Skin Disease

Skin Disease

Diagnosis and Treatment

Author: Thomas P Habif MD, James L Campbell Jr MD MS, M Shane Chapman MD, James GH Dinulos MD and Kathryn A Zug MD

ISBN: 9780323027533

Skin Disease

1: Appendices (pages 0-0, 16 images)

Page 581: Macule and Patch
Page 582: Papule
Page 582: Plaque
Page 583: Nodule
Page 583: Pustule
Page 583: Vesicle
Page 584: Bulla
Page 584: Wheal (Hive)
Page 584: Scales
Page 585: Crust
Page 585: Erosion
Page 585: Ulcer
Page 585: Fissure
Page 586: Atrophy
Page 586: Scar
Page 589: Body Regions

2: Topical Therapy (pages 0-0, 11 images)

Page 5: Occlusion of the hand
Page 5: Occlusion of the arm
Page 6: Steroid atrophy
Page 7: Striae
Page 8: Steroid rosacea
Page 8: Atrophy and telangiectasia
Page 8: Steroid atrophy
Page 9: Striae of the groin
Page 9: Steroid atrophy
Page 9: Typical presentation of tinea of the groin
Page 9: Tinea incognito

3: Eczema (pages 0-0, 99 images)

Page 10: Acute eczema
Page 11: Acute inflammation
Page 11: Vesicles
Page 11: Acute eczematous inflammation
Page 11: Acute eczema
Page 13: Classic presentation of poison ivy
Page 14: Poison ivy - vesicles disappear
Page 15: Poison ivy can involve wide areas
Page 15: Poison ivy
Page 16: Erythema and scaling
Page 17: Erythema and scale can be extensive and suggest a diagnosis of psoriasis
Page 17: Configuration of subacute inflammation varies
Page 17: Plaque is dense and covered with scale
Page 17: Atopic dermatitis
Page 18: Subacute eczematous inflammation
Page 19: Erythema and scale appeared in this older man with dry skin
Page 19: Subacute eczema of the fingers
Page 20: Weeks of scratching and rubbing with the hell has caused skin thickening
Page 21: Chronic eczematous inflammation
Page 21: Isolated plaque is thick with accentuation of skin lines
Page 21: Itching about the anal area is common
Page 21: Rubbing and scratching has thickened the skin
Page 22: Localized neurodermatitis
Page 23: The classic presentation of lichen simplex
Page 23: Upper back is another target for repetitive scratching
Page 23: The occipital lower scalp is possibly the most common target
Page 25: Hand eczema - skin is very dry, cracked and painful
Page 25: Hand eczema - dry, thick fissured hyperkeratotic
Page 25: Hand eczema - irritant hand eczema
Page 25: Hand eczema - constant hand washing
Page 27: Hand eczema - scratching has caused skin thickening
Page 27: Hand eczema - irritant contact dermatitis
Page 27: Adult atopic patients develop chronic hand eczema
Page 27: Irritant hand dermatitis on the palmar surfaced
Page 28: Asteatotic eczema body areas
Page 29: Asteatotic eczema - skin is very dry, cracked
Page 31: Eczema - skin has split into a cracked pattern
Page 31: Asteatotic eczema
Page 31: Serum oozes from the fissures and dries
Page 33: Cracks and fissures appear
Page 33: Early stages of chapped, fissured feet
Page 33: Chapped, fissured feet begin with erythema
Page 34: Neosporin was used to treat seborrheic dermatitis
Page 35: Subacute inflammation of the upper lid
Page 37: Contact dermatitis
Page 37: Classic presentation of poison ivy
Page 37: Vesicles become confluent and form blisters
Page 38: Patch testing experts rely on large numbers of different antigens for contact dermatitis
Page 39: Allergic contact eermatitis to nickel
Page 39: Allergic contact dermatitis to lacquer
Page 41: Irritant contact dermatitis
Page 43: Lip licking causers dryness and chapping
Page 43: Lip licking for several weeks resulted in chapping with fissures
Page 45: Inflammation may start on the fingertips
Page 45: Patients protect these deep, painful cracks with bandage strips
Page 45: Fingertip eczema
Page 45: Dry skin is a constant feature of fingertip eczema
Page 46: Spontaneous peeling of the palms
Page 47: Some cases persist and the skin becomes red and fragile
Page 47: Longstanding cases may not respond to treatment
Page 48: Nummular eczema body regions
Page 49: The most common areas are the dorsa of the hands
Page 49: Nummular eczema may look like ringworm or psoriasis
Page 50: Nummular eczema
Page 51: Nummular eczema
Page 52: The acute process ends as the skin peels
Page 53: Pustular psoriasis
Page 54: Prurigo nodularis body regions
Page 55: Thick, hard nodules are typically found on the extensor surfaces of the arms and legs
Page 55: Lesions measure 0.5-1 cm and are red to dark brown
Page 56: Stasis dermatitis
Page 57: Subacute eczema with erythema
Page 57: Erythema and scale have extended onto the foot
Page 58: Infection or irritation from washing can precipitate severe acute exacerbations
Page 58: Inflammation has been present for months
Page 59: Recurrent stasis dermatitis
Page 61: The skin is diffusely red, thickened, and bound down by fibrosis
Page 63: Stasis ulcers
Page 65: A common appearance in children with erythema
Page 65: Generalized infantile atopic dermatitis
Page 65: Classic appearance of confluent papules forming plaques
Page 67: Atopic dermatitis of the upper eyelids
Page 67: Erythema and scale on the cheeks
Page 67: The mother was afraid to use topical steroids
Page 68: Papules and lichenification are characteristic of atopic dermatitis
Page 68: Accentuation of the skin creases on the palms
Page 69: Eczematous inflammation on the back of the hands in adults
Page 69: Atopic dermatitis
Page 70: Autosomal dominant ichthyosis vulgaris body regions
Page 71: Dominant ichthyosis vulgaris
Page 71: Sex-linked ichthyosis vulgaris
Page 71: Dominant ichthyosis
Page 71: Patient has severe dry skin
Page 72: Upper arm is the most common site to find keratosis pilaris
Page 73: Keratosis pilaris
Page 73: Keratosis pilaris presenting with a deep red halo
Page 73: Infected lesions in a uniform distribution
Page 75: Pityriasis alba
Page 75: Pityriasis alba

