Goodheart s Photoguide to Common Skin Disorders-4판

Goodheart’s Photoguide to Common Pediatric and Adult Skin Disorders: Diagnosis and Management
Cover
Title Page
Copyright Information
Dedication
Authors
Foreword
Preface
Acknowledgments
Multimedia Resources
Patient Handouts in English
Patient Handouts in Spanish
Additional Images
Chapter 1
Chapter 2
Chapter 4
Chapter 6
Chapter 8
Chapter 9
Chapter 12
Chapter 15
Chapter 16
Chapter 19
Chapter 21
Chapter 23
Chapter 27
Chapter 32
Chapter 34
Efigure 1.1: Nevus sebaceous. Verrucous plaque on scalp.
Efigure 1.2: Nevus Simplex (“salmon patch,” “stork bite”).
Efigure 1.3: Port wine stain (nevus flammeus).
Efigure 1.4: Infantile hemangioma (IH).
Efigure 1.5: Involuting infantile hemangioma (IH).
Efigure 1.6: Dermal melanocytosis (Mongolian spots).
Efigure 1.7: Epidermal nevus.
Efigure 2.1: Erythema toxicum neonatorum (ETN).
Efigure 2.2: Miliaria rubra.
Efigure 2.3: Seborrheic dermatitis of scalp.
Efigure 2.4: Psoriasis in an infant.
Efigure 4.1: Atopic dermatitis.
Efigure 4.2: Atopic dermatitis.
Efigure 4.3: Atopic dermatitis on legs.
Efigure 4.4: Atopic dermatitis of lips (atopic cheilitis).
Efigure 4.5: Atopic dermatitis of lips (atopic cheilitis).
Efigure 4.6: Atopic dermatitis of eyelids.
Efigure 4.7: Atopic dermatitis of eyelids.
Efigure 4.8: Atopic dermatitis of trunk.
Efigure 4.9: Atopic dermatitis of antecubital fossae.
Efigure 4.10: Atopic dermatitis of antecubital fossae.
Efigure 4.11: Atopic dermatitis of antecubital fossae.
Efigure 4.12: Atopic dermatitis of neck.
Efigure 4.13: Atopic dermatitis of feet.
Efigure 4.14: Atopic dermatitis of foot.
Efigure 4.15: Excoriations.
Efigure 4.16: Ichthyosis vulgaris.
Efigure 4.17: Ichthyosis vulgaris.
Efigure 4.18: Seborrheic dermatitis.
Efigure 6.1: Verruca vulgaris.
Efigure 8.1: Pilomatricoma (calcifying epithelioma of Malherbe).
Efigure 8.2: Pilomatricoma.
Efigure 8.3a: Mastocytoma/Darier sign.
Efigure 8.3b: Mastocytoma/Darier sign.
Efigure 8.4: Bullous bite reaction.
Efigure 8.5: Spider angioma.
Efigure 8.6: Lichen striatus.
Efigure 8.7: Lichen striatus.
Efigure 9.1: Alopecia areata.
Efigure 9.2: Alopecia areata.
Efigure 9.3: Congenital triangular alopecia.
Efigure 9.4: Tinea capitis/kerion.
Efigure 9.5: Tinea amiantacea.
Efigure 9.6: Head lice (Pediculosis capitis).
Efigure 9.7: Head lice (Pediculosis capitis).
Efigure 9.8: Head lice (Pediculosis capitis).
Efigure 9.9: Trachyonychia of toenails.
Efigure 9.10: Trachyonychia of fingernails.
Efigure 9.11: Onychomycosis of toenails.
Efigure 12.1: Acne vulgaris.
Efigure 12.2: Acne vulgaris.
Efigure 12.3: Rhinophyma, severe.
Efigure 15.1: Granuloma annulare.
Efigure 15.2: Lichen planus.
Efigure 15.3: Lichen planus/linear.
Efigure 16.1: Hidradenitis suppurativa (acne inversa).
Efigure 19.1: Alopecia areata.
Efigure 21.1: Squamous cell carcinoma of the palate.
Efigure 23.1: Idiopathic guttate hypomelanosis.
Efigure 23.2a: Confluent and reticulated papillomatosis (Gougerot-Carteaud disease).
Efigure 23.2b: Confluent and reticulated papillomatosis (Gougerot-Carteaud disease).
Efigure 27.1: Majocchi purpura (purpura annularis telangiectodes).
Efigure 32.1: Pyogenic granuloma.
Efigure 32.2: Pruritic urticarial papules and plaques of pregnancy (PUPPP).
Efigure 34.1: Dermatomyositis/Gottron papules.
Patient Handouts in English and Spanish
Acne
What is acne?
Who gets it?
What causes it?
What makes it worse?
Myths and Facts About Acne
Exhibit 79
Exhibit 80
Exhibit 81
Acné
¿Qué es el acné?
¿A quién le da acné?
¿Qué lo causa?
¿Qué lo empeora?
Mitos y Realidades sobre el Acné
Exhibit 83
Exhibit 84
Exhibit 85
Acne: How to Apply Duac Gel, Benzaclin Gel, and Benzamycin Gel
Dealing with side effects
Tip
Cómo Aplicar: Duac Gel, Benzaclin Gel, y Benzamycin Gel
Cómo lidiar con los efectos secundarios
Consejo
Acne: How to Apply Topical Retinoids
What are topical retinoids?
How do these medications work?
How should I apply these medications?
How long do they take to work?
How do I deal with side effects?
Tips
Exhibit 89
Los Retinoides Tópicos y Cómo Aplicarlos
¿Qué son los retinoides tópicos?
¿Cómo funcionan estos medicamentos?
¿Cómo debo aplicar estos medicamentos?
¿Cuánto tiempo tardan en surtir efecto?
¿Cómo combatir los efectos secundarios?
Consejos
Exhibit 91
Alopecia Areata
What is alopecia areata (AA)?
What does it look like?
Who gets it?
What causes it?
How is it treated?
Exhibit 93
Exhibit 94
Exhibit 95
Alopecia Areata
¿Qué es alopecia areata (AA)?
¿Cómo es?
¿A quién le da?
¿Qué lo causa?
¿Cómo se trata?
Exhibit 97
Exhibit 98
Exhibit 99
Athlete’s Foot (Tinea Pedis)
What causes athlete’s foot?
Who gets it?
What does it look like?
The acute toe web infection
The “moccasin” or “dry” type
Keep in mind
Exhibit 101
Exhibit 102
Pie de Atleta (Tinea Pedis)
¿Qué causa el pie de atleta?
¿A quién le da?
¿Cómo es?
Infección aguda entre los dedos de los pies
El tipo “seco” o de “mocasín”
Recuerde
Exhibit 104
Exhibit 105
Atopic Dermatitis
What is atopic dermatitis?
Who gets it?
How is it treated?
Topical steroids
Other treatment measures
Is there a cure?
How is it prevented?
Exhibit 107
Exhibit 108
Exhibit 109
Exhibit 110
Dermatitis Atopica
¿Qué es la dermatitis atópica?
¿A quién le da?
¿Cómo se trata?
Esteroides tópicos
Otros tratamientos
¿Hay una cura?
¿Cómo se previene?
Exhibit 112
Exhibit 113
Exhibit 114
Exhibit 115
Atypical Nevus (Mole)
What is an atypical nevus?
What does it look like?
Where is it seen on the body?
