Index

Note: Figures and tables are indicated by ‘f ’and‘t’respectively.

AA. See Alopecia areata (AA) intradermal naevus, 164, 164f Anti-proliferative agents ABPI. See Ankle brachial pressure index (ABPI) junctional naevus, 164, 164f 5 fluorouracil, 214 Acanthosis nigricans (AN), 72–73, 73f spitz naevus, 165, 165f diclofenac, 214 Acitretin, 23 Actinic keratoses (AKs) imiquimod, 214 Acne conglobata, 92–93, 93f cryotherapy, 184 ingenol mebutate, 214 Acne excoriée, 92, 92f management, 173 Arterial ulcers Acne fulminans, 92–93, 93f and SCC, 172 compression bandaging, 87 Acne keloidalis nuchae, 91, 91f sun-damaged skin, 172, 172f simple/magnetic resonance angiography, 86 Acne Acute arthropathy X-ray signs, 17, 17f ATM. See Atypical mycobacteria (ATM) androgenic hormones, 90 Acute generalised pustular , 14, 16f Atopic dermatitis (AD), 1, 1f , 27, 28 causing factors, 90 Acute generalized exanthematous pustulosis Atrophie blanche, 84, 84f classic rash, dorsal hand secondary to taking (AGEP), 54, 54f Atypical mycobacteria (ATM), 102 oral isotretinoin, 94–95, 94f Addison’s disease, 193 cleansers, 93 AGA. See Androgenetic alopecia (AGA) Bacillary angiomatosis, 103, 103f , 117, 117f with closed/open comedones, 89, 90f AGEP. See Acute generalized exanthematous Bacterial folliculitis, 99–100, 100f conglobata/fulminans, 92–93, 93f pustulosis (AGEP) Bacterial infections diet, 91 AKs. See Actinic keratoses (AKs) antiseptic skin, 99 dry lips, oral isotretinoin, 94, 94f Allergic contact dermatitis bacillary angiomatosis, 103, 103f , 117, 117f excoriée, 92, 92f antigens, 32–33 Cat-scratch disease, 103 fluid retention, 90 immunological response, 33, 33f common patterns, 97, 98t hormone therapies, 94 T-lymphocytes, 33 cutaneous leishmaniasis, 137–139 ‘ice-pick’ scars, 92, 92f Alopecia areata (AA) deeper infection, 101–102. See Deeper infantile, 92 contact sensitization, 146 infections with inflammatory papules and pustules, 91, exclamation mark hairs, 145, 146f impetigo, 116–117 91f mycology and skin biopsy, 146 Loiasis (Loa loa), 143 keloid scars, 92, 92f nail abnormalities, 145, 146f normal skin flora, 97 keloidalis nuchae, 91, 91f prognostic markers, 145 PVL, 97, 99, 99f laser ablation, dilated telangiectatic vessels, 96 systemic immunosuppression, 146 RMSF, 103, 104f oral antibiotics/retinoids, 94, 96 topical minoxidil, 146 secondary syphilis, 103–104, 104f Rosacea. See Rosacea topical/intralesional corticosteroids, 146 staphylococcal and streptococcal covers, 99 scars, types, 92, 92f COPYRIGHTEDAN. See Acanthosis nigricans (AN)MATERIALsubcutaneous myiasis, 141–142 seasons, 91 Androgenetic alopecia (AGA) superficial. See Superficial infections sebaceous gland, pathology and histology, 89, female androgenetic alopecia, syphilis, 117, 118f 89f 145, 145f topical and systemic antibiotics, 99 stress, 90 FUT, 145 traumatic break, skin, 97 topical treatments. See Topical treatments hair transplantation, 145 tungiasis, 141 treatment, 93, 93t Angio-oedema. See Urticaria Bandaging treatment ladder, Rosacea, 91, 92 Ankle brachial pressure index (ABPI), application, 208 vulgaris. See Acne vulgaris 29, 82 classification, 207–208 Acquired melanocytic naevi Annular , 71, 72f compression, 208–210 Becker’s naevus, 165, 165f Annular (ring-shaped) lesions, granuloma medicated paste, 210, 210f Blue naevus, 164, 164f annulare, 4, 7f rubber sensitivity, 210 compound naevus, 164, 164f Annular plaques, 13, 14f sternal wound, 207 halo naevus, 165, 165f Annular urticaria, 39, 40f tubular, 210

ABC of Dermatology, Sixth Edition. Edited by Rachael Morris-Jones. © 2014 John Wiley & Sons, Ltd. Published 2014 by John Wiley & Sons, Ltd.

