1. Acne
Disease)
--- Content provided by FirstRanker.com ---
Rosacea
8. Pre-malignant and Malignant Les
--- Content provided by FirstRanker.com ---
2. Bacterial Infectionsions
Folliculitis
--- Content provided by FirstRanker.com ---
Actinic Keratoses
Impetigo
Basal Cell Carcinoma
--- Content provided by FirstRanker.com ---
Squamous Cell Carcinoma
3. Benign Neoplasms
Malignant Melanoma
--- Content provided by FirstRanker.com ---
Seborrheic KeratosesAtypical Mole (Dysplastic)
Granuloma Pyogenicum
--- Content provided by FirstRanker.com ---
Atypical MoleLentigo Simplex
Atypical Mole
--- Content provided by FirstRanker.com ---
Atypical Mole4. Childhood Infectious Disea
ses/skin Lesions
--- Content provided by FirstRanker.com ---
9. PsoriasisVaricella (Chicken Pox)
Psoriasis of the Nails
--- Content provided by FirstRanker.com ---
Hand, Foot and Mouth DiseaseIntertriginous Psoriasis
Verruca Plana
Psoriasis of the Scalp
--- Content provided by FirstRanker.com ---
Pustular Psoriasis5. Eczematous Dermatitis
Guttate Psoriasis
--- Content provided by FirstRanker.com ---
Pityriasis Rosea
Vesicular Hand Dermatitis
10. Sexually Transmitted Diseases
--- Content provided by FirstRanker.com ---
Seborrheic Dermatitis
Herpes Simplex, Penis
--- Content provided by FirstRanker.com ---
Nummular DermatitisHerpes Simplex, Vulva
Herpes Simplex, Perineum
--- Content provided by FirstRanker.com ---
6. Fungal InfectionsHerpes Simplex in AIDS
Tinea Capitis
--- Content provided by FirstRanker.com ---
Condyloma Acuminatum (Genital
Tinea Versicolor
--- Content provided by FirstRanker.com ---
Warts)Candidiasis
Secondary Syphilis
--- Content provided by FirstRanker.com ---
11. Stings and Insect BitesScabies
Pediculosis (Lice)
--- Content provided by FirstRanker.com ---
12. UrticariaPapular Urticaria
Urticaria
--- Content provided by FirstRanker.com ---
13. Viral InfectionsMolluscum Contagiosum
Herpes Simplex
Herpes Zoster
--- Content provided by FirstRanker.com ---
RosaceaRosacea is a congestive blushing and
flushing reaction of the central areas of
--- Content provided by FirstRanker.com ---
the face. It is usually associated with an
acneiform component (papules,
--- Content provided by FirstRanker.com ---
pustules, and oily skin). It usuallyoccurs in middle-aged and older people.
The cheeks, nose, and chin, on the
--- Content provided by FirstRanker.com ---
entire face, may have a rosy hue.
Burning or stinging often accompanies
--- Content provided by FirstRanker.com ---
episodes of flushing. It is much morecommon than lupus erythematosus, with which it is often confused. Rosacea
is distinguished from acne by age, the presence of the vascular component, and
--- Content provided by FirstRanker.com ---
the absence of comedones.
Folliculitis
--- Content provided by FirstRanker.com ---
Folliculitis is characterized by red-ringedpapules and pustules at hair follicles. Gram
negative folliculitis may be spread by
contaminated hot tubs. Gram stain and culture
will help to differentiate bacterial from non
--- Content provided by FirstRanker.com ---
bacterial folliculitis. History is important forpinpointing the cause of non-bacterial
folliculitis.
Impetigo
--- Content provided by FirstRanker.com ---
Superficial honey-colored serous crusts arecharacteristic of this disorder. It is usually
caused by a staphylococcus infection. Culture is
rarely reliable.
Seborrheic Keratoses
--- Content provided by FirstRanker.com ---
These lesions are benign overgrowths of
epithelium, largely appearing on the torso,
face, and neck. They are seen on almost every
one over the age of 50. The borders are
--- Content provided by FirstRanker.com ---
typically irregular, and they range in colorfrom beige or gray-white to very dark brown.