What does it mean if I have only one or two of them?
What does it mean if I have many of them?
How is it treated?
What can be done to prevent the development of melanoma?
Exhibit 117
Exhibit 118
Nevus Atipicos (Lunares)
¿Que es el nevus atípico?
¿Cómo es?
¿En qué parte del cuerpo aparece?
¿Qué pasa si tengo uno o dos lunares atípicos?
¿Qué pasa si tengo muchos lunares atípicos?
¿Cómo se trata?
¿Qué se puede hacer para prevenir el desarrollo de melanoma?
Exhibit 120
Exhibit 121
Basal Cell Carcinoma
What is a basal cell carcinoma (BCC)?
Who gets it?
What does it look like?
How is it diagnosed?
How is it treated?
How do I avoid getting BCCs in the future?
What are some general preventive methods?
Exhibit 123
Exhibit 124
Exhibit 125
Carcinoma de Células Basales
¿Qué es un carcinoma de células basales (CCB)?
¿A quién le da?
¿Cómo es?
¿Cómo se diagnostica?
¿Cómo se trata?
¿Cómo puedo evitar contraer CCB en el futuro?
Métodos preventivos generales
Exhibit 127
Exhibit 128
Exhibit 129
Bleach Baths
What are bleach baths for?
How to prepare a bleach bath?
What to do after a bleach bath?
How often?
Additional instructions:
Exhibit 131
Baños con Cloro
Para qué se usan los baños con cloro?
Cómo preparar un baño con cloro?
Que hacer despues de remojarse en cloro diluido?
Con cuál frecuencia?
Nota:
Instrucciones adicionales:
Exhibit 133
Burow’s Solution
What is Burow’s solution?
Where do I get it?
How do I use it?
Solucion de Burow
¿Qué es la solución de Burow?
¿Dónde la consigo?
¿Cómo se usa?
Contact Dermatitis
What is contact dermatitis?
What are the TOP TEN allergens?
What does the rash of ACD and ICD look like?
How is the cause determined?
What can be done to prevent ACD and ICD?
How are ACD and ICD treated?
What is diaper rash?
Helpful hints
Exhibit 137
Exhibit 138
Exhibit 139
Dermatitis de Contacto
¿Qué es dermatitis de contacto?
¿Cuáles son los diez principales alérgenos?
¿Cómo es la dermatitis de contacto?
¿Cómo se determina la causa?
¿Qué se puede hacer para prevenirla?
¿Cómo se trata?
¿Qué es la rozadura de pañal?
Consejos
Exhibit 141
Exhibit 142
Exhibit 143
Cysts
What is a cyst?
What does a cyst look like?
What are the symptoms of cysts?
What can be done about them?
How are cysts diagnosed?
Exhibit 145
Exhibit 146
Quistes (Cysts)
Qué es un quiste?
Cuál es la apariencia de un quiste?
Cuáles son los síntomas de los quistes?
Cómo se pueden tratar?
Cómo se diagnostican?
Exhibit 148
Exhibit 149
Dry Skin (Xerosis)
Measures to prevent and treat dry skin
Tips
Exhibit 151
Piel Seca
Medidas para prevenir y tratar la piel seca
Consejos
Exhibit 153
Fungal Nails (Onychomycosis)
What are fungal nails (onychomycosis)?
What causes it?
What does it look like?
What are its symptoms?
Who gets it?
How is it diagnosed?
How is it treated?
What are some other treatment methods?
Helpful hints
Keep in mind
Exhibit 155
Exhibit 156
Uñas con Hongos (Onicomicosis)
¿Qué es onicomicosis?
¿Qué lo causa?
¿Cómo es?
¿Cuales son los síntomas?
¿A quién le da?
¿Cómo se diagnostica?
¿Cómo se trata?
¿Hay otros tratamientos?
Consejos
Recuerde
Exhibit 158
Exhibit 159
Genital Warts
What are genital warts?
What causes them?
How are they diagnosed?
How are they treated?
Office treatment
Home treatment
How are they prevented?
What are the long-term consequences of HPV?
Exhibit 161
Exhibit 162
Exhibit 163
Exhibit 164
Verrugas Genitales
¿Qué son las verrugas genitales?
¿Qué las causa?
¿Cómo se diagnostican?
¿Cómo se tratan?
Tratamiento en la oficina
Tratamiento en casa
¿Cómo se previenen?
¿Cuáles son las consecuencias a largo plazo de VPH?
Exhibit 166
Exhibit 167
Exhibit 168
Exhibit 169
Exhibit 170
Granuloma Annulare
What is granuloma annulare?
Who gets it?
What does it look like?
What causes it?
How is it diagnosed?
What other skin rashes can it be confused with?
What can I expect?
How is it treated?
Exhibit 172
Exhibit 173
Granuloma Anular
¿Qué es el granuloma anular?
¿A quién le da?
¿Cómo es?
¿Qué lo causa?
¿Cómo se diagnostica?
¿Con qué se puede confundir?
¿Qué puedo esperar?
¿Cómo se trata?
Exhibit 175
Exhibit 176
Hair Loss (Androgenic Alopecia)
What is androgenic alopecia?
What does it look like?
What causes AGA?
How is AGA diagnosed?
What can be done about AGA?
Exhibit 178
Exhibit 179
Pérdida de Cabello (Alopecia Androgénica)
¿Qué es la alopecia androgénica?
¿Cómo es?
¿Qué la causa?
¿Cómo se diagnostica?
¿Qué se puede hacer al respecto?
Exhibit 181
Exhibit 182
Hand Eczema
What is hand eczema?
Who gets it?
What does it look like?
What are the symptoms?
How is it diagnosed?
How is it treated?
Is there a cure?
What can be done to help prevent hand eczema?
Exhibit 184
Exhibit 185
Exhibit 186
Exhibit 187
Eczema en la Mano
¿Qué es eczema de la mano?
¿A quién le da?
¿Cómo es?
¿Cuáles son los síntomas?
¿Cómo se diagnostica?
¿Cómo se trata?
¿Hay una cura?
¿Qué se puede hacer para prevenir el eczema en la mano?
Exhibit 189
Exhibit 190
Exhibit 191
Exhibit 192
Head Lice
What are head lice?
Who gets the condition?
What does it look like and what are its symptoms?
How is it diagnosed?
How is it treated?
First-line treatments
Piojos
¿Qué son los piojos?
¿Quién tiene esta condición?
¿Cómo son y cuales son los síntomas?
¿Cómo se diagnostica?
¿Cómo se tratan?
Tratamientos de primera instancia
Herpes Simplex
What is herpes simplex?
What are its symptoms?
What causes it?
HSV-1
HSV-2
What types of infection are caused by HSV?
Primary HSV
Recurrent HSV
How is HSV treated?
Topical therapy
Oral therapy
Some facts about genital HSV
A point to remember
Exhibit 196
Exhibit 197
Exhibit 198
Herpes Simple (“Fuegos”)
¿Qué es herpes simple?
¿Cuáles son los síntomas?
¿Qué lo causa?
HSV-1
HSV-2
¿Qué tipo de infecciones son causadas por el HSV?
HSV primario
HSV recurrente
¿Cómo se trata el HSV?
Terapia tópica
Terapia oral
Datos sobre el HSV genital
Algo que recordar
Exhibit 200
Exhibit 201
Exhibit 202
Herpes Zoster (Shingles)
What is herpes zoster?