221 222 Index

two-layer long/short stretch, 210 CAD. See Chronic actinic dermatitis (CAD) clubbing, 154, 154f type I retention, 207 Calcineurin inhibitors, 213–214 colour change, 154 type II light support, 207 Calcinosis cutis, 65, 65f in situ melanoma, 159, 159f Basalcellcarcinoma(BCC) Candida albicans, 125, 126f irritant dermatitis (eczema), 152 cryotherapy, 184 Cell-mediated immunity, 138 koilonychia, 154 Gorlin’s syndrome, 173 Central centrifugal cicatricial alopecia longitudinal/transverse splits, 153 morphoeic/sclerosing type, 174, 175f (CCCA), 147 Myxoid pseudocysts, 158, 158f nodular-type, 173, 174f , 40 nail loss (onychomadesis), 153 pigmented, 174, 174f Chromoblastomycosis, 140 nail plate thickening, 152 recurrent nodular, 173, 174f Chronic actinic dermatitis (CAD), 46, 46f onycholysis, 152 ‘rolled edge’, 173 Chronic paronychia, 126 periungual fibrokeratomas, 159 superficial, 174, 174f Chronic psoriatic arthropathy, 17, 17f pitting, 151 surgical scars, 175 Ciclosporin A, 23 plate infection, dermatophyte fungi, 157, 157f Benign skin tumours Compression bandaging, 208–210 psoriasis, onycholysis, 155, 155f cutaneous lesions, 161 Connective tissue disease (CTD), 62 pterygium formation, lupus, 156, 156f differential diagnosis, 161, f161 Cosmetic camouflage, 216 pustules, periungual skin, 153–154 nodules, 169–170 ‘CREST syndrome’, 64 subungual exostosis, 159, 159f pattern recognition, 161 Cryotherapy subungual hyperkeratosis, 151 pigmented, 162–165 ‘freeze–thaw’ cycle, 183 transverse ridges, 152 plaques, 170–171 liquid nitrogen, canister, 183, 184f treatment, 159–160 tumour papules, 167–169 risks and precautions, 184 viral warts, 158 vascular tumours, 165–167 skin lesions, freezing, 184 DLE. See Discoid (DLE) Benign tumour nodules CTCLs. See Cutaneous T-cell lymphomas DPN. See Dermatosis papulosa nigra (DPN) eccrine poroma, 170, 170f (CTCLs) Dracunculus medinensis (Dracunculiasis), 143 epidermoid cyst, 169, 169f CTD. See Connective tissue disease (CTD) DRESS, 53–54, 54f keloid scar, ear piercing, 170, 170f CTLA-4. See Cytotoxic T-lymphocyte-associated Dressings leiomyoma, scalp vertex, 169, 169f antigen 4 (CTLA-4) adverse effects, 207 lipoma, 169, 169f Curettage surgery, 185–186 alginate, 202–203 Benign tumour papules Cutaneous B-cell lymphoma, 78, 78f alginogels, 206 apocrine hidrocystomas, 168, 168f Cutaneous leishmaniasis, 137–139, 138f antimicrobial agents, 203–204, 204f milia, 168, 169f Cutaneous T-cell lymphomas (CTCLs), 181–182, capillary action, 206 sebaceous gland hyperplasia, 168, 169f 182f categorization, 200 syringomas, 168, 168f Cytotoxic T-lymphocyte-associated antigen 4 cavity, 204, 205f trichoepitheliomas, 168, 168f (CTLA-4), 220 description, 200 Benign tumour plaques film, 201, 201f epidermal naevus, 171, 171f Darier’s disease, 153, 153f honey, 204–205, 205f ILVEN, 171 DDTUs. See Dermatology day treatment units hydrocolloid, 201, 202f naevus sebaceous, 170, 170f (DDTUs) hydrofibres, 201–202, f203 Biological therapies Dermabrasion and chemical peels, 195 hydrogel, 201, 202f Ⓡ adalimumab (Humira ),24 Dermatitis artefacta, 88, 88f interactive, 200 eczema, 220 Dermatitis herpetiformis (DH) larvae therapy, 204, 205f Ⓡ etanercept (Enbrel ),24 gastrointestinal system and liver, skin MMPs, 206 Ⓡ infliximab (Remicade ),24 changes, 75, 75f non-or low adherent, 200–201, 200f metastatic melanoma, 219–220 gluten-free diet, 59–60 odour-controlling, 204 NICE guidelines (UK), 24 investigation, immunobullous disease. See passive, 200 proteins/antibodies, 23 Immunobullous disorders patient-focused issues, 198, 200 rituximab, 220 on knees, 59, 59f PHMB, 206 T-cell mediated disease and cytokines, linear IgA, 60, 60f polyurethane foam, 203, 203f 23–24 Dermatology day treatment units (DDTUs), 19 super-absorbent, 206 treatment, psoriasis, 219 Dermatomyositis TNP, 206 Ⓡ ustekinumab (Stelara ),24–25 hands, 68, 69f Drug rashes Blashko’s lines, 80, 80f rash on ‘V’ of neck, 68, 68f AGEP, 54, 54f Blastomycosis, 141 treatment, high dose systemic alteration, normal skin function. See Normal Blepharitis, 95, 95f corticosteroids, 69 skin alteration, drug rashes Blisters, 55–56, 55f Dermatosis papulosa nigra (DPN), diagnosis, 48 Bowen’s disease, 173, 184 162, 162f DRESS. See Drug reaction with eosinophilia and Bullous , 66, 66f DH. See Dermatitis herpetiformis (DH) systemic symptoms (DRESS) Bullous pemphigoid Diabetic/neuropathic ulcers, 87, 87f drug-induced exanthems, 51, 51f bullae, 4, 4f , 8, 9f Discoid lesions, discoid eczema, 4, 5f drug-induced lupus, 51–52, 51f histopathology, 60, 60f Discoid lupus erythematosus (DLE), 68, 68f drug-induced vasculitis, 52, 52f immunofluorescence, 60, 61f Diseases, nails , 52 mouth erosions, 57, 58f acute illness, 158 examination, 48 urticated plaques, pre-bullous pemphigoid, 57, bacterial infection, periungual tissues, 157, fixed , 52,f 53 57f 157f history, 48, 50t vesicles, 8, 9f Beau’s line, 153 immune-mediated and Bullous vasculitis with necrosis, 63, 63f chronic illness, 158, 158f non-immune-mediated, 49 Index 223