These "barnacles" of older skin can number
only a few to as many as hundreds. Although
often raised and dry, they can be flatter and
--- Content provided by FirstRanker.com ---
greasier (seborrheic) in texture.Granuloma Pyogenicum
This is a vascular reactive nodule that develops as
a response to a minor injury. The overgrowth of
--- Content provided by FirstRanker.com ---
capillaries leads to a raised red lump which bleedsprofusely when torn.
Lentigo Simplex
These lesions occur on sun-exposed skin, especially
face, arms, and hands. Lesions are flat, and
--- Content provided by FirstRanker.com ---
pigmented in shades of brown, with characteristicallysharp borders. They tend to fade with sun avoidance.
Varicella
Chicken Pox
--- Content provided by FirstRanker.com ---
The rash is pruritic and most prominent on the face,
scalp and trunk. It appears as multitudes of red
--- Content provided by FirstRanker.com ---
ringed papules and vesicles in varying stages ofdevelopment. Crusts eventually form and slough off
in 7 to 14 days. Nondermatomal distribution and
--- Content provided by FirstRanker.com ---
lesions of varying stages distinguish primary
varicella from herpes zoster. Fever and malaise may be mild in children and
--- Content provided by FirstRanker.com ---
much more severe in adults.Hand, Foot, and Mouth Disease
The disorder is characterized by stomatitis and
--- Content provided by FirstRanker.com ---
vesicular rash on palms of hands and soles of feet. It
is caused by Coxsackieviruses A5, 10, 16. The
--- Content provided by FirstRanker.com ---
development of mouth sores is most troublesome toadults. The skin lesions are vesicopustules, 0.5 to 5
mm, red-ringed, more oval than round, on palms,
--- Content provided by FirstRanker.com ---
sides of fingers and soles.
Verruca Plana
--- Content provided by FirstRanker.com ---
The numerous discrete lesions, closely set, usuallyoccur on face, dorsa of hands and shins. Lesions are
flat-topped, slightly elevated, well demarcated,
generally flesh-colored, with a matte-smooth surface.
Lesions tend to spontaneously disappear.
--- Content provided by FirstRanker.com ---
Pityriasis RoseaThis disorder is a common, but unexplainable,
reaction. The initial lesion, "herald patch", is red and
scaly, followed in 1 to 2 weeks by widespread, oval,
--- Content provided by FirstRanker.com ---
scaling, fawn-colored macules 4 to 5 mm indiameter over the trunk and proximal extremities.
Pityriasis rosea is usually an acute self-limiting
illness that lasts 4 to 8 weeks. It is not highly infectious.
Vesicular Hand Dermatitis
--- Content provided by FirstRanker.com ---
This disorder is a severely pruritic reaction in
individuals with a personal or family history of
allergic manifestations. It is characterized by flares
of congestion resulting in deep and superficial
--- Content provided by FirstRanker.com ---
blisters, followed by peeling, scaling, and a dry,reddened surface. Flares generally result from
contact with irritants, but stress is also a significant
factor.
Seborrheic Dermatitis
--- Content provided by FirstRanker.com ---
Seborrheic dermatitis is generally limited to the scalp;
however, dry scales and underlying erythema can
--- Content provided by FirstRanker.com ---
occur on the face, ears, chest, back, and body folds.Skin may be dry or oily. In infants, a widespread
reaction is associated with minimal discomfort. The
--- Content provided by FirstRanker.com ---
yeast organism, Pityrosporum, may be a factor. Mild
scaling without any erythema is often termed simple
--- Content provided by FirstRanker.com ---
dandruff. Tinea capitis may simulate dandruff or seborrheic dermatitis, andscrapings should be taken for KOH examination and fungal culture, especially
in children, if hair loss is present.
--- Content provided by FirstRanker.com ---
Nummular Dermatitis
A pruritic dermatosis, characterized by round to oval
(coin-shaped) areas of vesiculation, superficial
--- Content provided by FirstRanker.com ---
crusting, and redness. Number of lesions varies fromfew to many. More often this is a symmetrical
pattern in young adults. Not related to atopic
dermatitis.
