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A Clinical Atlas of 101 Common Skin Diseases

Allergic (Leukocytoclastic) Vasculitis

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A systemic inflammatory process involving venules by deposits of fibrin within their wall in conjunction with neutrophils and nuclear “dust” of neutrophils in the dermis and, at times, the subcutaneous fat.

A Clinical Atlas of 101 Common Skin Diseases

Cysts and Cystic Hamartomas

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Papules, nodules, and tumors that, on gross examination, are usually skin colored and, on histopathologic examination, consist of an epithelium-lined sac that contains fluid, cells, or both in the case of true cysts and of cysts that are associated with other epithelial elements of adnexa in the case of cystic hamartomas.

A Clinical Atlas of 101 Common Skin Diseases

Dermatofibroma

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An inflammatory process that develops secondary to trauma, usually in the form of a penetrating injury or rupture of a follicle, and that proceeds through stages of granulation tissue with numerous extravasated erythrocytes, granulomatous inflammation, and fibrosis.

A Clinical Atlas of 101 Common Skin Diseases

Dermatofibrosarcoma Protuberans

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A malignant nonepithelial neoplasm (a sarcoma) presumably of perineural fibrocytes that presents itself usually on the trunk, but sometimes elsewhere, such as the extremities, face, and scalp.

A Clinical Atlas of 101 Common Skin Diseases

Dermatomyositis

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An inflammatory disease of children and adults that tends to involve skin and skeletal muscle mostly, the findings in the skin being patches with the color of heliotrope, especially in the periocular region.

A Clinical Atlas of 101 Common Skin Diseases

Dermatophytosis

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An inflammatory process caused by superficial fungi, i.e., fungi situated superficially in the cornified layer and in other cornified structures, and expressed clinically as smooth-surfaced papules, scaly papules, scaly plaques, nodules, pustules, vesicles, and bullae.

A Clinical Atlas of 101 Common Skin Diseases

Histiocytosis X

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A proliferation of abnormal Langerhans’ cells that may affect internal organs, e.g., the spleen, liver, and bone, sometimes with fatal outcome, as well as the skin, where lesions usually manifest themselves as purpuric papules or ulcers that may be localized (to the vulva, for example) or widespread.

A Clinical Atlas of 101 Common Skin Diseases

Keratosis Pilaris/Lichen Spinulosus

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Keratotic spikes that emerge from dilated ostia of infundibula and are equidistant from one another.

A Clinical Atlas of 101 Common Skin Diseases

Lupus Erythematosus

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An inflammatory process that expresses itself in the skin in protean ways that are variations on a basic pathologic theme, and includes evanescent patches on the face (“butterfly blush”), scaly papules and plaques that resolve with atrophy and hyperpigmentation (classic discoid lupus erythematosus), arcuate, annular, and serpiginous lesions (subacute cutaneous lupus erythematosus), nonscaling plaques (tumid lupus erythematosus), subcutaneous nodules (lupus profundus), and blisters (bullous lupus erythematosus).

A Clinical Atlas of 101 Common Skin Diseases

Lymphomatoid Papulosis

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A distinctive type of CD 30 lymphoma characterized by the presence mostly of papules, some of them purpuric, that may ulcerate and heal with a scar, and by lesions that tend to come and go for years, eventually disappearing entirely or, on occasion, becoming nodular and even tumorous, which is an indication of likelihood of detectable lymphomatous involvement of some organs besides the skin.

A Clinical Atlas of 101 Common Skin Diseases

Neurofibromatosis

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A constellation of lesions that represent disorders of melanocytes (e.g., axillary "freckles" and café au lait "spots") and of proliferations of Schwann cells (e.g., papules, nodules, and tumors of neurofibroma).

A Clinical Atlas of 101 Common Skin Diseases

Palmar and Plantar Keratoderma

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A keratotic condition of the palms and soles, inherited usually, but sometimes acquired, in which involvement may be diffuse, circumscribed (including striate), or punctate.

A Clinical Atlas of 101 Common Skin Diseases

Phototoxic Dermatitis

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An inflammatory process that represents the combined effects of a toxic substance applied topically or administered systemically in combination with the effects of ultraviolet light, the result being a caricature of sunburn.