Why is it sometimes so painful?
What does it look like?
How is it treated?
Oral medications
Topical therapy
Pain management
Things to keep in mind
Is there any way to prevent it?
Exhibit 204
Exhibit 205
Herpes Zoster
¿Qué es herpes zoster?
¿Por qué es tan doloroso?
¿Cómo es?
¿Cómo se trata?
Medicamentos orales
Terapia tópica
Cómo manejar el dolor
Datos que recordar
¿Hay manera de prevenirlo?
Exhibit 207
Exhibit 208
Hives (Urticaria)
What are hives?
What causes acute hives?
What causes chronic hives?
Who gets hives?
What should be done to determine the cause?
What can be done to treat and prevent them?
Exhibit 210
Exhibit 211
Urticaria
¿Qué es la urticaria?
¿Qué causa urticaria aguda?
¿Qué causa urticaria crónica?
¿A quién le da urticaria?
¿Qué debe hacerse para determinar la causa?
¿Qué se puede hacer para tratar y prevenir la urticaria?
Exhibit 213
Exhibit 214
Keratosis Pilaris (Rough, Bumpy Skin)
What is keratosis pilaris?
What does it look like?
Where does it appear?
What can be done about it?
Exhibit 216
Exhibit 217
Queratosis Pilaris (Piel Con Granos Ásperos)
¿Qué es la queratosis pilaris?
¿Cómo es?
¿Dónde aparece?
¿Qué se puede hacer?
Exhibit 219
Exhibit 220
Lichen Planus
What is lichen planus?
Who gets it?
What causes it?
Where does it occur on the body?
What does it look like?
What are its symptoms?
What diseases are associated with it?
What can I expect?
How is it diagnosed?
How is it treated?
Exhibit 222
Exhibit 223
Liquen Plano
¿Qué es liquen plano?
¿A quién le da?
¿Qué lo causa?
¿En qué parte del cuerpo aparece?
¿Cómo es?
¿Cuáles son los síntomas?
¿Qué enfermedades se asocian con el?
¿Qué puedo esperar?
¿Cómo se diagnostica?
¿Cómo se trata?
Exhibit 225
Exhibit 226
Lyme Disease
What is Lyme disease?
Who gets it?
What does the tick look like?
What are the symptoms of the disease?
How soon do symptoms appear?
How is it diagnosed?
How is it treated?
How can it be prevented?
Exhibit 228
Exhibit 229
Enfermedad de Lyme
¿Qué es la enfermedad de Lyme?
¿A quién le da?
¿Cómo es la garrapata?
¿Cuáles son los síntomas de la enfermedad?
¿Cuándo se presentan los síntomas?
¿Cómo se diagnostica?
¿Cómo se trata?
¿Cómo se puede prevenir?
Exhibit 231
Exhibit 232
Lyme Disease: Prevention
What is Lyme disease?
What can I do to prevent it?
How can I find ticks on myself or members of my family?
How should I remove ticks when I find them?
Prevencion de la Enfermedad de Lyme
¿Qué es la enfermedad de Lyme?
¿Qué puedo hacer para prevenirla?
¿Cómo puedo encontrar garrapatas en mi o en mi familia?
¿Cómo debo quitar las garrapatas cuando las encuentre?
Malignant Melanoma
What is malignant melanoma (MM)?
Who gets it?
What does it look like?
Where do melanomas occur on the body?
What can be done to prevent the development of melanoma?
Exhibit 236
Exhibit 237
Exhibit 238
Exhibit 239
Melanoma Maligno
¿Qué es el melanoma maligno (MM)?
¿A quién le da melanoma maligno?
¿Cómo es un melanoma?
¿En qué partes del cuerpo ocurren los melanomas?
¿Qué se puede hacer para prevenir el desarrollo del melanoma?
Exhibit 241
Exhibit 242
Exhibit 243
Exhibit 244
Melasma
What is melasma?
Who gets it?
What does it look like?
What can I expect?
How is it treated?
Exhibit 246
Exhibit 247
Melasma
¿Qué es Melasma?
¿A quién le da?
¿Cómo es?
¿Qué puedo esperar?
¿Cómo se trata?
Exhibit 249
Exhibit 250
Molluscum Contagiosum
What is molluscum contagiosum (MC)?
Who gets it?
What causes it?
How does it spread?
What does it look like?
Are there any symptoms?
Where does it occur?
How is it treated?
Office treatment
Home treatment
Things to keep in mind
Exhibit 252
Exhibit 253
Molusco Contagioso
¿Qué es el molusco contagioso (MC)?
¿A quién le da MC?
¿Qué lo causa?
¿Cómo se contagia y se esparce?
¿Cómo es un molusco contagioso?
¿Hay síntomas?
¿Dónde ocurre?
¿Cómo se trata?
Tratamiento en el consultorio
Tratamiento en la casa
Recuerde
Exhibit 255
Exhibit 256
Pityriasis Rosea
What is pityriasis rosea?
Who gets it?
What causes it?
What does it look like?
What are its symptoms?
How is it diagnosed?
How is it treated?
Exhibit 258
Exhibit 259
Pitiriasis Rosada
¿Qué es la pitiriasis rosada?
¿A quién le da?
¿Qué la causa?
¿Cómo es?
¿Cuáles son los síntomas?
¿Cómo se diagnostica?
¿Cómo se trata?
Exhibit 261
Exhibit 262
Poison Ivy and Poison Oak (Rhus Dermatitis)
What is rhus dermatitis?
How is it acquired?
What does the rash look like?
How is it diagnosed?
How is it treated?
How can I avoid getting it?
Helpful hints
Exhibit 264
Exhibit 265
Exhibit 266
Exhibit 267
Dermatitis Por Rhus (Hiedra Venenosa y Zumaque o Roble Venenoso)
¿Qué es la dermatitis por rhus?
¿Cómo se adquiere?
¿Cómo es?
¿Cómo se diagnostica?
¿Cómo se trata?
¿Cómo se previene?
Consejos
Exhibit 269
Exhibit 270
Exhibit 271
Exhibit 272
Pseudofolliculitis Barbae (Razor Bumps)
What is pseudofolliculitis barbae (PFB)?
How does it develop?
Who gets it?
How can it be prevented?
Exhibit 274
Exhibit 275
Pseudofoliculitis Barbae (“Irritación de Rasuradora”)
¿Qué es pseudofoliculitis barbae (PFB)?
¿Cómo se desarrolla?
¿A quién le da?
¿Cómo se puede prevenir?
Exhibit 277
Exhibit 278
Exhibit 279
Psoriasis
What is psoriasis?
Who gets it?
What causes it?
What does it look like, and where on the body does psoriasis occur?
What are its symptoms?
What makes it worse?
What is the usual course of psoriasis?
How is it diagnosed?
How is it treated?
Exhibit 281
Exhibit 282
Exhibit 283
Psoriasis
¿Qué es la psoriasis?
¿A quién le da psoriasis?
¿Qué la causa?
¿Cómo es la psoriasis y en qué parte del cuerpo ocurre?
¿Cuáles son los síntomas?
¿Qué lo empeora?
¿Cuál es el curso usual que sigue la psoriasis?
¿Cómo se diagnostica?
¿Cómo se trata?
Exhibit 285
Exhibit 286
Exhibit 287
Exhibit 288
Rosacea
What is rosacea?
Who gets it?
What does it look like?
Where does it appear?