Tinea Capitis
--- Content provided by FirstRanker.com ---
Along with hair loss, the scalp surface showsseborrheic dermatitis-like scaling, impetigo-like
crusting, pustules, inflammatory nodules or kerion.
Identify tinea with KOH culture onto a fungal media.
No longer a disease confined to children. If infection
--- Content provided by FirstRanker.com ---
suspected, all family members should be examined.Tinea Versicolor
Asymptomatic to mildly itchy macules that scale
--- Content provided by FirstRanker.com ---
readily on scraping. Lesions, usually occur on thetrunk, but may appear on upper arms, neck, face,
and groin. Caused by a yeast organism,
--- Content provided by FirstRanker.com ---
Pityrosporum orbiculare. Altered pigmentation can
be very subtle to obvious, both hypo and
--- Content provided by FirstRanker.com ---
hyperpigmented. KOH shows characteristic spores and hyphae. Fungal cultureis not useful.
Candidiasis
--- Content provided by FirstRanker.com ---
Common normal flora, but it may become an
opportunistic pathogen widespread in patients with
--- Content provided by FirstRanker.com ---
AIDS and other immunosuppressed patients.Mucocutaneous candidiasis occurs on the vulva, anus,
breast or groin folds. Superficial denuded beefy red
--- Content provided by FirstRanker.com ---
areas with or without scattered satellite
vesicopustules with marginal scaling. Microscopic examination with 10%
--- Content provided by FirstRanker.com ---
KOH reveals budding spores and short hyphae.Erythema Chronicum Migrans
Lyme Disease
--- Content provided by FirstRanker.com ---
Caused by the spirochete Borrelia burgdorferi, which
is transmitted to humans by a deer tick bite, infection,
--- Content provided by FirstRanker.com ---
is characterized by erythema migrans. A flat orslightly raised red lesion appears at the site. The
reaction can become quite large, is generally circular
--- Content provided by FirstRanker.com ---
in shape, and can show several concentric rings
(target pattern). Erythema migrans is often accompanied by flu-like illness
--- Content provided by FirstRanker.com ---
with fever, chills, and myalgias. At this stage, laboratory tests are not reliable.Actinic Keratoses
Actinic keratoses are single or multiple, flesh
--- Content provided by FirstRanker.com ---
colored or slightly hyperpigmented, dry, rough,scaly lesions which occur on skin exposed to the
sun. Cells are atypical, and they are considered to
be pre-malignant because some may eventually
become squamous cell cancers.
--- Content provided by FirstRanker.com ---
Basal Cell CarcinomaThis lesion represents 90% of skin cancers. Basal
cell carcinoma is the most common cancer. On the
--- Content provided by FirstRanker.com ---
face, it usually starts as a reddened papule or nodule
with a smooth surface and a translucent, pearly
--- Content provided by FirstRanker.com ---
quality. Because of a poorly formed stroma, it isfragile and often bleeds. On the torso, the lesion has
an irregular surface, bright red color, sometimes scaly, with a distinct edge.
--- Content provided by FirstRanker.com ---
Histologic examination is required.
Squamous Cell Carcinoma
--- Content provided by FirstRanker.com ---
This lesion usually appears on skin that shows othersignificant changes of chronic sun exposure.
Especially prevalent in fair-skinned people who
--- Content provided by FirstRanker.com ---
sunburn easily and tan poorly. It may arise out of
actinic keratoses. Characteristically, the lesion
--- Content provided by FirstRanker.com ---
appears fairly rapidly as a small red, conical, hardnodule. Should it appear on the mucus membrane or lip area, it behaves much
more aggressively and can be fatal. Histologic examination is required.
--- Content provided by FirstRanker.com ---
Malignant Melanoma
Recognized through the mnemonic, "A-B-C-D:"
Asymmetry of contour, irregularity of Border and
--- Content provided by FirstRanker.com ---
Color, and Diameter larger than 6 mm. Melanomasvary from macules to nodules. Color ranges from
flesh tints to pitch black and mixtures of white, blue,
purple, and red. Any pigmented skin lesion with
recent change in appearance should be suspected.