4: Urticaria (pages 0-0, 24 images)

Page 77: Circumscribed, raised, edematous, red plaques involve the superficial portion of the dermis
Page 77: Urticaria resolves spontaneously
Page 77: Lesions occur on any skin surface
Page 77: Plaques have become confluent on the trunk
Page 78: Urticaria
Page 79: Lesions may become confluent
Page 79: Portion of the border may be reabsorbed
Page 79: Presentation is highly variable
Page 79: Some patients with extensive involvement have systemic symptoms
Page 81: Dermographism
Page 81: Dermographism is the most common form of physical urticaria
Page 82: Angioedema body regions
Page 83: Angioedema affects the face, lips, palms, soles, or a portion of an extremity
Page 83: Angioedema is a hive-like swelling
Page 83: Angioedema
Page 85: A single small brown macule
Page 85: A ffew to many slightly elevated plagues
Page 85: Stroking a lesion produces a wheal
Page 86: Urticaria pigmentosa
Page 87: Urticaria pigmentosa
Page 88: Pruritic urticarial papules and plaques of pregnancy body regions
Page 89: Lesions begin as red papules
Page 89: The abdomen is often the initial site of involvment
Page 89: Lesions spread in a symmetric fashion

5: Acne, Rosacea and Related Diso… (pages 0-0, 32 images)

Page 90: Acne body regions
Page 91: Open comedones (blackheads)
Page 92: Closed comedone (whiteheads)
Page 93: Papular acne
Page 93: Pustular acne
Page 93: Cystic acne
Page 93: Cystic acne
Page 94: Parents often think that keratosis pilaris on the cheeks in acne
Page 95: Papulopustular acne of moderate intensity
Page 95: Cystic acne
Page 95: Papulopustular and comedone acne
Page 95: Acne can evolve quickly and scar
Page 95: Papulopustular acne of moderate intensity
Page 95: Milia are microcysts
Page 96: Perioral dermatitis body regions
Page 97: Pinpoint pustules
Page 97: Pinpoint papules and pustules similar to those seen next to the nostrils
Page 97: Group V topical steroids
Page 97: A classic case with the typical distribution
Page 98: Rosacea body regions
Page 99: Deep erythema of the nose
Page 99: Active rosacea with pustules
Page 100: Acne and rosacea may coexist
Page 100: Erythema and telangiectasia
Page 101: Steroid rosacea
Page 101: Papules and pustules on the nose
Page 101: Ocular complications often occur in patients with rosacea
Page 102: Hidradenitis suppurativa body regions
Page 103: Hidradenitis
Page 103: Double and triple comedones are blackheads
Page 103: Hidradenitis of the axillae
Page 103: Hidradenitis may occur under the breasts

6: Psoriasis and Other Papulosqua… (pages 0-0, 63 images)

Page 106: Psoriasis body regions
Page 107: Plaque psoriasis
Page 107: Plaque psoriasis
Page 107: Plaque psoriasis
Page 108: Scalp psoriasis
Page 109: Scalp psoriasis
Page 109: Pustular psoriasis of the soles
Page 109: Psoriasis of the palms
Page 109: Pustular psoriasis
Page 110: Erythrodermic psoriasis
Page 111: Pustular psoriasis
Page 111: Psoriasis pitting
Page 111: Psoriasis oil spot lesion
Page 111: Psoriasis nail deformity
Page 112: Psoriatic onycholysis
Page 112: Psoriasis onycholysis and nail deformity
Page 113: Psoriatic plaques typically clear
Page 113: Inflammatory plaque psoriasis may be painful
Page 113: This plaque has partially responded to clobetasol cream
Page 114: Chronic inflammation of the palms is a difficult diagnostic problem
Page 115: Chronic plaque psoriasis may be asymptomatic
Page 115: Sunlight is an effective treatment
Page 116: Seborrheic dermatitis body regions
Page 116: Erythema and scaling
Page 117: Scale of the lid margins occurs more often in children
Page 117: Patients with a propensity to develop seborrheic dermatitis
Page 117: Dense patches of quadrangular scale
Page 117: Seborrheic dermatitis of the ears
Page 117: Active disease in all of the characteristic areas
Page 117: A classic presentation for seborrheic dermatitis
Page 119: Seborrheic dermatitis
Page 119: Very active inflammation with erythema and dense scale
Page 119: Infantile seborrheic dermatitis
Page 120: Grover's disease body regions
Page 121: Glover's disease
Page 122: Pityriasis rosea body regions
Page 123: The first lesion is usually the largest
Page 123: An extensive case in a typical distribution with lesions in the lower abdominal region
Page 124: Highly active disease involving the neck, trunk, and extremities
Page 125: A ring of tissue-like scale
Page 125: Lesions are typically concentrated in the lower abdomen and groin
Page 126: Lichen planus body regions
Page 127: The primary lesion is a flat-topped papule
Page 127: Close inspection of the surface shows a lacy reticular pattern
Page 127: White plaques are located on the buccal mucosa
Page 127: White lacy reticular pattern is present on the glans and shaft
Page 127: Lichen planus
Page 128: Mucous membrane lichen planus
Page 129: Localized lichen planus
Page 129: Generalized lichen planus
Page 129: Generalized lichen planus
Page 129: Hypertrophic lichen planus
Page 130: Lichen sclerosus body regions
Page 131: Early lesions are ivory-colored
Page 131: The epidermis is thin and atrophic
Page 131: This is the classic presentation for a lesion
Page 133: A white atrophic plaque encircles the vagina and rectum
Page 133: The glans is smooth, white and atrophic
Page 133: There is diffuse sclerosis of the glans and shaft
Page 133: Clerosis is limited to the glans
Page 134: Pityriasis lichenoides body regions
Page 135: Crops of papules
Page 135: Lesions in children are vesicular or pustular