What are its symptoms?
What makes it worse?
How is it treated?
Exhibit 290
Rosácea
¿Qué es la rosácea?
¿A quién le da rosácea?
¿Cómo es la rosácea?
¿Dónde aparece?
¿Cuáles son los síntomas?
¿Qué la empeora?
¿Cómo se trata?
Exhibit 292
Scabies
What is scabies?
What causes it?
How is it spread?
Where does the rash occur?
How is it treated?
What should I expect after treatment?
Exhibit 294
Sarna (Escabiosis)
¿Qué es la sarna (escabiosis)?
¿Qué la causa?
¿Cómo se contagia?
¿Dónde ocurre?
¿Cómo se trata?
¿Qué puede suceder después del tratamiento?
Exhibit 296
Scalp Psoriasis: Scale Removal
Here’s how
Exhibit 298
Psoriasis Del Cuero Cabelludo: Eliminacion de Escamas
Cómo quitar las escamas
Exhibit 300
Seborrheic Dermatitis of the Face
What is seborrheic dermatitis?
What does it look like?
Where does it occur?
What can I expect?
How is it treated?
Exhibit 302
Exhibit 303
Dermatitis Seborreica
¿Qué es la dermatitis seborréica?
¿Cómo es la dermatitis seborréica?
¿Dónde se presenta la dermatitis seborréica?
¿Qué puedo esperar?
¿Cómo se trata?
Exhibit 305
Exhibit 306
Seborrheic Dermatitis of the Scalp and Dandruff
What are seborrheic dermatitis and dandruff?
What are the symptoms?
How is it treated?
Important tips
Special instructions
Exhibit 308
Dermatitis Seborreica del Cuero Cabelludo y Caspa
¿Qué es la dermatitis seborreica y la caspa?
¿Cuáles son los síntomas?
¿Cómo se trata?
Consejos importantes
Instrucciones especiales
Exhibit 310
Seborrheic Keratoses
What is it?
What does an SK look like?
What are the symptoms of seborrheic keratosis?
How is it diagnosed?
How are SKs treated?
Exhibit 312
Exhibit 313
Seborrheic Keratoses
Que son keratosis seborreicas?
Cual es la apariencia clínica?
Cuales son los síntomas de keratosis seborreicas?
Cómo se hace el diagnóstico clínico?
Cual es su tratamiento?
Exhibit 315
Exhibit 316
Short-Term Cortisone Therapy
What is short-term cortisone?
How is it taken?
What are its side effects?
How does it affect other medications or diseases?
Terapia de Cortisona a Corto Plazo
¿Qué es la cortisona a corto plazo?
¿Cómo se toma?
¿Cuáles son los efectos secundarios?
¿Cómo afecta a otros medicamentos o enfermedades?
Skin Tags
What are skin tags?
What do skin tags look like?
Do they cause any problem?
Where do they appear?
How are they diagnosed?
How can they be removed?
Exhibit 320
Acrocordones (Skin Tags)
Que son acrocordones?
Cual es su apariencia?
Causan problemas?
Dónde son más frecuentes?
Cómo pueden removerse?
Exhibit 322
Soak and Smear Instruction Sheet
How does the “soak and smear” technique work?
What steps are involved?
A word about soap
Instrucciones Para Remojar y Ungir
¿Cómo funciona la técnica de “remojar y ungir”?
¿Qué pasos hay que seguir?
Un detalle sobre el jabón
Solar Keratosis (Actinic Keratosis)
What are solar keratoses?
What do they look like?
Where do they appear?
Who gets them?
What causes them?
What are the symptoms?
How are they diagnosed?
How are they treated?
Office treatment
Home treatment
How do I prevent them?
Exhibit 326
Exhibit 327
Exhibit 328
Exhibit 329
Queratosis Solar
¿Qué es la queratosis solar?
¿Cómo es la queratosis solar?
¿Dónde aparece?
¿A quién le da queratosis solar?
¿Qué la causa?
¿Cuáles son los síntomas?
¿Cómo se diagnostica?
¿Cómo se trata?
Tratamiento en el consultorio?
Tratamiento en casa
¿Cómo la prevengo?
Exhibit 331
Exhibit 332
Exhibit 333
Exhibit 334
Squamous Cell Carcinoma
What is squamous cell carcinoma (SCC)?
What does it look like?
Where does it appear?
Who gets it?
Where does it come from?
How is it diagnosed?
How is it treated?
How is it prevented?
Keep in mind
Exhibit 336
Exhibit 337
Carcinoma de Celula Escamosa
¿Qué es el carcinoma de célula escamosa (CCE)?
¿Cómo es?
¿Dónde aparece?
¿A quién le da?
¿De dónde viene?
¿Cómo se diagnostica?
¿Cómo se trata?
¿Cómo se previene?
Recuerde
Exhibit 339
Exhibit 340
Sun Protection Advice
Further advice
Consejos Para Protejerse Contra el Sol
Más consejos
Tinea Capitis
What is tinea capitis?
What does it look like?
What are its symptoms?
Who gets it?
Is it contagious?
How is it diagnosed?
How is it treated?
What are some newer treatments?
Helpful hints
Exhibit 344
Exhibit 345
Tiña Capitis
¿Qué es la tiña capitis?
¿Cómo es?
¿Cuáles son los síntomas?
¿A quién le da?
¿Es contagiosa?
¿Cómo se diagnostica?
¿Cómo se trata?
¿Cuáles son los nuevos tratamientos?
Consejos
Exhibit 347
Exhibit 348
Tinea Cruris (Jock Itch)
What is tinea cruris?
Who gets it?
What are the symptoms?
How is it treated?
How can it be prevented?
Keep in mind
Exhibit 350
Tiña Crural (“Tiña Inguinal”)
¿Qué es la tiña crural?
¿A quién le da?
¿Cuáles son los síntomas?
¿Cómo se trata?
¿Cómo se puede prevenir?
Recuerde
Exhibit 352
Tinea Versicolor
What is tinea versicolor?
What does it look like?
Can it be cured?
How is it treated?
By your health care provider
On your own
What you can expect
Exhibit 354
Exhibit 355
Exhibit 356
Tiña Versicolor
¿Qué es la tiña versicolor?
¿Cómo es la tiña versicolor?
¿Se puede curar?
¿Cómo se trata?
Por su médico
Por su parte
Lo que puede esperar
Exhibit 358
Exhibit 359
Exhibit 360
Vitiligo
What is vitiligo?
Who gets it?
What causes it?
What does it look like?
How is it treated?
Exhibit 362
Exhibit 363
Vitíligo
¿Qué es vitíligo?
¿A quien le da vitíligo?
¿Qué lo causa?
¿Cómo es el vitíligo?
¿Cómo se trata?
Exhibit 365
Exhibit 366
Warts
What are warts?
What causes them?
What do they look like?
How are they treated?
Home treatment
Office treatment
How do I know when the warts are gone?
How do you get warts and how do you avoid spreading warts to others?
Wart facts
Exhibit 368
Exhibit 369
Exhibit 370
Exhibit 371
Exhibit 372
Verrugas
¿Qué son las verrugas?
¿Qué causa verrugas?
¿Cómo son las verrugas?
¿Cómo se contagian y cómo se evitan?
¿Cómo se tratan?
Tratamiento en casa
¿Cómo sé que las verrugas se eliminaron?