--- Content provided by FirstRanker.com ---
Malignant melanoma can exist in a superficial spreading mode for years and
still be curable by excision with 1 to 2 cm margins. Once a vertical growth
phase develops, rapid spread through blood and lymph vessels occurs.
--- Content provided by FirstRanker.com ---
Histologic examination is required.Atypical Moles
Dysplastic change implies abnormal cell
development, which does not necessarily imply
--- Content provided by FirstRanker.com ---
precancerous change. These atypical moles, showirregular outlines, and different shades and patterns
of brown color. If they appear in a person with a
family history of melanoma and are multiple in
number, the incidence of cancer developing reaches
--- Content provided by FirstRanker.com ---
100%. If they are sporadic in pattern and number,they should be photographed and reexamined
regularly. Histopathologic examination is required.
Psoriasis of the Nails
--- Content provided by FirstRanker.com ---
Pitting of nail surface with spots of white to yellowbrown (oil droplets) reflects psoriatic changes in the
nail matrix and nail bed respectively. Distally, there
are irregular onycholysis, splitting, and dystrophic
changes. Onycholysis may simulate onychomycosis;
--- Content provided by FirstRanker.com ---
therefore, fungal culture will be valuable indiagnosis.
Intertriginous Psoriasis
Sebopsoriasis
--- Content provided by FirstRanker.com ---
The skin fold areas are shades of red and orange,
with mild to severe itching. The characteristic sign
--- Content provided by FirstRanker.com ---
is the uniform appearance (unlike tinea) and distinctborder (unlike candida). Generally, a complete skin
exam will reveal other signs of psoriasis.
--- Content provided by FirstRanker.com ---
Psoriasis of the Scalp
The lesions are red, sharply defined plaques covered
with thick silvery scales. This distinguishes psoriasis
--- Content provided by FirstRanker.com ---
from the diffuse or patchy redness and scaling ofseborrheic dermatitis.
Pustular Psoriasis
Generally, a chronic, disabling condition of the
--- Content provided by FirstRanker.com ---
palms and soles, it can also be a part of a verysevere generalized reaction.
Guttate Psoriasis
A form of psoriasis characterized by the rapid
--- Content provided by FirstRanker.com ---
development of myriad small lesions, 3 to 10 mm indiameter, on all areas of the body, especially the
extremities. More often seen in young people.
Herpes Simplex, Penis
--- Content provided by FirstRanker.com ---
Red, sharply marginated, grouped vesicles usuallybecome crusted sores within 48 hours. Typical
distribution includes prepuce, coronal sulcus, glans,
shaft. Deep aching pain of the perineum may occur
2 to 3 days before appearance of the skin lesions.
--- Content provided by FirstRanker.com ---
Itchy and painful, lesions generally recur in thesame location.
Herpes Simplex, Vulva
Painful, recurrent, grouped vesicles. Viral
--- Content provided by FirstRanker.com ---
shedding occurs even when no lesions are present.This sexually transmitted disease can complicate
pregnancy.
Herpes Simplex, Perineum
--- Content provided by FirstRanker.com ---
Recurrence of painful sores is a diagnostic sign.Herpes Simplex in AIDS
Lesion in the perianal area becomes a deeply
ulcerated, very painful, disabling infection.
--- Content provided by FirstRanker.com ---
Condyloma AcuminatumGenital Warts
Highly contagious and sexually transmitted, soft,
--- Content provided by FirstRanker.com ---
skin-colored, fleshy warts can be pin-head papules
or cauliflower-like masses that are caused by the
--- Content provided by FirstRanker.com ---
human papilloma virus. On the vulva, perianal area,vaginal walls, cervix, or on the shaft of the penis,
warts can be raised clusters and obviously wart-like, or so small they only
--- Content provided by FirstRanker.com ---
become recognizable after application of 5% acetic acid (vinegar) for ten
minutes. Lesions must be distinguished from condylomata lata caused by
--- Content provided by FirstRanker.com ---
syphilis. Diagnosis of syphilis is based on a positive serologic test or discoveryof Treponema pallidum on darkfield examination.