7: Bacterial Infections (pages 0-0, 40 images)

Page 136: Impetigo body regions
Page 137: Bullous impetigo
Page 137: A tinea-like scaling border
Page 137: Impetigo occurs most often on the face
Page 138: Pustules and round plaques with peripheral crust
Page 139: A thick, honey-yellow, adherent crust
Page 139: Widespread dissemination followed 3 weeks of treatment
Page 140: Excoriation of insect bites
Page 140: This patient had molluscum contagiosum
Page 141: Bullous impetigo
Page 141: A bullous rim extened slowly for weeks
Page 142: Cellulitis body regions
Page 143: Cellulitis of the pinna
Page 144: Cellulitis is characterized by erythema, edema and pain
Page 145: Cellulitis
Page 145: Cellulitis
Page 145: Perianal cellulitis
Page 146: Erysipelas body regions
Page 147: Recurrent episodes of infection
Page 147: Erysipelas
Page 148: Folliculitis body regions
Page 149: Folliculitis is inflammation of the hair follicle
Page 149: Staphylococcal folliculitis
Page 151: Pseudofolliculitis
Page 151: The problem is more severe in the neck area
Page 151: Pseudofolliculitis is difficult to manage
Page 153: Acne keloidalis
Page 153: Acne keloidalis presents as hard papules
Page 154: Furuncles and carbuncles body regions
Page 155: Boils (furuncles) are present on the buttock
Page 156: A furuncle has rapidly evolved in a plaque of atopic dermatitis
Page 157: The abscess either remains deep and reabsorbs
Page 157: A single lesion on the finger
Page 158: Pseudomonas folliculitis body regions
Page 159: Occlusion and superhydration of the stratum
Page 159: About 48 hours after the patient used a contaminated whirlpool
Page 159: The rash may be a follicular, maculopapular, vesicular, pustular
Page 161: Otitis externa
Page 161: Pseudomonas cellulitis
Page 161: Malignant external otitis

8: Sexually Transmitted Infection… (pages 0-0, 38 images)

Page 165: Treponema pallidum
Page 166: Primary syphilis
Page 166: Primary syphilis
Page 167: Secondary syphilis
Page 169: The lesions of secondary syphilis
Page 169: Secondary syphilis
Page 169: Secondary syphilis
Page 171: Several small, painful ulcers
Page 171: The ulcers have coalesced
Page 171: Wright's stain of purulent material of the base of the ulcer
Page 172: Wart at the urethral meatus
Page 172: Warts spread rapidly over moist areas
Page 173: These warts are similar in appearance to common warts
Page 173: Multiple discrete warts on the shaft of the penis
Page 174: Genital warts are pale pink
Page 174: Pearly penile papules
Page 174: A large cauliflower-like wart projects from the vagina
Page 174: Warts in the anal area may be numerous and very large
Page 175: Anal warts are often numerous and very large
Page 175: Many small warts may be found in the analy area
Page 176: Primary herpes simplex
Page 177: Tzanck smear
Page 177: Primary herpes simplex
Page 177: Primary herpes simplex
Page 178: Recurrent herpes simplex
Page 178: Recurrent herpes simplex
Page 179: Recurrent herpes simplex under the foreskin
Page 179: Recurrent herpes simplex
Page 181: Phthirus pubis (pubic louse or craf louse)
Page 181: Pediculosis pubis
Page 182: Molluscum contagiosum body regions
Page 183: Lesions are usually discrete
Page 183: Close observation of individual lesions
Page 183: Molluscum are difficult to see through pubic hair
Page 184: Molluscum are commonly found in the genital area in children
Page 185: Molluscum are commonly found in the pubic are in adults
Page 185: A single legion became inflamed
Page 185: Molluscum spread rapidly

9: Viral Inffections (pages 0-0, 58 images)

