Skin Disorder Presentations
Terms in this set (91)
blister with minimal scarring
generalized erythema and blisters, start at birth, extend to early childhood
superficial blisters of epidermis and oral mucosa w/o scarring
atopic dermatitis (eczema)
chronic skin sensitivity to many different environmental agents.
Itch and xerosis, inflamed skin. Starts vesicular and weepy, progresses to chronic lichenification with pigment.
autosomal recessive congenital icthyosis
thick-plate-like scales and red skin
x-linked recessive ichthyosis
large, dark scales, tacked down in center. No erythema. Fail to desquamate cells
Psoriasis and Chronic Dermatitis
inflammation -> serum proteins leak into epidermis -> steroid sulfatase inhibited -> scaling
old people. Stratum corneum less flexible, prone to microfissures and cracks
Junctional EB with a milder course
mild blistering and erosion that improve with time.
Severe Junctional EB
Severe lamina lucida splitting
Extremely fragile skin. Early death from systemic infection or airway obstruction from excessive granulation tissue.
Bulla bellow lamina lucida. Extensive scarring. Skin contracture, disabling mitten deformaties of hands. Increased SCC, a common cause of death.
tense fluid-filled vesicles and bullae on extremities, axillae, groin. Extreme pruritus. Acquired.
Blistering during pregnancy.
Mucous Membrane Pemphigoid
Mucosal blistering that heals with scars.
Epidermolysis Bullosa Acquisita
Acral blisters, heal with scarring and milia
Linear IgA Bullous Dermatosis
Vesiculobullous eruption in annular/arcuate patterns.
glomerulosclerosis and hearing loss. Skin compensates.
Ehlers-Danlos I and II
hyperextensible skin, hypermobile joints. Delay in walking, tendency for recurrent joint dislocations.
Ehlers-Danlos IV (Vascular Type)
thin fragile skin, easy brusiing, arterial aneurysms, uterine rupture, premature death (Gorlin's sign)
Loose redundant skin with no recoil - Hound Dog Facies
Pulmonary emphysema, cor pulmonale, diaphragmatic hernias, diverticulae. Early mortality if internal organs involved.
tall, thin, arachnodactily, MV prolapse, aortic aneurysms, aortic dissection, stretch marks, decreased SubQ fat.
easy bruising, perifollicular hemorrhage, corkscrew hair, gingival bleeding, anemia, altered wound healing.
excessive ECM, thick fibrotic skin. Hyperpigmented areas under pressure, pigment loss with sparing of perifollicular skin, telangiectasia, sclerodactyly. May have Raynaud's.
Photoaging (Solar elastosis)
decreased skin tone, increased wrinkling, change in pigment.
One or more circular bald patches of scalp/beard.
Entire body hairless
Whole scalp bald
Thick hair during pregnancy, massive hair shedding after pregnancy.
bitemporal scalp and vertex loss of hair. Seen in 50% of men.
Female Pattern Hair Loss
diffuse thinning of crown of hair. Almost never look bald. Seen in 30% of women.
Hydradenitis Suppurativa (acne inversa)
Nodulocystic acne of apocrine areas leading to recurrent draining abscesses in areas rich in apocrine glands.
Sweat too much. Significant psychosocial sequellae.
capillary in nail bed ruptures. Blood accumulates in trough formed between longitudinal rete ridge and dermal papillae.
disrupt hyponychium with minor trauma, allows dermatophytes to enter and spread in subungual space.
Cuticle disrupted allowing bacteria to infect and form a microabscess. Can get along the lateral nail fold.
Erythematous plaques with hypopigmented borders, may have central pallor, be arcuate/serpiginous. Lasts less than 24 hours.
Deeper Hives. From release of vasoactive peptides (especially Histamine) by mast cells.
Allergic Contact Dermatitis
Pruritic, erythematous papules and plaques. Often geometric, need sensitization.
Irritant Contact Dermatitis
nonspecific inflammation of the skin in response to direct cellular injury. Severity directly related to dose. React with first exposure.
salmon-colored, well-demarcated plaques, with prominent micaceous silvery scale.
widespread infiltration of skin by M. leprae, esp. face (leonine facies)
One or more anesthetic skin lesions, few M. leprae bacteria.