lichenoid drug eruptions, 52, 52f lichen simplex, 28, 28f superficial dermatophyte and yeast, 116, pre-existing dermatoses, 50–51 Paget’s disease, 29, 30f 122 SJS and TEN, 52–53, 53f , 53t alba, 27 systemic antifungal drugs, 127 skin biopsy, 48–49 plantar dermatitis, 27, 28f Tinea capitis (scalp ringworm), 122, 122f skin reactions, 49 pompholyx, 28, 29f Tinea incognito, 123, 123f urticaria/angio-oedema, 51, 51f RAST, 29 trunk, 124–125 Drug reaction with eosinophilia and systemic skin and nasal swabs, 29 yeast infections, 126–127 symptoms (DRESS), 53–54, 54f varicose, 28, 29f zoophilic (animal) fungi, 122 Drug-induced exanthems, 51, 51f venous (stasis), 28, 29 Drug-induced lupus, 51–52, 51f Eosinophilic folliculitis (EF), 116, 116f Gastrointestinal system and liver disorders Drug-induced vasculitis, 52, 52f Epidermal atrophy, extra-genital lichen Crohn’s disease, 75 Dysplastic naevi, 176, 177f sclerosus, 4, 5f dermatitis herpetiformis, 75, 75f Epstein–Barr virus (EBV), 117–118, 118f inflammatory conditions, bowel, 75 EAC. See Erythema annulare centrifugum (EAC) Erosions, paraneoplastic bullous pemphigoid, 4, malabsorption, 74 EBV. See Epstein–Barr virus (EBV) 6f Peutz–Jeghers syndrome, 75 Ecthyma, 101, 102f Erysipelas, 100f , 101 pyoderma gangrenosum, 75, 75f Eczema (dermatitis) Erythema annulare centrifugum (EAC) vitamin C deficiency, 74 AD, 35 annular, 71, 72f zinc deficiency, 74, 74f allergic contact dermatitis, 32–33 non-infectious causes, 71 GCS. See Gianotti–Crosti Syndrome (GCS) antibiotics, 36 Erythema chronicum migrans, 71 Generalised plaques, 13, 14f chronic atopic dermatitis, 26, 26f Erythema induratum (Bazin’s disease), 102, 103f Genetic disorders, photosensitivity cleansers, 35 Erythema infectiosum, 111–112, 112f oculocutaneous albinism, 43, 43f contact urticaria, 34 (EM), 71, 71f xeroderma pigmentosum, 43 emollients, 35 Erythema nodosum (EN) Genetics and skin disease endogenous. See Endogenous eczema drug-induced rashes, 52 abnormality underlying inherited epidermis, 26 pregnancy, 1, 2f disorders, 79, 79t exogenous, 30 skin reactions with infections, 71, 72f filaggrin, 79–80 fragrance allergy, 30–31, 31f Erythrasma, 100–101, 100f human genome database, 79 herpeticum, 106, 106f Erythrodermic psoriasis, 16, 16f ichthyosis vulgaris, 79, 80f histology, 26, 27f Erythropoietic porphyria, 43, 44f inherited blistering disorders, 80 immune dysregulaion, 26 Etanercept (EnbrelⓇ),24 mosaicism, 80–81 immunomodulators, 35–36 Exogenous substances, photosensitivity single gene disorders, 80 inflammation, 26 medications, 44–45, 44f Gianotti–Crosti Syndrome (GCS), 71, iodine, 30, 31f phytophotodermatitis, 45, 45f 112, 112f irritant contact dermatitis, 33, 34f Extending cellulitis, 100f , 101 Glucocorticoid response elements (GREs), 212 melamine formaldehyde resin, 30, 31f Glucose-6-phosphate dehydrogenase (G6PD) morphology, 30, 31 Female pattern hair loss (FPHL), 145 deficiency, 219 neomycin, 31, 32f Filariasis, 142 Gorlin’s syndrome, 173 patch testing, 34–35 Fitzpatrick skin type classification, 42–43 Granuloma annulare, 73–74, 73f photodermatitis, 33, 33f Flexural Candida infection, 116, 117f GREs. See Glucocorticoid response elements phototherapy, 36 Flexural psoriasis, 16, 16f (GREs) potassium dichromate, 30, 31f Follicular unit hair transplantation ‘Guinea worm’ (dracunculiasis), 143 PPD, 31, 32f (FUT), 145 , 13, 15, 15f pruritus, 36–37 FPHL. See Female pattern hair loss (FPHL) secondary bacterial infection, 33 Fungal infections HAART. See Highly active anti-retroviral therapy stoma dressing, 31, 32f alopecia and inflammation, 122, 123f (HAART) systemic therapy, 36 animal ringworm, 122, 122f Haemachromatosis, 77, 77f topical steroids, 35 candidiasis, 116 Hair cycle EF. See Eosinophilic folliculitis (EF) deeper tissues, 127, 127f growth phases, 144, 144f Electrocautery, 185 diagnosis, 121 seasonal variation, 145 Electrodessication (diathermy/hyfrecation), 185 flexural Candida infection, 116, 117f types, 144 Electrosurgery, 184–185 fusarium infection, bone marrow Hair loss (alopecia), 145 EM. See Erythema multiforme (EM) recipient, 127, 127f Hand, foot and mouth disease, 112, 112f Emollients, topical therapy ‘id reaction’, 123, 123f