Page 186: Wart body regions
Page 187: Warts form cylindric projections
Page 187: Digitate wart
Page 187: Warts remain confined to the epidermis
Page 187: Thrombosed black vessels
Page 188: Warts on hands are the most common area
Page 188: Filiform and digitate warts
Page 188: Warts on the palms
Page 188: Confluent warts
Page 189: Warts are frozen until the ""freeze front"" extends for about 1-2 mm beyond the growth
Page 189: Warts blister a day or two after freezing
Page 189: Large blisters form on back of hands
Page 189: Wart virus spread to the edge of the blister
Page 190: Warts are often grouped and are easily spread by scratching
Page 190: Flat warts body regions
Page 191: Flat warts are pink, light brown, or light yellow
Page 191: The face is a commonly involved site
Page 192: Plantar warts frequently occur at points of maximal pressure
Page 192: ""Kissing lesions.""
Page 193: Wart that has little callus on the surface
Page 193: Care should be used when removing the callus
Page 194: Molluscum contagiosum body regions
Page 195: Inoculation around the eye
Page 195: Molluscum contagiosum
Page 195: Lesions spread to inflamed skin
Page 195: Molluscum
Page 197: It is common to see erythema and scaling
Page 197: Several warts become inflamed
Page 199: Primary herpes simplex infection
Page 199: Recurrent herpes
Page 199: Recurrent infection
Page 199: Recurrent infection
Page 200: Recurrent herpes
Page 200: Recurrent herpes
Page 201: Recurrent herpes
Page 201: Recurrent herpes
Page 202: Recurrent herpes on the finger
Page 203: Eczema herpeticum
Page 204: The lesion starts as a 2-4 mm red papule
Page 207: Vesicles become umbilicated and cloudy
Page 208: Lesions of different stages
Page 209: Numerous lesions on the trunk
Page 209: Lesions present in all stages
Page 211: The vesicles vary in size
Page 211: Vesicles either umbilicate or rupture
Page 211: A crust forms
Page 213: A large group of vesicles
Page 213: The eruption begins with red swollen plaques of various sizes
Page 213: Vesicles arise in clusters from the red base
Page 213: Herpes zoster may involve any dermatome
Page 213: Sacral zoster
Page 215: Ophthalmic zoster
Page 215: Ophthalmic zoster
Page 215: Varicella zoster of the geniculate ganglion
Page 215: A classic presentation of grouped vesicles and crusts
Page 217: Cloudy vesicles with red halos
Page 219: Cloudy vesicles with red halos
Page 219: Pale white oval vesicles

10: Fungal Infections (pages 0-0, 76 images)

Page 221: The uncircumcised penis
Page 221: Candida balanitis
Page 221: Infection and inflammation
Page 223: Intense erythema
Page 223: Diaper dermatitis
Page 223: An artificial intertriginous area
Page 225: Skinfolds contain heat and moisture
Page 225: Pustules form
Page 226: A shallow to deep fissure is commonly found in groin intertrigo
Page 226: Intertrigo in the groin
Page 227: Candidiasis
Page 227: Candidiasis
Page 228: Tinea versicolor body regions
Page 229: An extensive eruption in a dark-skinned person
Page 229: Lesions begin as multiple small circular macules
Page 230: Tinea versicolor
Page 231: Classic presentation of tinea versicolor
Page 231: Lesions may be hyperpigmented
Page 231: A powdery scale that may not be obvious on inspection
Page 231: Tinea versicolor
Page 232: Pityrosporum folliculitis body regions
Page 233: Pityrosporum folliculitis
Page 235: Distal subungual onychomycosis
Page 235: Distal subungual onychomycosis
Page 236: Distal subungual onychomycosis
Page 236: Distal subungual onychomycosis
Page 237: White superficial onychomycosis
Page 237: White superficial onychomycosis
Page 237: Proximal subungual onychomycosis
Page 237: Proximal subungual onychomycosis
Page 239: Patients lick and moisten the area in an attempt to prevent cracking
Page 239: Chronically inflamed surfaces become infected with a mixed flora of yeast and bacteria
Page 239: This elderly patient experiences recurrent inflammation from saliva
Page 239: Fissures have formed in the valleys of the skin creases
Page 241: A very characteristic pattern of inflammation is the active border of infection
Page 241: Scale is obtained by holding a #15 surgical blade
Page 243: Dermatophytes
Page 243: Hyphae
Page 245: Interdigital tinea pedis (toe web infection)
Page 245: Interdigital tinea pedis (toe web infection)
Page 245: Tinea of the soles
Page 247: Classic ringworm pattern of fungal infection
Page 247: Erthema and scale exted onto the sides of the foot
Page 247: The classic presentation of hand and foot eczema
Page 248: A half-moon-shaped plaque forms
Page 249: The entire surface of this lesion is dry and scaling
Page 249: The ringworm pattern of infection
Page 249: The ringworm pattern of infection
Page 250: Inflammatory lesions
Page 251: Round annular lesions
Page 251: Tinea may be asymptomatic or itchy
Page 251: Tinea incognito
Page 252: Plaques covering a wide area appear to be eczema
Page 252: Tinea can occur on the face and look like eczema
Page 252: Round annular lesions
Page 252: Classic ringworm pattern of infection
Page 253: Ringworm pattern of infection
Page 253: Tinea incognito
Page 253: Ringworm of the face is not common
Page 253: Large plaque was diagnosed as psoriasis
Page 254: Tinea of the dorsal aspect of the hand
Page 255: Tinea of the palms
Page 255: Tinea incognito
Page 255: Ringworm pattern of infection
Page 256: Tinea incognito
Page 257: Tinea incognito
Page 257: Tinea incognito
Page 257: Tinea incognito
Page 259: Inflammatory tinea capitis
Page 259: Tinea of the scalp
Page 259: Inflammatory tinea capitis (kerion).
Page 261: Scale and pustules may be seen
Page 261: Non-inflammatory lesions
Page 263: Tinea begins insidiously with a small group of follicular pustules
Page 263: Superficial infection
Page 263: Deep follicular infection

11: Exanthems and Drug Reactions (pages 0-0, 19 images)

