 557 37.4 Deep Venous Thromboses ̈ 558 37.5 Stasis Dermatitis and Venous LegUlcers ̈ 560 37.6 Phlebologic Surgery ̈ 563

38 Occupational Dermatoses ̈ 565 38.1 Overview ̈ 565 38.2 Occupational Hand Dermatitis ̈ 565 38.3 Occupational Contact Urticaria ̈ 566 38.4 Other Occupational Dermatoses ̈ 567

39 Skin Diseases in Different Age Groups ̈ 569 39.1 Skin Diseases in Pregnancy ̈ 569 39.2 Dermatoses in Childhood ̈ 571 39.3 Geriatric Dermatology ̈ 576

40 Psychodermatology ̈ 579

...... Red Section: Therapy

41 Topical Therapy ̈ 583 41.1 Overview ̈ 583 41.2 Topical Antiviral Therapy ̈ 589 41.3 Topical Antibiotics ̈ 591 41.4 Dyes and Antiseptics ̈ 592 41.5 Topical Antifungal Agents ̈ 594 41.6 Topical Antiparasitic Agents ̈ 595 41.7 Topical Corticosteroids ̈ 596 41.8 Calcineurin Inhibitors ̈ 599 41.9 Vitamin D Analogues ̈ 600 41.10 Retinoids ̈ 601 41.11 Other Topical Agents ̈ 602 41.12 Sunscreens ̈ 604 . . XII Sterry, Paus, Burgdorf, Dermatology (ISBN 3131359110), ᮊ 2006 Georg Thieme Verlag . Contents .

41.13 Phototherapy ̈ 605 41.14 Photochemotherapy ̈ 607 41.15 Photodynamic Therapy ̈ 609 41.16 Balneotherapy ̈ 609 41.17 Aesthetic Dermatology ̈ 610 Contents

42 Systemic Therapy ̈ 615 42.1 Antiviral Therapy ̈ 615 42.2 Dapsone ̈ 616 42.3 Antifungal Agents ̈ 617 42.4 Antihistamines ̈ 618 42.5 Antimalarials ̈ 621 42.6 Retinoids ̈ 622 42.7 Corticosteroids ̈ 624 42.8 Immunosuppressive Agents ̈ 626 42.9 Biologicals ̈ 631 42.10 Antiemetic Therapy ̈ 631 42.11 Pain Therapy ̈ 632 42.12 Miscellaneous Agents ̈ 633 42.13 DrugInteractions ̈ 636

43 Radiation Therapy ̈ 644

44 Therapy During Pregnancy and Nursing ̈ 647

45 Operative Dermatology ̈ 651 45.1 Principles of Dermatologic Surgery ̈ 651 45.2 Basic Techniques ̈ 654 45.3 Closure Techniques ̈ 659 45.4 Other Techniques ̈ 663 45.5 Laser Therapy ̈ 666

46 Wound Healing ̈ 671

47 Dermatologic Emergencies ̈ 673

...... Purple Section

Appendix I Common Systemic Medications ̈ 681 Appendix II Favorite Compounding Recipes ̈ 689 Overview ̈ 689 Practical Approach ̈ 689

Green...... Section

Appendix III Dermatologic Differential Diagnosis ̈ 702 How to Use This Chapter ̈ 702 Differential Diagnostic Lists ̈ 702 Cutaneous Signs of Systemic Disease ̈ 730

Index ̈ 737 . XIII . Sterry, Paus, Burgdorf, Dermatology (ISBN 3131359110), ᮊ 2006 Georg Thieme Verlag