Henoch–Schönlein purpura (HSP), 64 complications, 212 immunosuppressant and antimicrobial Herpes simplex virus (HSV) psoriasis, 214, 215t drugs, 121 ‘cold sore’, 105, 106, 106f treatment, 212 kerion formation and occipital EBV, 117–118 EN. See Erythema nodosum (EN) lymphadenopathy, 122, 123f eczema herpeticum, 106, 106f Endogenous eczema mycoses, 121 external genitalia, 105–106 ABPI, 29 nails, 125–126 HSV, 117, 118f AD, 27, 27f , 28f normal skin flora, 121 inoculation herpes, 105, 106f asteatotic, 28, 28f patchy alopecia, 122, 122f IRIS, 106 chronic lichenified, 27,f 27 PCR tests and ELISA, 121 KS, 118–119, 118f , 119f discoid, 28, 29f Pseudomembranous Candida, 116, 117f secondary prophylaxis, 106 herpeticum, 28, 28f SD, 124, 124f types, 117 juvenile plantar dermatosis, 27 skin and subcutaneous tissues, 121 vesicles on posterior pinna, 105, 106f 224 Index

Highly active anti-retroviral therapy (HAART) Immunobullous disorders LASER. See Light amplified by stimulated CD4 count, 116 bullous pemphigoid, 57, 57f , 58f emission of radiation (LASER) cutaneous manifestations, HIV, 114 clinical features, 57, 57t Laser resurfacing, 194–195 IRIS, 117, 118f diagnosis, 56, 56t LE. See Lupus erythematosus (LE) skin disorders, HIV/AIDS, 115 durability and distribution, 56 Leg ulcers Hirsutism, 149, 149f histopathology, 60–61, 60f , 61f arterial. See Arterial ulcers Histoplasma capsulatum (Histoplasmosis), 141 management, 61 assessment parameters, 82–83 HIV. See Human immunodeficiency virus (HIV) mucous membrane pemphigoid, 58, 58f , 59f diabetic/neuropathic, 87, 87f Hormonal imbalance, skin pemphigoid gestationis, 57–58, 58f infectious, 87–88 acanthosis nigricans (AN), 72–73, 73f pemphigus vulgaris, 58–59, 59f in ammatory conditions, 87, 87f diabetes, 73 skin biopsy findings, 60,t 60 malignant diseases, 88, 88f granuloma annulare, 73–74, 73f Immunomodulatory drugs prevalence, 82 hyperpigmentation, 72, 73f azathioprine, 218 trauma, 88, 88f hypopigmentation, 72 Biologics, 219–220 venous. See Venous ulcers necrobiosis lipoidica, 73, 73f ciclosporin, 218 Leprosy HPA. See Hypothalamic pituitary axis (HPA) corticosteroids, 217 aerosols, 135 HPV. See Human papillomavirus (HPV) methotrexate, 217–218 bacterial index (BI), 137 HSP. See Henoch–Schönlein purpura (HSP) MMF, 218 borderline leprosy, 136, 136f HSV. See Herpes simplex virus (HSV) systemic retinoids, 218, 218t chronic granulomatous infection, 135 Human immunodeficiency virus (HIV) Impetigo diagnosis, 137 bacterial infections, 116–117, 117f , with bullae and erosions, 99, 99f hypopigmented patches, 136, 136f 118f with golden crusting, 99, 99f incubation period, 135 CD4 cell count, 114 Incisional biopsy, 187 lepromatous leprosy, 136, 136f crusted scabies on hand, 119, 120f Indirect fluorescent antibody test (IFAT), 138 slit skin smears, 137 diagnosis and treatment, 115 Infectious disorders spectrum, clinical disease, 136, 136f drug rashes, 119–120, 120f antibacterial drugs, 216 treatment, 137 EF, 116 antibiotics, 216, 216t tuberculoid leprosy, 136, 136f fungal infections, 116, 117f antifungal drugs, 217 Leukonychia, 154, 154f HAART, 114 antiparasite drugs, 217 Lice nodular prurigo, 116, 116f antiviral drugs, 217 body, 133–134 primary HIV infection, 115 Infectious ulcers, 87–88 head, 133, 133f psoriasis, 115–116 Infestations, scabies pubic, 134, 134f RNA retrovirus, 114 cutaneous larva migrans, 134 Lichen planus (LP) SD, 115 lice, 133–134 bullous, 66, 66f and skin, 114 scabies (Sarcoptes scabiei), 131–133 lichenoid drug eruptions, 52, 52f , 66 viral infections. See Viral infections Inflammatory linear verrucous epidermal naevus in mouth, 66, 66f Human papillomavirus (HPV), 119, 119f (ILVEN), 171 on wrist, 66, 66f Hyperkeratosis with fissures, rubber allergy, Inflammatory sterile pustules, contact Lichen sclerosus (LS), 65, 66f 4, 6f dermatitis, 4, 5f Light amplified by stimulated emission of Hyperkeratotic palmar psoriasis, 13, 15f Insect bites and stings radiation (LASER) Hyperpigmentation allergic reaction, 129 complications, treatment, 191, 191t haemachromatosis, 77, 77f bulla bite reaction, 128, 129f dermabrasion and chemical peels, 195 phenytoin, 77 clinical features, 128 fractional laser treatment, 195 Hypertrichosis, 149–150, 150f delusions of parasitosis, 129 hair removal, 194 Hypopigmentation linearity, reactions, 128, 128f perioperative anaesthesia, 191–192 autoimmune associations with vitiligo, 76–77, Lyme disease, 130, 130f pigmented lesions, 192–194 77f management, 129–130 port wine stain, 192, 192f piebaldism, 76, 76f papular and inflammatory reactions, 128, postoperative care, 192 Hypothalamic