Page 265: Viral exanthems and drug rashes
Page 265: Viral exanthems
Page 265: Symmetrical eruption of sudden onset
Page 266: Numerous pale pink, almond-shaped macules
Page 267: Pale pink macules
Page 268: Net-like pattern of erythema
Page 269: Facial erythema
Page 271: The hands become red and swollen
Page 272: Kawasaki syndrome
Page 274: Cutaneous drug reactions body regions
Page 279: Maculopapular eruption
Page 279: Erythema multiforme
Page 279: Urticarial eruption
Page 280: Acute generalized exanthematous pustulosis
Page 280: Acute generalized exanthematous pustulosis
Page 281: Fixed drug eruption
Page 281: Photosensitivity drug eruption
Page 281: Photosensitivity drug eruption
Page 281: Classic vieral, generalized, symmetrical, maculopapular eruption

12: Hypersensitivity Syndromes and… (pages 0-0, 27 images)

Page 284: Erythema multiforme body regions
Page 285: A dusky red macule or urticarial papule
Page 285: Target regions for urticaria and drug eruptions
Page 287: Severe bullous form
Page 287: Skin lesions are flat atypical targets
Page 289: Shedding of full-thickness epidermis
Page 289: Wrinkling with slight pressure in toxic epidermal necrolysis
Page 290: Erythema nodosum body regions
Page 291: Red node-like swelling in the characteristic distribution
Page 291: Lesions begin as red node-like swellings over the shins
Page 292: Cutaneous small vessel vasculitis body regions
Page 294: Purpura
Page 294: Purpura found on the lower extremities
Page 295: Purpura vary from pinpoint to several centimeters
Page 295: A few to numerous discrete, purpuric lesions
Page 295: Lesions are most often found on the legs
Page 296: Henoch-Schonlein purpura body regions
Page 297: Henoch-Schonlein purpura
Page 298: Schamberg's Disease body regions
Page 299: Asymptomatic, irregular patches of varying shapes on the lower extremities
Page 299: Lesions begin as asymptomatic, localized areas of cutaneous hemorrhage
Page 299: Changes are more subtle and resemble the hyperpigmentation
Page 299: Distribution is haphazard
Page 300: Sweet's Syndrome body regions
Page 301: Acute, tender, erythematous plaques, nodes
Page 302: Skin lesions are tender erythematous papules and plaques
Page 302: Atypical Sweet's syndrome

13: Infestations and Bites (pages 0-0, 44 images)

Page 304: Scabies body regions
Page 305: Burrow
Page 305: Burrow
Page 305: Vesicles and papules
Page 305: Secondary lesions
Page 306: Sarcoptes scabiei
Page 306: Elderly man with scabies
Page 307: Secondary lesions
Page 307: Secondary lesions dominate the clinical picture
Page 307: Infants can develop vesicles and pustules
Page 307: Infant with 3 month infestation
Page 308: Pediculosis capitis
Page 309: Eyelash infestation
Page 309: Body lousse
Page 311: The louse egg
Page 311: Pthirus pubis (pubic or crab louse)
Page 313: Myiass
Page 313: Large maggot
Page 313: Xylocaine injected into the cavity to aid in extracting the maggot
Page 314: Large local allergic reaction
Page 315: Large urticarial plaque
Page 315: Severe local reaction with necrosis
Page 315: Huge urticarial plaque
Page 317: Black widow
Page 317: Severe muscle pain sign of envenomation
Page 318: Brown recluse spider
Page 319: Distribution of brown recluse spider
Page 319: Violin-shaped or fiddle-shaped marking on spider's back
Page 320: Erythema migrans
Page 321: Ticked Off
Page 321: Lesion is circular
Page 323: Rash is reported in 83% of cases
Page 323: Generalized petechial eruption
Page 323: Reported cases of Rocky Mountain spotted fever, 1990
Page 324: Flea bites in a child were excoriated and became infected
Page 325: Fleas
Page 325: Flea bites
Page 325: Flea bites are typically clustered about the lower leg
Page 326: Cutaneous larva migrans body regions
Page 327: Trapped larva
Page 327: 1 cm larva
Page 327: Many larvae may be present in the same area
Page 327: During larval migration
Page 328: Fire ant stings

14: Vesicular and Bullous Disease (pages 0-0, 14 images)

Page 332: Dermatitis herpetiformis body regions
Page 333: Vesicles are symmetrically distributed
Page 333: Herpetiform refers to the typical grouping of vesicles
Page 333: Vesicles appear singly or in clusters
Page 335: Symmetric distrivution of vesicles
Page 335: Vesicles and bullae are present in this generalized eruption
Page 336: Pemphigus vulgaris body regions
Page 337: Oral erosions
Page 337: Flaccid blisters rupture easily
Page 338: Pemphigus foliaceus body regions
Page 339: The disease begins gradually on the face
Page 340: Bullous pemphigoid body regions
Page 341: Pemphigoid
Page 341: The eruption is often generalized

15: Connective Tissue Disease (pages 0-0, 20 images)

Page 342: Lupus erythematosus body regions
Page 343: Chronic cutaneous lupus of the scalp
Page 343: Keratin accumulates on the surface causing scale
Page 344: The face is themost commonly affected area
Page 345: Follicular plugs
Page 345: Discoid LE
Page 345: Red scaling plaques
Page 345: Lesions in African Americans
Page 345: Discoid lupus
Page 347: Subacute cutaneous lupus erythematosus
Page 349: Acute lupus erythematosus
Page 351: Violaceous erythema
Page 351: Heliotrope rash
Page 352: Violaceous papules
Page 353: Violaceous erythema and scale
Page 355: The skin is tightly bound down
Page 356: Scleroderma
Page 357: Telangiectasias
Page 357: Scleroderm
Page 359: Morphea

16: Light-Related Diseases and Dis… (pages 0-0, 38 images)