Cutaneous T-cell lymphoma
erythematous, scaly patches and plaques, pruritic
Cutaneous T-cell lymphoma
Circulating neoplastic T cells present de novo in tumor stage
Graft vs Host Disease
Histo: normal appearing lymphocytes next to necrotic keratinocytes
Cellulitis (Staph Aureus or Strep pyogenes)
red, hot tender area of affected skin, without raised borders.
commonly w/ fever + lymphadenopathy
Erysipelas (Strep pyogenes, non-group A strep, H. flu in kids)
red plaque with elevated borders, redness, warmth, induration.
commonly w/ fever + lymphadenopathy
classically on face, also extremities
Erythrasma (corynebacterium minutissimum)
well-dermarcated reddish-brown plaque in intertriginous spaces and maceration in toe-web spaces
Coral red fluorescence with Wood's lamp
Pitted Keratolysis (kytococcus sedentarius)
Crateriform pits on plantar surface of foot. Occasional confluence with serpiginous sulci and erosions
Tinea corporis (Dermatophytes: trichophyton, epidermophyton, microsporum)
red, scaly annular plaques with central clearing
moccasin distribution on feet, hair loss on scalp
Tinea Versicolor (malassezia furfur)
hypopigmented and hyperpigmented papules and plaques that coalesce on central trunk with fine scale. Often more prominent in summer
Beefy red plaque with satellite lesions. Can see pustules and/or follicular involvement
localized vesicles on erythematous base with pain
Groups of small umbilicated papules. Commonly on trunk and extremities of kids. Groin in adults.
Gram stain: inclusion bodies
verrucous papules and plaques, frequently with thrombosed capillaries (black dots). On palmar and plantar surfaces, lose dermatoglyphs.
Scar that is thicker or more raised than desired but stays within boundary of original wound
Scar that is thickened and overgrows boundaries of original wound.
focal hypopigmentation, white forlock, and deafness. Associated with Hirschsprung's Megacolon.
Dermal melanocytosis (Mongolian Spot)
Bluish-black hyperpigmented spot, usually lumbosacral in African and Native American babies. Fades with age.
Patterned, depigmented patches at birth that persist unchanged. Most have white forlock.
Decreased or complete lack of pigment in hair, skin, and eyes. Severe optic system defects.
Pigmentary dilution from decreased tyrosine and melanin. Blue eyes, pale skin, blondwhite hair, mental deficiency, seizure
Variable immunodeficiency, diffuse hypopigmentation, silvery hair
transient increase in pigment after inflammation in skin. Melanosome engulfed by macrophages who sit in dermis for months.
Adrenal Insufficiency (Addison's)
Diffuse bronze pigmentation
Increased estrogen and progesterone in pregnancy stimulate melanin synthesis
Patchy depigmentation of skin
Blue-black discoloration of shins/scars and black discoloration of thyroid, bones, teeth, sclera.
Extreme photosensitivity and increased skin cancer. Sunburn with minimal exposure. Exposure to UV increased risk of skin cancer by 1000x
Basal Cell Carcinoma
Pearly papule w/ telangiectasias, sometimes ulcerated. Can be pigmented.
Squamous Cell Carcinoma
Skin cancer. Precursor lesion is actinic keratosis. Precursor cell is keratinocyte. Risk of metastasis is 5-30%.
Skin cancer. Precursor lesion: none, normal nevi, large congenital nevi, atypical nevi. Precursor cell is melanocyte. Risk of metastasis depends on presentation.
Basal cell nevus syndrome
Multiple BCCs, palmar/plantar pits, skeletal abnormalities, calcification of falx cerebri
Patient has multiple invasive melanomas.
netlike appearance of vascular perfusion of the skin.
Acral localized acquired cutis laxa
Swelling of fingers and toes, papular urticaria.
Fragmentation and total loss of dermal elastic fibers followed by skin laxity.
Tight braids lead to separation of inner root sheath from hair follicle, and then follicle scars down.
Edematous hands and feet after chemo
Staph Scalded Skin Syndrome
Present with fever, skin tenderness, erythema -> superficial exfoliation.
Fine pink papular exanthem in generalized distribution. May be in areas of trauma, many morphologies.
well-demarcated plaque on medial thigh extending into inguinal area. Almost never on scrotum. Usually fine red border with a little scale.
Infection of the hair shaft, excess sweating and body odor.
Charcoal and purple color on surface of skin. Skin looks like it is sliding off.
Staph secretes toxin that cleaves desmoglien, causing blisters and ruptured vesicles on skin. Mostly in kids. Local SSSS.
Get pigmentary dilution and bleeding (no granules in platelets). Decreased visual acuity/photophobia.
Pigmentary dilution/albinism and giant lysosomal granules, with defective PMN function.
Exposure to plant substances (lime juice) and then exposure to sun -> blister. Can look like a bruise.
Scaly, pink, ill-defined areas.
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