¿Cómo sé contraen verrugas y cómo sé evita tener verrugas y transmitiralas?
Datos sobre las verrugas
Exhibit 374
Exhibit 375
Exhibit 376
Exhibit 377
Exhibit 378
Part One: Common Pediatric Skin Conditions: Diagnosis and Management
Introduction
Illustrated Glossary of Basic Skin Lesions
Primary Lesions
Secondary (Modified) Lesions
Reaction Patterns, Shapes, and Configurations
Reaction Patterns
Shape of Lesions
Configuration of Lesions
Distribution of Lesions
Exhibit 380
Macule.
Patch.
Exhibit 383
Papule.
Exhibit 385
Nodule.
Exhibit 387
Vesicle.
Exhibit 389
Bulla.
Exhibit 391
Pustule.
Exhibit 393
Plaque.
Exhibit 395
Atrophic plaque.
Exhibit 397
Wheal.
Exhibit 399
Cyst.
Exhibit 401
Scale.
Exhibit 403
Crust.
Exhibit 405
Erosion.
Exhibit 407
Ulcer.
Fissure.
Exhibit 410
Excoriation.
Exhibit 412
Papulosquamous reaction pattern.
Papulosquamous reaction pattern.
Acute eczematous reaction pattern. Poison ivy.
Chronic eczematous reaction pattern.
Vesicobullous reaction pattern.
Dermal reaction pattern.
Subcutaneous reaction pattern.
Vascular reaction pattern.
Exhibit 421
Annular lesion.
Exhibit 423
Nummular lesions.
Exhibit 425
Linear lesion.
Exhibit 427
Grouped lesions.
Exhibit 429
Follicular lesions.
Lines of cleavage.
Bilateral symmetry.
Topical Therapy
Overview
Basics
Vehicles
A Cream, an Ointment, a Gel, or a Lotion?
Wet Dressings
Topical Steroids
Basics
Mechanism of Action
Potencies
Delivery (Percutaneous Penetration)
Potential Side Effects
Topical Immunomodulators (Calcineurin Inhibitors)
Basics
Mechanism of Action
Potential Side Effects
Safety
Table I.1: Topical Steroids (“The Short List”)a
Table I.2: Classification, Strength, and Vehicle of Some Commonly used Topical Corticosteroids (“The Long
List”)
Figure I.1
Exhibit 437
Exhibit 438
Figure I.2: Occlusion.
Figure I.3: Perioral dermatitis resembling rosacea and peroral dermatitis.
Chapter 1: Birthmarks
Overview
Aplasia Cutis Congenita
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 1.1: Aplasia cutis congenita.
Figure 1.2: Aplasia cutis congenita.
Figure 1.3: Aplasia cutis congenita.
Management
Figure 1.4: Aplasia cutis congenita.
Nevus Sebaceous
Basics
Clinical Manifestations
Pathogenesis
Diagnosis
Figure 1.5: Nevus sebaceous.
Efigure 1.1: Nevus sebaceous. Verrucous plaque on scalp.
Figure 1.6: Nevus sebaceous.
Figure 1.7: Nevus sebaceous.
Management
Nevus Simplex (aka Salmon Patch)
Basics
Clinical Manifestations
Pathogenesis
Diagnosis
Figure 1.8: Nevus Simplex.
Figure 1.9: Nevus Simplex.
Efigure 1.2: Nevus Simplex (“salmon patch,” “stork bite”).
Management
Port-Wine Stain (Nevus Flammeus)
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Sturge–Weber Syndrome
Basics
Clinical Manifestations
Diagnosis
Klippel–Trenaunay Syndrome
Basics
Clinical Manifestations
Diagnosis
Figure 1.10: Port-wine stain.
Efigure 1.3: Port wine stain (nevus flammeus).
Table 1.1: Location of PWS and Associated Syndrome
Management
Management
Figure 1.11: Port-wine stain.
Figure 1.12: Port-wine stain.
Management
Infantile Hemangioma
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 1.13: Infantile hemangioma.
Efigure 1.4: Infantile hemangioma (IH).
Figure 1.14: Involuting infantile hemangioma.
Efigure 1.5: Involuting infantile hemangioma (IH).
Figure 1.15: Infantile hemangioma.
Figure 1.16: Infantile hemangioma.
Figure 1.17: An ulcerated infantile hemangioma.
Table 1.2: High-Risk Infantile Hemangiomas Location and Required Intervention
Management
Topical Treatments
Intralesional Therapy
Systemic Treatments
Dosing
Side Effects
Atenolol
Systemic Corticosteroids
Dosing
Side Effects
Treatments for Ulceration
Surgery
Café au Lait Spots
Basics
Pathology
Clinical Manifestations
Diagnosis
Figure 1.18: Café au lait macule.
Figure 1.19: Café au lait macule.
Figure 1.20: Café au lait macule.
Figure 1.21: Becker Nevus.
Management
Dermal Melanocytosis (aka Mongolian Spot(s))
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 1.22: Dermal Melanocytosis.
Efigure 1.6: Dermal melanocytosis (Mongolian spots).
Figure 1.23: Dermal Melanocytosis.
Management
Congenital Melanocytic Nevus
Basics
Pathology
Clinical Manifestations
Clinical Variant
Associated Risks
Figure 1.24: Congenital Melanocytic Nevus.
Figure 1.25: Congenital Melanocytic Nevus.
Figure 1.26: Congenital Melanocytic Nevus.
Figure 1.27: Nevus spilus.
Figure 1.28: Satellite Nevi.
Management
Epidermal Nevus
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 1.29: Epidermal Nevus.
Efigure 1.7: Epidermal nevus.
Figure 1.30: Epidermal Nevus.
Management
Nevus Depigmentosus
Basics
Pathogenesis
Clinical Manifestations
Clinical Variants
Diagnosis
Figure 1.31: Nevus depigmentosus.
Figure 1.32: Nevus depigmentosus.
Figure 1.33: Pigmentary mosaicism.
Figure 1.34: Pigmentary mosaicism.
Management
Chapter 2: Neonatal and Infantile Eruptions
Overview
Cutis Marmorata
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.1: Cutis marmorata.
Figure 2.2: Cutis marmorata telangiectatica congenita.
Management
Sebaceous Gland Hyperplasia
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.3: Sebaceous gland hyperplasia.
Management
Transient Neonatal Pustular Melanosis
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.4: Transient neonatal pustular melanosis.
Figure 2.5: Transient neonatal pustular melanosis.
Figure 2.6: Transient neonatal pustular melanosis.
Management
Erythema Toxicum Neonatorum
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.7: Erythema toxicum neonatorum.
Efigure 2.1: Erythema toxicum neonatorum (ETN).
Figure 2.8: Erythema toxicum neonatorum.
Management
Sucking Blisters
Basics
Clinical Manifestations
Diagnosis
Figure 2.9: Sucking blister.
Management
Milia (See also Chapter 30)
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.10: Milia.
Figure 2.11: Milia.
Management
Miliaria
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.12: Miliaria crystallina.
Figure 2.13: Miliaria rubra.
Efigure 2.2: Miliaria rubra.
Management
Neonatal Lupus Erythematosus
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.14: Neonatal lupus erythematosus.
Figure 2.15: Neonatal lupus erythematosus.
Management
Seborrheic Dermatitis
Basics
Clinical Manifestations
Figure 2.16: Seborrheic dermatitis.
Efigure 2.3: Seborrheic dermatitis of scalp.
