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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

Lupus: Key Points

…ic forms of cutaneous lupus may also occur in association with systemic lupus erythematosus. It is also important to note that some patients with cutaneous-only lupus may meet criteria for systemic lupus erythematosus. The diagnosis of cutaneous lupu…

Therapeutic Strategies in Dermatology

Psoriasis: Principles of Psoriasis Management

…nsive body surface involvement (greater than 10% surface area) Topical treatment-resistant scalp or palm/sole involvement Arthritis or nail involvement Generalized pustular and erythrodermic variants Topical therapy Phototherapy Systemic therap…

Therapeutic Strategies in Dermatology

Acne Vulgaris: Treatment

…cne treatment with all female patients. A general guideline is to discontinue all potentially teratogenic medications at least one month prior to attempts for conception. Azelaic acid (15 or 20% cream) b.i.d. and topical or systemic erythromycin base…

Therapeutic Strategies in Dermatology

Pyoderma Gangrenosum: Treatment

…and both elevation and support stockings should be prescribed to minimize venous pooling that can lead to leg ulcers. Subsequent steps If the response to systemic steroids is inadequate and the process is extremely rapid, treat with cyclosporine A…

Therapeutic Strategies in Dermatology

Kaposi’s Sarcoma: Overview

…interferon alpha, 3 million units three times weekly, is well tolerated and over several months may lead to marked improvement and clinical remissions. For debilitating extensive cutaneous disease, symptomatic visceral involvement, and relapses afte…

Therapeutic Strategies in Dermatology

Drug Eruptions: Initial Evaluation

Initial Evaluation Introduction Adverse reactions to medications are common, and cutaneous drug eruptions may occur in 3% of all hospitalized patients who are receiving medications. They can represent 1% of consultations in office-based dermatology…

Therapeutic Strategies in Dermatology

Borreliosis (Lyme Disease): Key Points

…cum migrans initially presents, and may remain negative for up to 6 weeks. In endemic areas, seropositivity may exist in four to as high as 50% of residents. The therapeutic strategy is to eradicate the pathogenic organism. Systemic antibiotic therap…

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