A Clinical Atlas of 101 Common Skin Diseases

Porokeratosis

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A constellation of conditions that assumes various forms clinically but whose most dependable denominator in common (the exception being the punctate manifestation) is a keratotic ring around a central zone of atrophy, e.g., in a congenital expression that takes the form of a plaque (Mibelli), in a congenital manifestation in which lesions are in linear array (segmental), in an acquired type induced by ultraviolet light (disseminated superficial actinic), and in an acquired form in which lesions are not in photodistribution (disseminated superficial).

A Clinical Atlas of 101 Common Skin Diseases

Scars, Keloids, and Anetodermas

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A type of fibrosing inflammation characterized clinically by lesions that at first are elevated and that do not extend beyond the exact site of injury and that in time tend to shrink, sometimes even becoming atrophic.

A Clinical Atlas of 101 Common Skin Diseases

Anetoderma

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The end-stage of an inflammatory or neoplastic process in which there is loss of collagen and elastic tissue in the mid-reticular dermis with consequent formation of lesions that protrude in dome-like fashion above the skin surface and that can be herniated below the skin surface.

A Clinical Atlas of 101 Common Skin Diseases

Seborrheic Keratosis, Including Solar Lentigo

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A benign neoplasm of keratinocytes that consists of pigmented macules, papules, and plaques distributed on sun-exposed sites for a solar lentigo and the reticulated type of seborrheic keratosis, which represents a later stage of solar lentigo, and on the trunk mostly for other types of seborrheic keratosis unrelated to solar lentigo.

A Clinical Atlas of 101 Common Skin Diseases

Urticaria Pigmentosa

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A benign neoplastic process of mast cells.

A Clinical Atlas of 101 Common Skin Diseases

Folliculitis (Infundibulitis) and Pseudofolliculitis (Pseudoinfundibulitis)

Infundibulitis, usually a suppurative inflammatory process that involves infundibula, is either noninfectious, as in the case of pustules of acne vulgaris, or infectious, as in the case of pustules caused by Staphylococcus aureus. In contrast, pseud…

Therapeutic Strategies in Dermatology

Psoriasis: Principles of Psoriasis Management

…ac, Vanamide) in petrolatum may also be used with occlusion. Topical corticosteroids. Are the most commonly prescribed agents for treatment of localized psoriatic lesions. High-potency topical steroids (class 1 or 2) are required, except for the f…

Therapeutic Strategies in Dermatology

Acne Vulgaris: Treatment

Treatment Mild to moderate acne First-line therapy (comedonal acne only): topical retinoid First-line therapy (mild inflammatory acne): topical retinoid alone, topical retinoid + topical antimicrobial Topical retinoids are considered first…

Therapeutic Strategies in Dermatology

Periorificial Dermatitis: Treatment

…herapy: The first-line therapy for periorificial dermatitis is to stop any offending agents. Several therapeutic strategies, including oral antibiotics, topical medications, or both are used to reduce inflammation. Use of gentle skin care is an impor…

Therapeutic Strategies in Dermatology

Seborrheic Dermatitis: Principles of Seborrheic Dermatitis Management

…the treatment of seborrheic dermatitis. First-line treatment: Topical ketoconazole 2% shampoo such as Nizoral (scalp), cream or gel such as Xolegel (face). Topical antifungal agents are first-line treatment of seborrheic dermatitis. Severe cases wil…

Therapeutic Strategies in Dermatology

Scabies: Principles of Management of Scabies

…t course of treatment, or require a keratolytic agent (such as topical urea or salicylic acid cream) as an adjunctive treatment. Pitfalls Most therapeutic failures are related to improper use of the topical agents. The topical scabicides must be ap…

Therapeutic Strategies in Dermatology

Lichen Sclerosus et Atrophicus: Overview

…ncrease the risk for the development of neoplasia. Superpotent topical steroid treatment is often associated with coexistent candidiasis, which can be managed with appropriate oral or topical agents. Laser and excisional surgery may be followed by re…

Therapeutic Strategies in Dermatology

Hailey-Hailey Disease: Overview

…xacerbations are triggered by heat, sweating, friction, and/or secondary infections. Lesions also affect the chest and back, but these lesions tend to be easier to control. Hence, the therapeutic strategy is to minimize and/or control all of these pr…

Therapeutic Strategies in Dermatology

Rosacea: Subtypes of Rosacea and Their Treatment

…e face. Patients often complain of intolerance or sensitivity to topical products and cosmetics. This subtype is best treated with avoidance of flushing, photoprotection, and surgical or laser therapies (see table, Subtype Directed Therapy). Though…

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