pituitary axis (HPA), 213 128f preoperative assessment, 191 persistent insect bite reaction, 128, 129f pulsed dye laser treatment, 192, 193f ‘Ice-pick’ scars, 92, 92f prevention, 130 resurfacing, 194–195 Ichthyosis vulgaris, 79, 80f risk factors, 128, 129 safety, 192 Idiopathic disorders, photosensitivity spider bite (Nigeria), 130, 131f science, 191 CAD, 46, 46f wasp and bee stings, 131 tattoos, 194 photoprotective behaviour, 46 Intense pulsed light (IPL), 195 type, cutaneous disorders, 191, 192t PMLE. See Polymorphous light eruption IPL. See Intense pulsed light (IPL) vascular lesions, 192 (PMLE) IRIS. See Immune reconstitution inflammatory Lipodermatosclerosis, 84, 85f , 46 syndrome (IRIS) Liver disease IFAT. See Indirect fluorescent antibody test jaundice, 76 (IFAT) Kaposi’s sarcoma (KS), 118, 118f , 119f multiple spider naevi, 76 ILVEN. See Inflammatory linear verrucous Keloid scars, 92, 92f PCT, 76, 76f epidermal naevus (ILVEN) Keratolytics, 215 porphyrias, 76 Immune reconstitution inflammatory syndrome Kerion formation, 122, 123f , 147, 147f and skin, 75 (IRIS) Koebner’s phenomenon, psoriasis in surgical skin signs, 76 defined, 114 scar, 13, 14f xanthomas, 76, 76f HAART, 117, 118f Koplick’s spots, measles, 111, 111f Loa loa (L.loa), 143 Immune-mediated rashes, 49 KS. See Kaposi’s sarcoma (KS) Loiasis, 143 Index 225

LP. See Lichen planus (LP) Melasma, 72, 73f Normal skin alteration, drug rashes LS. See Lichen sclerosus (LS) Metabolic disorders, photosensitivity excessive hair, 49–50 Lupus erythematosus (LE) erythropoietic porphyria, 43, 44f hair loss, 50 clinical variants, 67 porphyia cutanea tarda hand, 43, 44f nails, 50 diagnostic criterias, SLE, 67, 67f varigate porphyria, 43, 44f photosensitivity, 49, 49f , 50t DLE, 68, 68f Methicillin-resistant S. aureus (MRSA), 97 pigmentation, 49, 50f neonatal lupus erythematosus, 68, 68f Methotrexate SLE, butterfly rash, 67,f 67 adverse effects, 22–23 Occipital lymphadenopathy, 122, 123f subacute, 67, 67f aspirin and sulphonamides, 23 OCPs. See Oral contraceptive pills (OCPs) Lupus vulgaris, 102, 102f folic acid synthesis, 22 Oculocutaneous albinism, 43, 43f Lyme disease, 130, 130f myelosuppression, 23 OHL. See Oral hairy leukoplakia (OHL) Lymphocytic disorders Mixed connective tissue disease (MCTD), 69 Onchocerciasis (river blindness), 142–143 Brocq pseudopelade, 147, 148f MMF. See Mycophenolate mofetil (MMF) Onycholysis, 12, 12f , 13, 15f CCCA, 147 MMPs. See Matrix metalloproteinases (MMPs) Onychomycosis discoid lupus erythematosus, 147, 148f Mohs’ micrographic surgery, 190 azole lotion, 126 lichen planopilaris, 147, 148f Molluscum contagiosum Candida albicans, 125, 126f skin biopsy, direct immunofluorescence, 147 crystacide and cryotherapy, 109 Chronic paronychia, 126 traction alopecia, 147 histology, bodies, 109, 109f Trichophyton rubrum, 125, 126f Lymphoedema, 84, 84f infections, 119, 119f Oral contraceptive pills (OCPs) orf, 109, 109f combined type and antiepileptic drugs, 91 Malignancies Mosaicism, 80–81 hormone balance, increased acne, 90 mycosis fungoides, 77–78, 78f MRSA. See Methicillin-resistant S. aureus hormone therapies, 94 non-specific skin changes, 77, 78 (MRSA) Oral griseofulvin/terbinafine, 147 , 78 Mucous membrane pemphigoid Oral hairy leukoplakia (OHL) poikiloderma, 78, 78f eyes, 58, 59f EBV, 117 skin markers, internal, 77 on scalp, 58, 58f haematological malignancy and organ Malignant skin tumours scarring skin eruption, 58, 58f transplantation, 118 BCC, 173–175 Multiple small plaques, 13, 13f overgrowth, epithelial plaques, 117–118 CTCLs, 181–182 Mycetoma (Madura foot), 140 dysplastic naevi, 176, 177f Mycobacterial disease PA. See (PA) melanoma. See Melanoma ATM, 102 Palmo-plantar pustular psoriasis (PPPP), moles/naevi, 176 clinical manifestations, 101–102 14, 15f SCC, 175–176 cutaneous M. tuberculosis, 102 PAN. See Polyarteritis nodosa (PAN) Management, psoriasis erythema induratum (Bazin’s disease), 102, Panton Valentine Leukocidin (PVL) biological therapy. See Biological therapies 103f mulitple abscesses, Staphylococcus aureus DDTUs, 19 lupus vulgaris, 102, 102f infection, 97, 99f exacerbating factors, 18 Mycobacterium ulcerans, 102–103, 103f skin biopsy and PCR, 99 medical practitioners, 18 sporotrichoid spread, Mycobacterium Papules, lichen planus, 3, 3f psoriasis disability index (PDI), 18 marinum, 102–103, 103f Paracoccidioides brasiliensis, 141 scalp, 20, 20f tuberculids, 102 Paraphenylenediamine (PPD), 31–32 systemic treatment. See Systemic therapy Mycophenolate mofetil (MMF), 23, 218 Parapsoriasis, 78 topical treatments. See Topical treatments Mycosis fungoides