Diaper Dermatitis
Basics
(Irritant) Diaper Dermatitis
Pathogenesis
Clinical Manifestations
Diagnosis
Specific Treatment Measures
Prevention
Table 2.1: Differential Diagnosis of Diaper Dermatitis
Efigure 2.4: Psoriasis in an infant.
Table 2.1: Differential Diagnosis of Diaper Dermatitis (Continued)
Table 2.1: Differential Diagnosis of Diaper Dermatitis (Continued)
Table 2.1: Differential Diagnosis of Diaper Dermatitis (Continued)
Figure 2.17: (Irritant contact) diaper dermatitis.
Management
Acropustulosis of Infancy
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.25: Infantile acropustulosis.
Management
Eosinophilic Pustular Folliculitis of Infancy
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.26: Eosinophilic pustular folliculitis.
Management
Acute Hemorrhagic Edema of Infancy (aka Finkelstein Disease)
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 2.27: Acute hemorrhagic edema of infancy.
Figure 2.28: Acute hemorrhagic edema of infancy.
Management
Chapter 3: Acne
Overview
Neonatal Cephalic Pustulosis (Neonatal Acne)
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 3.1: Neonatal cephalic pustulosis.
Figure 3.2: Neonatal cephalic pustulosis.
Management
Infantile Acne
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 3.3: Infantile acne.
Management
Childhood Acne
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 3.4: Childhood acne.
Management
Periorificial Dermatitis
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 3.5: Periorificial dermatitis.
Figure 3.6: Periorificial dermatitis.
Figure 3.7: Periorificial dermatitis.
Figure 3.8: Periorificial dermatitis.
Management
Adolescent Acne (aka Acne Vulgaris)
Basics
Figure 3.9: Preadolescent acne.
Figure 3.10: Preadolescent acne.
Chapter 4: Eczema in Infants and Children
Overview
Histopathology
Figure 4.1: Chronic atopic dermatitis.
Atopic Dermatitis
Basics
Pathogenesis
Clinical Manifestations
Description of Lesions
Infantile Phase
Childhood Phase
Adolescent Phase
Clinical Sequelae and Possible Complications
Diagnosis
Associated Conditions
Table 4.1: Clinical Clues to the Diagnosis of Atopic Dermatitis
Figure 4.2: Infantile atopic dermatitis.
Figure 4.3: Infantile atopic dermatitis.
Figure 4.4: Infantile atopic dermatitis.
Efigure 4.1: Atopic dermatitis.
Efigure 4.2: Atopic dermatitis.
Figure 4.5: Childhood atopic dermatitis.
Figure 4.6: Atopic dermatitis.
Figure 4.7: Atopic dermatitis.
Efigure 4.3: Atopic dermatitis on legs.
Figure 4.8: Atopic dermatitis.
Figure 4.9: Atopic cheilitis (atopic dermatitis of the lips).
Efigure 4.4: Atopic dermatitis of lips (atopic cheilitis).
Efigure 4.5: Atopic dermatitis of lips (atopic cheilitis).
Figure 4.10: Atopic dermatitis.
Efigure 4.6: Atopic dermatitis of eyelids.
Efigure 4.7: Atopic dermatitis of eyelids.
Figure 4.11: Atopic dermatitis, follicular eczema.
Figure 4.12: Dyshidrotic eczema.
Efigure 4.8: Atopic dermatitis of trunk.
Efigure 4.9: Atopic dermatitis of antecubital fossae.
Efigure 4.10: Atopic dermatitis of antecubital fossae.
Efigure 4.11: Atopic dermatitis of antecubital fossae.
Efigure 4.12: Atopic dermatitis of neck.
Efigure 4.13: Atopic dermatitis of feet.
Efigure 4.14: Atopic dermatitis of foot.
Figure 4.13: Eczema herpeticum.
Figure 4.14: Excoriations.
Efigure 4.15: Excoriations.
Figure 4.15: Hyperlinear palms.
Figure 4.16: Dennie-Morgan folds.
Figure 4.17: Allergic shiners.
Management
General Principles
Treatment
Topical Therapy (see Chapter 13 and “Introduction: Topical Therapy”)
Face and Body Folds
Body (Trunk, Arms, Legs, Scalp)
Adjunctive Therapies to Consider During AD Flares
Daily Maintenance Therapy
Gentle Bathing Tips
Other Therapeutic Measures
Table 4.2: Conditions Associated with Atopic Dermatitis
Keratosis Pilaris
Basics
Clinical Manifestations
Figure 4.18: Keratosis pilaris.
Figure 4.19: Keratosis pilaris.
Management
Ichthyosis Vulgaris
Basics
Clinical Manifestations
Figure 4.20: Ichthyosis vulgaris.
Efigure 4.16: Ichthyosis vulgaris.
Efigure 4.17: Ichthyosis vulgaris.
Figure 4.21: Ichthyosis vulgaris.
Management
Pityriasis Alba
Basics
Clinical Manifestations
Figure 4.22: Pityriasis alba.
Figure 4.23: Pityriasis alba.
Management
Seborrheic Dermatitis (See also Chapter 13)
Basics
Pathogenesis
Clinical Manifestations
Infancy
Adolescence
Clinical Sequelae
Figure 4.24: Seborrheic dermatitis.
Figure 4.25: Seborrheic dermatitis.
Figure 4.26: Seborrheic dermatitis.
Efigure 4.18: Seborrheic dermatitis.
Figure 4.27: Pityriasis amiantacea.
Management
Infants
Scalp
Face and Body Folds
Adolescents
Irritant Contact Dermatitis
(Irritant) Diaper Dermatitis
Basics
Lip Lickers Dermatitis
Basics
Clinical Manifestations
Diagnosis
Juvenile Plantar Dermatosis
Basics
Clinical Manifestations
Diagnosis
Table 4.3: Most Common Contact Allergens in Children
Table 4.4: Top 10 Sources of Irritant Contact Dermatitis in Children
Figure 4.28: Irritant diaper dermatitis.
Figure 4.29: Lip Licker’s dermatitis.
Management
Figure 4.30: Juvenile plantar dermatosis.
Figure 4.31: Juvenile plantar dermatosis.
Management
Chapter 5: Superficial Bacterial Infections
Overview
Impetigo
Basics
Clinical Manifestations
Nonbullous Impetigo
Bullous Impetigo
Diagnosis
Complications
Figure 5.1: Impetigo.
Figure 5.2: Impetigo.
Figure 5.3: Bullous impetigo.
Management
Folliculitis
Basics
Clinical Manifestations
Clinical Variant
Diagnosis
Figure 5.4: Folliculitis.
Figure 5.5: Folliculitis.
Management
Furunculosis
Basics
Clinical Manifestations
Diagnosis
Figure 5.6: Furuncle.
Figure 5.7: Furuncle.
Figure 5.8: Carbuncle.
Management
Perianal Streptococcal Dermatitis (Perianal Cellulitis)
Basics
Clinical Manifestations
Diagnosis
Figure 5.9: Perianal streptococcal dermatitis.
Management
Pitted Keratolysis
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 5.10: Pitted keratolysis.
Management
Chapter 6: Superficial Viral Infections
Overview
Warts
Basics
Pathogenesis
Clinical Manifestations
Clinical Variants
Common Warts
Plantar Warts
Flat Warts
Filiform Warts
Diagnosis
Figure 6.1: Common warts (verruca vulgaris).
