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Acne vulgaris

Atopic dermatitis

Photosensitive eruptions

Figure 8-123 Typical distributions of common skin conditions.

Table 8-1 describes the differential diagnosis of common maculopapular diseases. Table 8-2 lists the differentiation of some common eczematous disorders and gives some special hints about their causes derived from the history. Table 8-3 provides information for a differential diagnosis of the vesiculobullous diseases. Table 8-4 classifies some of the common benign tumors by color. Table 8-5 lists some of the common allergens associated with contact dermatitis. Table 8-6 lists the important differences between chickenpox and smallpox.

Table 8-1 describes the differential diagnosis of common maculopapular diseases. Table 8-2 lists the differentiation of some common eczematous disorders and gives some special hints about their causes derived from the history. Table 8-3 provides information for a differential diagnosis of the vesiculobullous diseases. Table 8-4 classifies some of the common benign tumors by color. Table 8-5 lists some of the common allergens associated with contact dermatitis. Table 8-6 lists the important differences between chickenpox and smallpox.

Table 8-1 Common Maculopapular Diseases*

Pityriasis

Characteristic Psoriasis Rosea

Tinea Versicolor

Lichen Planus

Seborrheic Dermatitis

Color

Dull red

Pinkish-yellow

Reddish-brown

Violaceous

Pinkish-yellow

Scale

Abundant

Fine, adherent

Fine

Shiny, adherent

Greasy

Induration1"

1 +

0

0

1+

1 +

Face lesions

Rare

Rare

Occasional

Rare

Common

Oral lesions1

0

0

0

2+

G

Nail lesions1

4+

0

0

Rare

G

*See Figures 8-14, 8-51, 8-52, 8-54, 8-55, 8-62, 8-72, 8-73, 8-98, 8-100, and 12-15. {0, rarely seen; 1+, occasionally seen; 2+, frequently seen; 4+, nearly always associated.

Table 8-2

Common Eczematous Diseases*

Characteristic

Contact Dermatitis

Atopic Dermatitis

Neurodermatitis

Stasis Dermatitis

History

Acute, localized to specific area

History in patient or family member of asthma, hay fever, or eczema

Chronic, in same areas, associated with anxiety

Varicosities, past history of thrombophlebitis or cellulitis

Location

Areas of exposure to allergen

Eyelids, groin, flexural areas

Head, lower legs, arms

Lower legs

*See Figures

8-49, 8

¡-110, 8-111, and 15-2.

Table 8-3 Vesiculobullous Diseases*

Dermatitis

Bullous

Characteristic Pemphigus Vulgaris

Herpetiformis

Epidermolysis Bullosa*

Pemphigoid

Age of patient Initial site Lesions

Sites

Groupings* Weight loss Duration Pruritus* Oral pain*

Palms/soles involved Typical lesion

40-60 years

Oral mucosa

Normal skin at margins

Mouth, abdomen, scalp, groin

Marked

1 or more years 0

Flaccid bullae

Children and adults Scalp, trunk Erythematous base

Knees, sacrum, back, elbows

None

Several years

Grouped vesicles

Infants and children

Extremities

Bullae produced by trauma

Hands, knees, elbows, mouth, toes

None

Normal lifetime

Flaccid vesicles

60-70 years

Extremities

Normal skin at margins

Trunk, extremities 0

Minimal

Months to years ±

Tense bullae

*See Figures 8-105, 8-106, 8-107, 8-108, and 8-109. {Refers to a group of inherited diseases.

*0, rarely seen; 1 +, occasionally seen; 4+, nearly always associated; ±, sometimes present.

Table 8-4 Common Benign Tumors by Color

Color Benign Tumor

Skin color

Pink or red

Brown

Tannish-yellow

Dark blue or black

Warts (see Figs. 8-26 and 8-27) Cysts

Hemangiomas (see Figs. 24-8 and 24-9) Keloids (see Fig. 8-103)

Seborrheic keratoses (see Fig. 8-101) Nevi (see Fig. 8-104) Lentigines (see Fig. 8-101) Dermatofibromas (see Fig. 8-48)

Xanthomata (see Figs. 14-12 to 14-15) Xanthelasma (see Fig. 14-18) Warts (see Fig. 8-26A) Keloids (see Fig. 8-103)

Seborrheic keratoses (see Fig. 8-101) Hemangiomas (see Figs. 24-8 and 24-9) Blue nevi (see Fig. 8-104) Dermatofibromas (see Fig. 8-48)

Table 8-5 Allergens Associated with Contact Dermatitis Location Possible Allergen

Scalp

Eyelids Neck

Trunk

Axillae

Genitalia

Feet

Hands

Hair dyes

Shampoos

Tonics

Eye makeup Hair sprays

Aftershave lotions

Perfumes

Soaps

Washing agents Nickel jewelry

Clothing Washing agents

Deodorants Soaps

Soaps

Contraceptives Deodorants Washing agents

Shoes Sneakers Deodorants Socks

Washing agents

Nickel jewelry Soaps Dyes Plants

Table 8-6 Important Differences Between Chickenpox and Smallpox Characteristics Chickenpox

Onset of symptoms Rash

Presence on palms and soles

Development into other lesions

Time frame of lesions

Nature of lesions

Patient appears extremely ill and moribund

Begin with rash

Evenly distributed all over body

Almost never

Rapidly into vesicles (less than 24 hours)

New lesions form and scab at different times

Pruritic but relatively soft Rarely

Smallpox

Begin 2-4 days before rash

More dense on face, head, arms, and legs (centrifugal distribution)

Common

Slowly into pustules (7-14 days)

Lesions form and go through their stages at the same time

Painful and hard

Commonly

Useful Vocabulary

Listed here are the specific roots that are related to diseases of the skin.

important to understand the terminology

Root

Pertaining to

Example

Definition

kerat(o)-

horny

keratoma

Horny growth

derm(a)-

skin

dermatitis

Inflammation of the skin

trich(o)-

hair

trichoid

Resembling hair

seb(o)-

sebum

seborrhea

Excess flow of sebum

hidr(o)-

sweat

hidradenitis

Inflammation of sweat glands

onych(o)-

nails

onychomycosis

Disease of the nails caused by fungus

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