Page 360: Sun-damaged skin, actinic-damaged skin, photoaging body regions
Page 361: Course wrinkling
Page 361: Solar elastosis
Page 362: White, round 2-3mm papules (milia)
Page 362: Coarse, deep wrinkles radiate from the lateral margin of the eye
Page 363: Bleeding occurs with the slightest trauma to the sun-damaged surfaces
Page 363: Poikiloderma of Civatte
Page 363: Sun-induced wrinkling on the back of the neck
Page 364: Polymorphous light eruption body regions
Page 365: The papular type is the most common form
Page 365: The papulovesicular type
Page 366: Small papules are disseminated
Page 367: The papulovesicular type
Page 367: Papules are localized and symmetrically distributed
Page 368: Porphyria cutanea tarda body regions
Page 369: The clinical features in order of frequency are blistering in sun-exposed areas
Page 370: Porphyria cutanea tarda
Page 371: Porphyria cutanea tarda
Page 371: White milia form during the healing process
Page 372: Vitiligo body regions
Page 373: The margins of the lesions may become more hyperpigmented
Page 373: Examine the axillae, groin and anal area
Page 374: The genitalia, axillae, and anal areas
Page 374: Vitiligo on the back of the hand
Page 375: Treatment with either PUVA or topical steroids
Page 375: Loss of pigment may be partial or complete
Page 375: Several areas of depigmentation
Page 376: Idiopathic guttate hypomelanosis body regions
Page 377: Idiopathic guttate hypomelanosis
Page 378: Lentigo, juvenile lentigo, solar lentigo body regions
Page 379: Reactive hyperplasia of melanocytes
Page 379: The lesions vary in size
Page 381: Labial lentigines
Page 381: Solar lentigo
Page 381: Lentigo (liver spots) occurs in sun-exposed areas
Page 381: A biopsy should be taken from any lentigo
Page 383: The pigmentation develops slowly
Page 383: The forehead, malar eminences, upper lip

17: Benign Skin Tumors (pages 0-0, 66 images)

Page 384: Seborrheic keratosis body regions
Page 386: Rough-surfaced seborrheic keratoses
Page 386: Rough-surfaced seborrheic keratoses
Page 386: Rough-surfaced seborrheic keratoses
Page 387: Smooth surface keratoses
Page 387: Smooth surface keratoses
Page 387: Smooth surface keratoses
Page 387: Smooth surface keratoses
Page 388: Keratoses mimicking melanoma
Page 388: Keratoses mimicking melanoma
Page 388: Keratoses mimicking melanoma
Page 388: Keratoses mimicking melanoma
Page 389: Irritated seborrheic keratoses
Page 389: Irritated seborrheic keratoses
Page 389: Irritated seborrheic keratoses
Page 390: Lesions can become very large and disfiguring and resemble melanoma
Page 390: Numerous lesions
Page 391: Lesions are often concentrated in the presternal area
Page 391: The number varies from less than 20
Page 391: Lesions may be localized to the areola
Page 392: Stucco keratoses
Page 392: Stucco keratoses body regions
Page 393: Stucco keratoses
Page 394: Skin tags body regions
Page 395: Skin tags begin as tiny, brown or skin-colored
Page 395: Skin tags occur around the eyes
Page 395: Skin tags start as small brown to flesh colored papules
Page 396: Dermatofibroma body regions
Page 397: Early lesions are elevated, hard and pink
Page 398: Rough-surfaced seborrheic keratoses
Page 398: New lesions are pink and elevated
Page 399: The density of the brown pigmentation
Page 399: Dermatofibromas retract beneath the skin surface
Page 400: Keloids and hypertrophic scars body regions
Page 401: A keloid extends beyond the margins of injury
Page 401: Small multiple hypertrophic scars and keloids form
Page 403: A keloid formed after an injury
Page 403: Very large keloids may form in the ear lobe
Page 404: Keratoacanthoma body regions
Page 405: Keratoacanthoma begins as a smooth, dome-shaped, red papule
Page 405: This lesion resembles both a keratoacanthoma
Page 406: Keratoacanthomas
Page 407: This large lesion was present for months
Page 408: Nevus sebaceus body regions
Page 409: This 12 year old boy has reached puberty and the lesion has become thicker
Page 409: Nevus sebaceous in a 30 year old man
Page 410: Nevus sebaceus occurs most often on the scalp
Page 411: Hormonal changes during puberty stimulate sebaceous gland growth
Page 411: Lesions are found on the scalp, face
Page 412: Chondrodermatitis nodularis helicis body regions
Page 413: During the active stage the base may become red and swollen
Page 413: The central scale lacks the keratinous plug of a keratoacanthoma
Page 414: Epidermal cyst body regions
Page 415: Epidermal cysts vary in size
Page 415: Ruptured cysts
Page 416: Spontaneous rupture of the wall results in discharge of the soft yellow keratin
Page 416: Giant comedones are variants of epidermal cysts
Page 417: Epidermal cysts occur commonly on the back of the ear
Page 418: Pilar cyst (Wen) body regions
Page 419: Pilar cysts occur in the scalp
Page 419: This large pilar cyst has exerted pressure against the skin
Page 420: Sebaceous hyperplasia body regions
Page 421: Individual lesions are made up of a cluster of yellow-white globules
Page 421: Yellow-white papules
Page 422: Syringoma body regions
Page 423: The lower lids are the most common area

18: Premalignant and Malignant Non… (pages 0-0, 69 images)