Figure 6.2: Common warts (verruca vulgaris).
Efigure 6.1: Verruca vulgaris.
Figure 6.3: Common warts (verruca vulgaris).
Figure 6.4: Plantar warts (verrucae plantaris).
Figure 6.5: Mosaic plantar warts (verrucae plantaris).
Figure 6.6: Verrucae planae (flat warts).
Figure 6.7: Filiform and common warts.
Management of Warts
General Principles
Home Treatment
Duct Tape (“Ducto-Therapy”)
Instructions
Topical Salicylic Acid Preparations
Advantages
Disadvantages
Over-the-Counter Cryotherapy
Immunotherapy: Interferon Induction
Topical Retinoids
Topical Chemotherapy
Oral Therapy
In-Office Treatments
Cryotherapy with Liquid Nitrogen (LN2)
Advantages
Disadvantages
Electrocautery and Blunt Dissection or Curettage
Advantages
Disadvantages
Laser Ablation
Sensitizing Agents
Vesicants
Caustic Agents
Intralesional Chemotherapeutic Agent
Surgical Excision
Table 6.1: Topical Wart Medications Formulary
Figure I6.1
Figure 6.8
Molluscum Contagiosum
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 6.9: Molluscum contagiosum.
Figure 6.10: Molluscum contagiosum.
Figure 6.11: Molluscum contagiosum.
Figure 6.12
Management
Management
In Office Treatment
Cryotherapy with Liquid Nitrogen (LN2)
Curettage
At-Home Treatments
Imiquimod Cream
Tretinoin Cream
Oral Cimetidine
Potassium Hydroxide
Other Treatments
Herpes Simplex Virus
Basics
Pathogenesis
Clinical Variants
Herpes Gingivostomatitis
Herpes Labialis
Cutaneous Herpes Infections
Eczema Herpeticum
Neonatal Herpes Simplex
Diagnosis
Figure 6.13: Herpes simplex virus.
Figure 6.14: Herpes simplex virus. Eczema herpeticum.
Management of Pediatric HSV Infections
General Principles
Systemic Treatments
Topical Treatments
Pain Control
Hydration
Eczema Herpeticum (Kaposi’s Varicelliform Eruption [KVE])
Neonatal Herpes Simplex
Chapter 7: Viral and Bacterial Exanthems
Overview
Measles (Rubeola)
Basics
Pathogenesis
Clinical Manifestations
Complications
Diagnosis
Figure 7.1: Measles.
Figure 7.2: Measles.
Management
Rubella (German Measles)
Basics
Pathogenesis
Clinical Manifestations
Complications
Diagnosis
Figure 7.3: Rubella.
Management
Erythema Infectiosum (Fifth Disease)
Basics
Pathogenesis
Clinical Manifestations
Clinical Variants
Complications
Diagnosis
Figure 7.4: Erythema infectiosum.
Figure 7.5: Erythema infectiosum.
Management
Roseola Infantum
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 7.6: Roseola.
Management
Hand-Foot-and-Mouth Disease
Basics
Pathogenesis
Clinical Manifestations
Distribution of Lesions
Diagnosis
Figure 7.7: Hand-foot-and-mouth disease.
Figure 7.8: Hand-foot-and-mouth disease.
Figure 7.9: Hand foot-and mouth disease.
Management
Gianotti–Crosti Syndrome (aka Papular Acrodermatitis of Childhood)
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 7.10: Gianotti–Crosti syndrome.
Figure 7.11: Gianotti–Crosti syndrome.
Management
Unilateral Laterothoracic Exanthem
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 7.12: Unilateral laterothoracic exanthem.
Management
Nonspecific Viral Exanthem
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 7.13: Nonspecific viral exanthem.
Management
Varicella (Chickenpox)
Basics
Pathogenesis
Clinical Manifestations
Complications
Diagnosis
Figure 7.14: Varicella.
Figure 7.15: Varicella.
Figure 7.16: Varicella.
Figure 7.17: Varicella atrophic scar.
Figure 7.18: Varicella hypertrophic scars.
Management
Acute Varicella
Varicella Vaccine
Varicella and Pregnancy
Scarlet Fever
Basics
Pathogenesis
Clinical Manifestations
Complications
Diagnosis
Figure 7.19: Scarlet fever.
Figure 7.20: Scarlet fever.
Management
Toxin-Mediated Streptococcal and Staphylococcal Disease
Basics
Toxic Shock Syndrome
Basics
Clinical Manifestations
Complications
Diagnosis
Staphylococcal Scalded Skin Syndrome (SSSS)
Basics
Pathogenesis
Clinical Features
Diagnosis
Figure 7.21: Toxic shock syndrome.
Management
Figure 7.22: Staphylococcal scalded skin syndrome.
Figure 7.23: Staphylococcal scalded skin syndrome.
Management
Chapter 8: Lumps, Bumps, and Linear Eruptions
Overview
Epidermal Cyst (Also Discussed in Chapter 30)
Basics
Clinical Manifestations
Diagnosis
Figure 8.1: Epidermal cyst, inflamed.
Management
Pilomatricoma
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Efigure 8.1: Pilomatricoma (calcifying epithelioma of Malherbe).
Figure 8.2: Pilomatricoma/calcified.
Figure 8.3: Pilomatricoma.
Efigure 8.2: Pilomatricoma.
Management
Juvenile Xanthogranuloma
Basics
Clinical Manifestations
Diagnosis
Figure 8.4: Juvenile xanthogranuloma.
Figure 8.5: Juvenile xanthogranuloma.
Management
Spitz Nevus (also Called Spindle and Epithelioid Cell Nevus)
Basics
Clinical Manifestations
Diagnosis
Figure 8.6: Spitz nevus.
Figure 8.7: Pigmented Spitz nevus.
Management
Mastocytoma
Basics
Clinical Manifestations
Solitary Mastocytoma
Urticaria Pigmentosa (Also Called Maculopapular Cutaneous Mastocytosis)
Diffuse Cutaneous Mastocytosis
Diagnosis
Figure 8.8: Solitary mastocytoma.
Figure 8.9
Efigure 8.3a: Mastocytoma/Darier sign.
Efigure 8.3b: Mastocytoma/Darier sign.
Table 8.1: Triggers of Mast Cell Degranulation
Figure 8.10: Urticaria Pigmentosa.
Management
Insect Bite Reactions (see Discussion in Chapter 29)
Basics
Clinical Manifestations
Papular Urticaria
Diagnosis
Figure 8.11: Bullous insect bite reaction.
Efigure 8.4: Bullous bite reaction.
Figure 8.12: Insect Bite Reaction.
Figure 8.13: Insect bites/Papular(nodular) urticaria.
Management
Prevention
Treatment
Papular Urticaria
Spider Angioma
Basics
Clinical Manifestations
Diagnosis
Figure 8.14: Spider angioma.
Efigure 8.5: Spider angioma.
Management
Lichen Nitidus
Basics
Clinical Manifestations
Diagnosis
Figure 8.15: Lichen nitidus.
Figure 8.16: Lichen nitidus.
Management
Lichen Spinulosus
Basics
Clinical Manifestations
Diagnosis
Figure 8.17: Lichen spinulosus.
Management
Frictional Lichenoid Dermatitis
Basics
Clinical Manifestations
Diagnosis
Figure 8.18: Frictional lichenoid dermatitis.