Secondary Syphilis
--- Content provided by FirstRanker.com ---
Generalized maculopapular eruptions are most
common, although lesions may be pustular or
--- Content provided by FirstRanker.com ---
follicular as well (or combinations of any of thesetypes). Condylomata lata are raised, weeping
papules on the moist areas of the skin and mucous
--- Content provided by FirstRanker.com ---
membranes. The patient generally feels sick, can
have regional lymphadenopathy, but complains only of minimal itching.
--- Content provided by FirstRanker.com ---
Diagnosis of syphilis is based on a positive serologic test or discovery ofTreponema pallidum on darkfield microscopy.
Scabies
--- Content provided by FirstRanker.com ---
Scabies is a common dermatitis caused by
infestation with Sarcoptes scabiei. The entire
--- Content provided by FirstRanker.com ---
family may be affected. Skin lesions are scatteredgroups of pruritic vesicles and pustules in "runs" or
"burrows" on the sides of the fingers, palms, wrists,
--- Content provided by FirstRanker.com ---
elbows, axillae, as well as around the waist and
groin. Itching occurs almost exclusively at night.
--- Content provided by FirstRanker.com ---
Microscopic examination of a scraping will reveal scabies mites, ova, andfeces.
Pediculosis
--- Content provided by FirstRanker.com ---
Lice
Pediculosis is a parasitic infestation of the skin of the
--- Content provided by FirstRanker.com ---
scalp, trunk, or pubic areas. Itching may be veryintense and scratching may result in deep
excoriations over the affected area. Head lice are
--- Content provided by FirstRanker.com ---
easiest to see above the ears and at the nape of the neck. The nits (egg sacs) are
attached to hairs, close to the skin. Body lice deposit visible nits on vellus hair.
--- Content provided by FirstRanker.com ---
Head and body lice are similar in appearance and are 3 to 4 mm long.Papular Urticaria
Almost exclusively in children, this is a widespread
--- Content provided by FirstRanker.com ---
reaction to insect bites such as fleas, bedbugs,chiggers, or gnats, and may persist for long periods.
The tendency will fade with onset of adolescence.
Urticaria
--- Content provided by FirstRanker.com ---
Usually intensely itching intradermal vascularreaction (wheals or hives). No epidermal changes
such as scaling, papules, or blisters. More often has
an unknown, nonspecific etiology, but can be
related to medications, foods, and similar vascular
--- Content provided by FirstRanker.com ---
stimulating agents. Laboratory studies are not likelyto be helpful in evaluation unless there are sugges
tive findings in the history and physical examination.
Molluscum Contagiosum
--- Content provided by FirstRanker.com ---
Caused by a large pox virus, these smooth-walled,dome-shaped, pearly papules, 2 to
5 mm in size, have an umbilicated center.
Occasionally a significant inflammatory reaction
will occur. Principal sites are face, hands, lower
--- Content provided by FirstRanker.com ---
abdomen, and genitals. A common viral infectionseen in AIDS. It is more difficult to eradicate in
these patients.
Herpes Simplex
--- Content provided by FirstRanker.com ---
Small red-ringed blisters can occur anywhere,especially around oral and genital areas. Associated
and often preceded by burning and stinging.
Regional lymph nodes may be swollen and tender.
Blisters rupture early, leaving serous crusts which
--- Content provided by FirstRanker.com ---
can then become secondarily infected. Viral culturesand ELISA are positive.
Herpes Zoster
Red-ringed blisters occur in a dermatomal
--- Content provided by FirstRanker.com ---
distribution of a nerve root. Papules change to
vesicles which become pustules before crusting.
--- Content provided by FirstRanker.com ---
New lesions appear for up to one week. Regionallymph glands may be tender and swollen. Since this
is primarily a nerve infection with secondary skin
--- Content provided by FirstRanker.com ---
manifestations, it is preceded, accompanied, and
followed by pain. In elderly patients, it is often severe and prolonged. In
--- Content provided by FirstRanker.com ---
immunosuppressed patients, herpes zoster may disseminate, producing lesionsbeyond the dermatome, visceral lesions, and encephalitis. Disseminated Zoster
is a serious, sometimes life-threatening complication.
--- Content provided by FirstRanker.com ---