Page 424: Basal cell carcinoma body regions
Page 425: Basal cell carcinoma may appear on the ear
Page 425: This nodular basal cell carcinoma
Page 425: The classic presentation for nodular basal cell carcinoma
Page 425: Nodular basal cell carcinoma
Page 427: Nodular basal cell carcinoma
Page 427: Pigmented basal cell carcinoma
Page 427: Superficial basal cell carcinoma
Page 429: Superficial basal cell carcinoma
Page 429: Superficial basal cell carcinoma
Page 429: Superficial basal cell carcinoma
Page 430: The back is a common place to find superficial basal cell carcinoma
Page 431: The cycle of growth, ulceration, and healing
Page 431: Basal cell carcinomas
Page 431: Morpheaform basal cell carcinoma
Page 432: Actinic keratosis body regions
Page 433: Pigmented actinic keratosis
Page 433: Actinic keratosis
Page 433: Actinic keratosis
Page 433: Actinic keratosis
Page 434: Actinic keratosis accumulate dense scale
Page 434: Almost the entire surface of the nose is covered with scale
Page 435: Actinic cheilitis
Page 435: Actinic keratosis
Page 435: Actinic keratosis
Page 435: Topical chemotherapy
Page 436: A clinical diagnosis of squamous cell carcinoma
Page 436: Actinic keratosis on the back of the hands
Page 437: Topical chemotherapy
Page 437: Actinic keratosis 4 weeks after starting treatment
Page 437: Actinic keratosis 3 weeks after treatment
Page 438: Squamous cell carcinoma body regions
Page 439: Squamous cell carcinoma is commonly found on the ears
Page 439: Differentiating actinic keratosis
Page 439: Large mass of basal cell carcinoma
Page 439: Squamous cell carcinoma
Page 441: Lower lip tumor
Page 441: Clinical diagnosis of cutaneous horn
Page 443: Diagnosis of actinic keratosis
Page 443: Squamous cell carcinoma
Page 444: Bowen's disease body regions
Page 445: Bowen's disease is a slowly growing lesion
Page 445: Diagnosis of Bowen's disease
Page 445: Plaque of Bowen's disease
Page 447: Analogous to Bowen's disease of the skin
Page 447: Bowen's disease of the penis
Page 448: Leukoplakia body regions
Page 449: Degeneration to carcinoma
Page 449: Leukoplakia 2 weeks after treatment
Page 449: Leukoplakia
Page 450: Cutaneous T cell lymphoma body regions
Page 451: Lesions tend to remain fixed in location
Page 451: A red psoriasis-like eruption
Page 451: Early lesions are red with subtle scale
Page 451: Infiltration of the entire skin
Page 452: Necrosis and ulceration of plaques
Page 453: Tumors develop from pre-existing palques
Page 453: Tumors vary in size
Page 453: The plaques vary in shape
Page 455: Malignant cells migrate through the epidermis
Page 455: The disease begins insidiously in one breast
Page 455: The process appears eczematous
Page 457: A white eroded plaque with ill-defined borders on the labia
Page 457: The disease appears as a white-to-red, scaling or macerated
Page 457: Three biopsies were taken before malignant cells were demonstrated
Page 458: Cutaneous metastasis body regions
Page 461: The most common representation of cutaneous metastasis
Page 461: The second most common pattern of cutaneous metastasis
Page 461: Biopsy of this hard nodule

19: Nevi and Malignant Melanoma (pages 0-0, 56 images)

Page 462: Nevi, melanocytic nevi, mole body regions
Page 463: Junctional nevi
Page 463: Compound nevi
Page 463: Intradermal nevi
Page 464: Blue nevi
Page 464: Nevus spilus
Page 464: Spitz nevus
Page 465: Halo nevi
Page 465: Recurrent nevi
Page 466: A dermal nevus with horn pearls on the surface
Page 466: A dome-shaped smooth-surfaced papule
Page 467: Speckled lentiginous nevi
Page 467: A common presentation for a dermal nevus
Page 467: Common presentation for scalp nevi
Page 467: Dermal nevus with no pigment
Page 467: Dermal nevus with a consistency of a wrinkled sack
Page 468: Atypical mole synderom body regions
Page 469: Atypical nevi
Page 469: The ""fried egg"" pattern for an atypical nevus
Page 471: Atypical Nevi
Page 471: Atypical Nevi
Page 471: Atypical Nevi
Page 471: Atypical Nevi
Page 472: Malignant melanoma, lentigo maligna body regions
Page 473: Superficial spreading melanoma
Page 473: Superficial spreading melanoma
Page 473: Superficial spreading melanoma
Page 473: Superficial spreading melanoma
Page 473: Superficial spreading melanoma
Page 474: Nodular melanoma
Page 474: Nodular melanoma
Page 474: Nodular melanoma
Page 474: Nodular melanoma
Page 474: Nodular melanoma
Page 475: Lentigo maligna and lentigo maligna melanoma
Page 475: Lentigo maligna and lentigo maligna melanoma
Page 475: Lentigo maligna and lentigo maligna melanoma
Page 475: Lentigo maligna and lentigo maligna melanoma
Page 476: Acral lentiginous melanoma
Page 476: Acral lentiginous melanoma
Page 476: Acral lentiginous melanoma
Page 481: Darkly pigmented smooth-surfaced seborrheic keratosis
Page 481: Inflamed seborrheic keratosis
Page 481: Rough-surfaced seborrheic keratosis
Page 481: Inflamed seborrheic keratosis
Page 481: Darkly pigmented rough-surfaced seborrheic keratosis
Page 481: Rough-surfaced seborrhic keratosis
Page 482: Pigmented basal cell carcinoma
Page 483: Smooth seborrheic keratosis
Page 483: Dermatofibroma
Page 483: Hemangiomas vary in size and color
Page 483: A bizzarre surface pattern
Page 483: Blue nevus
Page 483: A pigmented basal cell carcinoma
Page 485: Congenital nevi
Page 485: Congenital nevi