Patch testing, eczema ultraviolet treatment. See Phototherapy, cutaneous B-cell lymphoma, 78, 78f allergens, 34 psoriasis Sezary syndrome, 78, 78f optimum concentration, 34 Matrix metalloproteinases (MMPs), 206 positive reactions, 35, 35f MCTD. See Mixed connective tissue disease Nail cosmetics, 160 PCT. See Porphyria cutanea tarda (PCT) (MCTD) Nail dystrophy, 156, 156f PDT. See Photodynamic therapy (PDT) Melanoma Nail plate changes Pemphigoid gestationis (PG) acral malignant, 178, 179f adrenal disease, 155 on abdomen, 57, 58f adjuvant therapies, 180 linear melanonychia, 155, 155f maternal cutaneous eruption, 57–58 amelanotic malignant, 178, 179f longitudinal pigmented streaks, 155 Pemphigus vulgaris benign solar lentigo, 177, 178f patchy brown discolouration, 154 histopathology, 60, 60f chemotherapy, 180 true leukonychia, 155 immunofluorescence, 60, 61f dysplastic malignant, 178, 179f yellow nail syndrome, 155, 155f in mouth, 58, 59f immunotherapy, 180–181 Nail psoriasis, onycholysis, 155, 155f pemphigus foliaceus (PF), 59 incidence, 177 Napkin psoriasis, 16, 16f on trunk, 58, 59f lentigo maligna pre-imiquimod Necrobiosis lipoidica, 73, 73f PEP. See Polymorphous eruption of pregnancy treatment, 177, 178f Neonatal lupus erythematosus, 68, 68f (PEP) nodular malignant, 177, 179f Neutrophilic disorders, 148, 148f Perioral dermatitis, 91, 91f pre-existing moles, 177 Nodular prurigo, 116, 116f PG. See Pemphigoid gestationis (PG) prognosis, 178–179, 180t Nodules, hypertrophic lichen planus, 3, 3f PHMB. See Polyhexamethylene biguanide SLNB, 179–180 Non-immune-mediated rashes, 49 (PHMB) sun exposure, 177 Non-scarring alopecias Photochemotherapy. See Phototherapy, psoriasis superficial spreading malignant, 177, 177f AA, 145–146 Photodynamic therapy (PDT) targeted therapy, 181 AGA, 145 acne, 196 treatment, 179–181 telogen effluvium, 146–147 photoactivated toxin, 195 UV exposure, 177 tinea capitis, 147 superficial BCC, lower back, 195, 195f 226 Index

Photosensitivity Pretibial myxoedema, 74, 74f polymorphous light eruption, 6, 8f exogenous substances, 44–45, 44f , 45f Primary HIV infection, 115, 115f symmetrical chronic plaque psoriasis, 6, 7f Fitzpatrick skin type classification, 42–43 Pruritus, eczema vesicles and bullae, 8, 9f genetic disorders, 43, 43f inflammatoryskindiseases, 36 RAST. See Radioallergosorbent testing (RAST) idiopathic disorders, 45–46, 45f , 46f management, 37 Raynaud’s phenomenon, 64 metabolic disorders, 43–44, 43f , 44f skin itching, 36 Rhinophyma, 95, 95f sunscreens, 47 systemic disorder, 36 River blindness, 142–143 ultraviolet (UV) radiation, 42, 42f Pseudofolliculitis, 100, 100f Rocky Mountain spotted fever (RMSF), 103, 104f vitamin D levels and systemic disease, 46–47 Pseudomembranous Candida, 116, 117f Rosacea Phototherapy, psoriasis Psoralen with ultraviolet A (PUVA) blepharitis, 95, 95f antigen-presenting capacity, dendritic cells, 20 cabinet, 20–22 differential diagnosis, 95–96 Psoralen with ultraviolet A (PUVA) Psoriasis localized to nose, 95, 95f cabinet, 20, 21f , 16 rhinophyma, 95, 95f skin after/before, 21, 21f annular plaques, 13, 14f thin plaques, psoriasis suitable for TL01, 20, cellular abnormalities, 11 Sarcoidosis, 72, 72f 21f characterization, nail dystrophy, 12, 12f Scabies (Sarcoptes scabiei) types, 21–22 clinical appearance, 13, 13f babies and young children, 132 ultraviolet A (UVA)/ultraviolet B (UVB), 22, common patterns, distribution, 13, 13f burrows, 131, 131f 22f erythrodermic, 16, 16f crusted, 132 Phytophotodermatitis, 45, 45f flexural, 16, 16f diagnosis, 131–132 Piebaldism, 76, 76f generalized plaques, 13, 14f management, 133 Pigmented benign tumours guttate, 13, 15, 15f Scalp involvement acquired melanocytic naevi, 164–165 hyperkeratotic palmar, 13, 15f atopic eczema, 150 congenital melanocytic naevi, 163, 163f increased epidermal proliferation, 11, 11f , 150, 150f dermatofibroma, 165, f165 Koebner’s phenomenon, surgical scar, 13, 14f psoriasis, 13, 15f , 20, 20f DPN, 162, 162f management. See Management, psoriasis seborrhoeic dermatitis, 150, 150f lentigines (freckles), 162–163, 163f napkin, 16, 16f Scarring alopecias melanocytic naevi, 163 onycholysis in nail, 13, 15f lymphocytic disorders, 147–148 Mongolian blue spot, 163, 164f PA. See Psoriatic arthritis (PA) neutrophilic disorders, 148 seborrhoeic keratoses, 162, 162f pathophysiological mechanisms, 11, 11f primary causes, 147 skin tags, 162, 163f plaques, knees, 3, 4f secondary causes, 149 Pigmented lesions plaques on trunk, 11, 13, 14f SCC. See squamous cell carcinoma (SCC) Addison’s disease, 193 PPPP, 14, 15f SCORTEN parameters, 53, 53t amiodarone and minocycline, 194 scalp, 13, 15f SD. See Seborrhoeic dermatitis (SD) Café au lait macules, 193, 193f skin disorders, HIV, 115–116 Seborrhoeic dermatitis (SD), 115, 115f , 124, 124f forms, abnormal pigmentation, 193 typical patient, 13 Seborrhoeic keratoses, 184 haemosiderin, 194 Psoriatic arthritis (PA) Secondary syphilis, 104, 104f naevi (moles), 193 activated CD8 T-memory cells, 17 Sentinel lymph node biopsy (SLNB) post-inflammatory hyperpigmentation, 193 acute arthropathy X-ray signs, 17, 17f lymphoscintigraphy, 180 (PR), 107–108, 108f chronic psoriatic arthropathy, 17, 17f melanoma micrometastases, 180 Pityriasis versicolorhyperpigmented distal interphalangeal (DIP) joints, 17 nodal metastases, 179 scaling, 124, 125f environmental factors, 17 Sezary syndrome, 78, 78f hypopigmented scaling, 124, 125f types, 17 Shave biopsy, 186 Plantar wart (verucca), 110, 110f waxes and wanes, 17 SJS. See Stevens–Johnson syndrome (SJS) PMLE. See Polymorphous light eruption (PMLE) Pulsed dye laser treatment, 192, 193f Skin and systemic disease Podoconiosis, 142 Punch biopsy diagnostic clues, 70 Poikiloderma, 78, 78f local anaesthetic, 186, 186f EAC, 71, 72f Polyarteritis nodosa (PAN), 64 plug, skin, 186, 187f EM, 71, 71f Polyhexamethylene biguanide (PHMB), 206 tool insertion, 186, 186f EN, 71, 72f Polymerase chain reaction (PCR) techniques, 138 PUVA. See Psoralen with ultraviolet A (PUVA) erythema chronicum migrans, 71 Polymorphous eruption of pregnancy cabinet GCS, 71 (PEP), 78–79, 79f PVL. See Panton Valentine Leukocidin (PVL) hormonal imbalance. See Hormonal imbalance, Polymorphous light eruption (PMLE) Pyoderma gangrenosum, 75, 75f , 87, 87f skin management, 46 hyperpigmentation, 77 papular and erythematous eruption, 45, 45f Radioallergosorbent testing (RAST), 29 hypopigmentation, 76–77 Porphyia cutanea tarda hand, 43, 44f Rashes liver. See Liver disease Porphyria cutanea tarda (PCT), 76, 76f bilateral contact dermatitis to cement, 6, 8f malignancy. See Malignancies Poxviruses, 108 bullae from insect bite reactions, 8, 9f PG, 79, 79f PPD. See paraphenylenediamine (PPD) cellulitis bullae, lower leg, 8, 9f and pregnancy, 78–79, 79f PPPP. See Palmo-plantarpustularpsoriasis changes, skin surface (epidermis), 7–8 sarcoidosis, 72, 72f (PPPP) common skin conditions, 6 thyroid, 74 PR. See Pityriasis rosea (PR) diagnosis, 4–5 toxic erythema, 70–71, 71f Pregnancy, PEP, 78–79, 79f eczema, intraepidermal vesicle, 8, 9f Skin lesions Premalignant skin tumours EM, vesicles and bullae, 8, 9f actinic keratosis, 184 AKs. See Actinic keratoses (AKs) inflammation, 10 annular (ring-shaped) lesions, granuloma Bowen’s disease, 173 irritant eczema on dominant hand, 6, 8f annulare, 4, 7f Pressure urticaria, 40 patient assessment, 10, 10f BCC, 184 Index 227

biopsies, 1 Mohs’ micrographic surgery, 190 Trunk Bowen’s disease, 184 placement, epidermal sutures, 189, 189f erythema and satellite lesions, 124 bullae, bullous pemphigoid, 4, 4f ‘skin wrinkle lines’, 187, 187f , 188f pityriasis versicolor, 124, 125 desquamation, severe drug reaction, 4, 7f wound eversion, 188, 188f skin scrapings, 124 discoid lesions, discoid eczema, 4, 5f Symmetrical chronic plaque psoriasis, 6, 7f Tinea corporis, 125 DLQI, 2 Syphilis infection, 117, 118f Tinea cruris, 125 epidermal atrophy, extra-genital lichen Systemic sclerosis (SSc) Whitfield’s ointment, 124 sclerosus, 4, 5f calcinosis cutis, 65, 65f Tungiasis, 141 epidermis excoriation, atopic dermatitis, 4, 6f ‘CREST syndrome’, 64, 65, 65f erosions, paraneoplastic bullous morphoea, 65, 65f Ulceration, pyoderma ganrenosum, 4, 6f pemphigoid, 4, 6f Systemic therapy Ultraviolet A (UVA), 22, 22f hyperkeratosis with fissures, rubber allergy, 4, acitretin, 23 Ultraviolet B (UVB), 22 6f antimalarials, 219 Urticaria inflammatory sterile pustules, contact ciclosporin A, 23 angio-oedema, 40, 41f dermatitis, 4, 5f dapsone, 219 causes, physical and non-physical, 39 lichenification, chronic eczema, 4,f 5 drugs, infectious disorders, 216–217 cholinergic, 40 macule, 3, 3f immunomodulatory drugs, 217–219 cold-induced, cheeks, 39, 39f papillomas and tags, 184 methotrexate, 22–23 contact with brown caterpillar moths, papules and nodules, 3, 3f MMF, 23 39, 39f plaque, 3, 4f severe psoriasis, 22, 23f dermatographism, 41, 41f rashes. See Rashes oral antihistamines and corticosteroids, 41 reticulate pattern, vasculitis, 4, 7f Telogen effluvium, 146–147 ordinary, 39–40, 40f seborrhoeic keratoses, 184 TEN. See Toxic epidermal necrolysis (TEN) pathophysiology, 38 superficial spreading melanoma,f 2,2 Thyroid disease, 74, 74t,74f pressure, 40 ulceration, pyoderma