20: Vascular Tumors and Malformati… (pages 0-0, 40 images)

Page 486: Hemangiomas of infancy body regions
Page 487: Superficial hemangioma
Page 487: Superficial hemangioma
Page 487: Superficial hemangioma
Page 488: Deeper lesions are skin-colored
Page 489: This lesion is growing rapidly
Page 489: Large, deep hemangioma
Page 490: Venous malformations
Page 491: Venous malformation
Page 491: Capillary hemangioma
Page 493: Nevus anemicus
Page 495: Lymphangioma circumscriptum
Page 497: Cherry angioma
Page 497: Cherry angioma
Page 497: Cherry angiomas increase with age
Page 498: Angiokeratoma body regions
Page 499: Angiokeratoma of fordyce
Page 499: Angiokeratoma of fordyce
Page 501: Angiokeratoma corporis diffusum
Page 501: Angiokeratoma corporis diffusum
Page 502: Venous lake body regions
Page 503: Venous lakes
Page 503: Venous lakes are dark
Page 503: Venous lakes are common on sun-exposed surfaces
Page 504: Pyogenic granuloma body regions
Page 505: Pyogenic granuloma
Page 505: Pyogenic granuloma
Page 506: Kaposi's Sarcoma body regions
Page 507: Kaposi's sarcoma
Page 507: Classic Kaposi's sarcoma
Page 509: Classic Kaposi's sarcoma
Page 509: AIDS-related Kaposi's sarcoma
Page 511: Hereditary hemorrhagic telangiectasia
Page 511: Generalized essential talangiectasia
Page 513: Unilateral nevoid talangiectasia syndrome
Page 513: Telangiectasias of CREST syndrome
Page 513: Telangiectasias of CREST syndrome
Page 514: Spider angioma body regions
Page 515: Central vessel with radiating smaller vessels
Page 515: Spider angiomas

21: Hair and Nail Diseases (pages 0-0, 44 images)

Page 517: Progression and various patterns of hair loss classified by Hamilton
Page 519: Evolution of the femal type of androgenetic alopecia
Page 522: Alopecia areata body regions
Page 523: Alopecia areata
Page 524: Alopecia areata may involve the eyelashes
Page 525: The ophiasis pattern
Page 525: Alopecia areata
Page 526: The favorite site is the easily reached frontoparietal region
Page 527: The affected area has an irregular angulated border
Page 527: Several short broken hairs
Page 528: Longitudinal ridging
Page 528: Ridging and beading is an aging change
Page 529: Habit tic deformity
Page 529: Onycholysis
Page 529: Onycholysis
Page 530: Pitting is the most characteristic sign of psoriasis
Page 530: Habit-tic deformity
Page 531: Psoriasis
Page 531: Psoriasis of the nail unit
Page 531: Psoriasis (oil spot lesion)
Page 532: Acute paronychia
Page 532: Acute paronychia
Page 533: Chronic inflammation of the nail folds
Page 533: Chronic paronychia
Page 533: Chronic Pseudomonas infection
Page 533: Pseudomonas with green pigmentation
Page 534: Trauma to the nail
Page 534: Ingrown nail
Page 535: Accumulation of blood occurs under the nail plate
Page 535: Onychomycosis
Page 535: White bands are a common finding
Page 536: Distal nail splitting
Page 536: Beau's lines
Page 537: A junction nevus
Page 537: Mucous cysts
Page 537: Mucous cyst
Page 538: Distal subungual onychomycosis
Page 538: Nail bands
Page 538: Hutchinson's sign
Page 538: Distal subungual onychomycosis
Page 539: White superficial onychomycosis
Page 539: Distal subungual onychomycosis
Page 539: Distal subungual onychomycosis
Page 540: Proximal subungual onychomycosis

22: Cutaneous Manifestations of In… (pages 0-0, 34 images)

Page 547: Dermatomyositis
Page 547: Sign of Leser-Trelat
Page 549: Sweet's syndrome
Page 551: Glucagonoma syndrome
Page 553: Familial multiple cancer syndromes
Page 555: Cowden syndrome
Page 556: Acanthosis nigricans body regions
Page 557: Most common site of involvement is the axilla
Page 557: Symmetric brown thickening of the skin in the axillae
Page 559: Tumors are usually not present in childhood
Page 559: Tumors
Page 559: Lisch nodules are pigmented, melanocytic
Page 561: Caf-au-lait spots
Page 563: Adenoma sebaceum
Page 563: Adenoma sebaceum
Page 565: Shagreen patch
Page 565: Hypomelanotic macules
Page 566: Granuloma annulare body regions
Page 567: The borders are elevated with confluent papules
Page 567: Granuloma annulare
Page 567: Dense lesion that restricts range of motion of the finger
Page 568: This plaque has been present for months
Page 569: Granuloma annulare
Page 569: The ankle is a common site to find granuloma annulare
Page 570: Necrobiosis lipoidica body regions
Page 571: The eruption begins as an oval violaceous patch
Page 571: More than 50% of patients with this condition are generally insulin dependent
Page 571: Chronic inflammation
Page 572: Pyoderma gangrenosum body regions
Page 573: The initiating lesion consists of discrete pustules
Page 573: Differentiation from other diseases causing ulcers
Page 574: The legs are the most common site
Page 575: Eventually a lesion forms with multiple ulcers
Page 575: A huge ulcer with the characteristic violaceous border

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