ganrenosum, 4, 6f Tinea capitis, 147, 147f RAST/skin prick testing, 41 vesicle and bulla sites, 4, 4f Tinea corporis, 125 single-dose subcutaneous omalizumab, 41 viral warts, 184 Tinea cruris, 125 solar, 40 SLE. See Subacute lupus erythematosus (SLE) TNP. See Topical negative pressure dressings vasculitis with bruising, 38, 38f SLNB. See sentinel lymph node biopsy (SLNB) (TNP) Urticarial vasculitis with bruising, 38, 38f Solar urticaria, 40, 46 Topical antimicrobials, 214, 215t SPF. See Sun protection factor (SPF) Topical corticosteroids Vacuum-assisted wound closure (VAC), 206 Spider bite (Nigeria), 130, 131f classification, 213, t213 Varicella zoster virus (VZV) Squamous cell carcinoma (SCC) mode of action, 212 chicken pox infection, adult, 107, 107f dysplastic proliferations, 175 perioral dermatitis, 213, 214f in dermatome (shingles), 107 early stages, pinna, 175, 175f side effects, 213 greasy emollient, 107 histology, 175, 176f steroid induced atrophy and acne, mandibular nerve zoster, 107, 108f hyperkeratotic, 175, 175f 213, 214f multidermatomal, 107, 108f keratoacanthoma, 175, 176f striae formation, 213, 214f pityriasis rosea (PR), 107–108, 108f management, 176 Topical negative pressure dressings (TNP), 206 Varicose eczema, 84, 84f Squamous cell carcinoma, chronic diabetic Topical treatments Varicose veins, 83, 83f ulcer, 88, 88f advantages and disadvantages, 19 Varigate porphyria, 43, 44f SSc. See Systemic sclerosis (SSc) azelaic acid, 93–94 Vascular tumours Staphylococcus scalded skin syndrome benzoyl peroxide, 93 Campbell de Morgan spots, 166, 167f (SSSS), 101, 102f calcipotriol and tacalcitol, 19–20 capillary malformations, 166 Stevens–Johnson syndrome (SJS) corticosteroids, 20 Cavernous haemangioma (strawberry), 166, corneal involvement, acute phase, 53 dithranol, 19, 19f 167f eruption appearance, 53 emollients and coal tar, 19 Naevus flammeus neonatorum, 165, 166f SCORTEN parameters, 53, 53t ichthammol, 19 port-wine stains, 165 skin and mucous membranes, 52 phototherapy with ultraviolet/visible light, pyogenic granuloma, 166, 167f TEN, 53, 53f 94 spider naevi, 166, 167f Sturge–Weber syndrome, 166, 166f salicylic acid, 93 strawberry naevi, 166 Subacute lupus erythematosus (SLE), 67, 67f skin surface, 19 Sturge–Weber syndrome, 166, 166f Subcutaneous myiasis, 141–142 steroids, 20 Vasculitis Sun protection factor (SPF), 216 topical retinoids and antibiotics, 94 bullousvasculitiswithnecrosis, Sunscreens, 215–216 Toxic epidermal necrolysis (TEN) 63, 63f Superficial infections and SJS, 119–120, 120f causes and management, cutaneous, 63, 64 acne keloidalis, 100, 100f on trunk and mucosal involvement, and perniosis pre-ulceration, 87, 87f bacterial folliculitis, 99–100, 100f 53, 53f symptoms/pathophysiology, 63, 63f with bullae and erosions, impetigo, 99, 99f Toxic erythema, 70–71 Venous ulcers erythrasma, 100, 100f Trauma, 157, 158f atrophie blanche, 84, 84f impetigo with golden crusting, 99, 99f Trichophyton rubrum, 125, 126f lipodermatosclerosis, 84, 85f pseudofolliculitis, 100, 100f Tropical dermatology local/topical treatments, 85–86 Surgical excision bacterial infections, 135–139 long-standing ulcers, 85 alignment, collagen fibres, 188 dermatoses, 135 lymphoedema, 84, 84f buried dermal suture methods, 189, 189f florid disease, 135 pathology, 83, 83f ,84 keloid scar formation, 188 health care infrastructure, 135 risk factors, ulceration, 84, 84f local anaesthetic, 189 skin changes, 135 varicose eczema, 84–85 228 Index

Viral infections VZV. See Varicella zoster virus (VZV) Wound management Coxsackie A, 113 wart viruses. See Wart viruses bandages, 207–210 erythema infectiosum, 111–112, 112f bed preparation, 198 Gianotti–Crosti syndrome, 112, 112f Wart viruses deep necrotic, calciphylaxis, hand, foot and mouth disease, 112, 112f cervical/anal/vulval/vaginal/oral 197, 197f herpesviruses. See Herpes simplex virus carcinomas, 109 dressings, 198–207 (HSV) cutaneous HPV lesions, 110 evidence-based care, 197 HPV warts, extensive, 119, 119f diathermy loop cautery, 110 haemostasis, 197, 197f Koplick’s spots, measles, 111, filiform HPV wart, 109, 110f healing continuum, 198, 198f 111f immunotherapy, 111 patient concordance, 210–211 measles rash, 111, 111f liquid nitrogen, 110 types, 198, 199t Molluscum contagiosum infections, periungal hyperkeratotic HPV, 109, 110f 119, 119f plantar wart (verucca), 110, 110f Xanthomas poxviruses. See Poxviruses podophyllin and immune response in Alagille syndrome, 76, 76f Roseola infantum, 112 modifier, 110 lipid-laden macrophages, 76 Rubella, 111, 112f salicylic and lactic acids, 110 Xeroderma pigmentosum, 43