Management
Lichen Striatus
Basics
Clinical Manifestations
Diagnosis
Figure 8.19: Lichen striatus.
Figure 8.20: Lichen striatus.
Efigure 8.6: Lichen striatus.
Figure 8.21: Lichen striatus.
Efigure 8.7: Lichen striatus.
Figure 8.22: Segmental vitiligo.
Management
Chapter 9: Hair and Nail Disorders
Overview
Alopecia Areata (Also Discussed in Chapter 19)
Basics
Clinical Manifestations
Clinical Variants
Diagnosis
Figure 9.1: Alopecia areata.
Figure 9.2: Alopecia areata.
Efigure 9.1: Alopecia areata.
Efigure 9.2: Alopecia areata.
Figure 9.3: Alopecia areata.
Figure 9.4: Alopecia totalis.
Figure 9.5: Congenital triangular alopecia.
Efigure 9.3: Congenital triangular alopecia.
Management
Topical Treatments
Intralesional Treatment
Systemic Treatments
Telogen Effluvium (also Discussed in Chapter 19)
Basics
Clinical Manifestations
Clinical Variants
Occipital Alopecia of the Newborn (Telogen Effluvium of the Newborn)
Diagnosis
Figure 9.6: Occipital alopecia of the newborn.
Management
Trichotillomania
Basics
Clinical Manifestations
Diagnosis
Figure 9.7: Trichotillomania.
Management
Tinea Capitis
Basics
Clinical Manifestations
Diagnosis
Figure 9.8: Tinea capitis.
Figure 9.9
Figure 9.10: Tinea capitis.
Efigure 9.5: Tinea amiantacea.
Figure 9.11: Tinea capitis with kerion.
Efigure 9.4: Tinea capitis/kerion.
Figure 9.12: Tinea amiantacea.
Management
Griseofulvin
Terbinafine (Lamisil)
Itraconazole (Sporanox)
Fluconazole (Diflucan)
Head Lice (Pediculosis Capitis, see also Chapter 29)
Basics
Clinical Manifestations
Diagnosis
Figure 9.13: Head lice.
Efigure 9.6: Head lice (Pediculosis capitis).
Figure 9.14: Head lice.
Efigure 9.7: Head lice (Pediculosis capitis).
Efigure 9.8: Head lice (Pediculosis capitis).
Management
General Principles
Topical Treatments: Neurotoxic Mode of Action
Topical treatments: Physical mode of action
Oral Pediculicide
Trachyonychia
Basics
Clinical Manifestations
Diagnosis
Figure 9.15: Trachyonychia.
Figure 9.16: Trachyonychia.
Efigure 9.9: Trachyonychia of toenails.
Efigure 9.10: Trachyonychia of fingernails.
Figure 9.17: Onychomycosis.
Efigure 9.11: Onychomycosis of toenails.
Management
Onychomadesis & Beau Lines
Basics
Clinical Manifestations
Figure 9.18: Beau line.
Figure 9.19: Onychomadesis.
Management
Chapter 10: Cutaneous Manifestations of Systemic Disease
Overview
Henoch–Schönlein Purpura
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 10.1: Henoch–Schönlein purpura.
Figure 10.2: Henoch–Schönlein purpura.
Management
Kawasaki Disease
Basics
Pathogenesis
Clinical Manifestations
Clinical Sequelae
Diagnosis
Laboratory Findings
Figure 10.3: Kawasaki disease.
Figure 10.4: Kawasaki disease.
Figure 10.5: Kawasaki disease.
Figure 10.6: Kawasaki disease.
Management
Juvenile Dermatomyositis
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 10.7: Juvenile dermatomyositis.
Figure 10.8: Gottron papules.
Figure 10.9: Periungual telangiectasias.
Management
Chapter 11: Neurocutaneous Syndromes
Overview
Neurofibromatosis
Basics
Pathogenesis
Clinical Manifestations
Neurofibromatosis Type 1
Neurofibromatosis Type 2
Diagnosis
Neurofibromatosis Type 1
Neurofibromatosis Type 2
Laboratory Evaluation
Figure 11.1: Neurofibromatosis.
Figure 11.2: Neurofibromatosis.
Figure 11.3: Neurofibromatosis.
Figure 11.4: Neurofibromatosis.
Figure 11.5: Neurofibromatosis.
Management
Tuberous Sclerosis
Basics
Pathogenesis
Clinical Manifestations
Central Nervous System Lesions
Other Findings
Diagnosis
Major Diagnostic Criteria
Minor Diagnostic Criteria
Laboratory Evaluation
Figure 11.6: Tuberous sclerosis.
Figure 11.7: Tuberous sclerosis.
Figure 11.8: Tuberous sclerosis.
Figure 11.9: Tuberous sclerosis.
Management
Part Two: Common Adult/Elderly Skin Conditions: Diagnosis and Management
Chapter 12: Acne and Related Disorders
Overview
Acne Vulgaris (Adolescent Acne)
Basics
Pathogenesis
Clinical Manifestations
Inflammatory Lesions
Comedonal Lesions
Severity
Clinical Sequelae
Diagnosis
Figure I12.1: Androgenic stimulation.
Figure I12.2: Follicular occlusion.
Figure I12.3: Comedogenesis.
Figure I12.4: Inflammatory acne.
Figure 12.1: Inflammatory acne (mild).
Figure 12.2: Inflammatory acne.
Figure 12.3: Inflammatory acne (moderate).
Efigure 12.1: Acne vulgaris.
Efigure 12.2: Acne vulgaris.
Figure 12.4: Inflammatory acne.
Figure 12.5: Severe cystic acne conglobata.
Figure 12.6: Noninflammatory (comedonal) acne and inflammatory acne.
Figure 12.7: Follicular prominence.
Figure 12.8: Acne scars.
Figure 12.9: “Ice-pick scars.”
Figure 12.10: Acne scars.
Figure 12.11: Postinflammatory hyperpigmentation secondary to acne.
Management
Goals
General Principles
Topical Therapies
How to Use Benzoyl Peroxide
Topical Retinoids
How to Use Topical Retinoids
Topical Antibiotics
How to Use Topical Antibiotics
Combination of Topical Antibiotic and Benzoyl Peroxide
How to Use Combination of Topical Antibiotics and Benzoyl Peroxide
Alternative Topical Prescription Drugs
Topical Nonprescription Agents
Alpha- and Beta-Hydroxy Acids
Systemic Therapies
Oral Antibiotics
Tetracyclines
Tetracycline
Minocycline
Doxycycline
Alternative Antibiotics
Hormonal Treatment
Oral Retinoids (Isotretinoin)
Mechanism of Action
Dosage
Side Effects
General
Depression and Suicide
Adjuvant Therapeutic Modalities
Comedo Extraction (Acne Surgery) (see Chapter 35)
Intralesional Corticosteroid Injection
Office-Based Chemical Peels
Lasers, Lights, and Other New Technologies
Photodynamic Therapy
Lasers
Table 12.1: Benzoyl Peroxide–containing Preparations
Table 12.2a: Topical Retinoids for Acne
Table 12.2b: Topical Combinations Containing Retinoids
Table 12.3: Topical Antibioticsa
Table 12.4: Combination Topical Antibiotic and Benzoyl Peroxide Agentsa
Table 12.5: Systemic Antibiotics for Acne and Rosacea
Postadolescent Acne (Adult-Onset Acne)
Basics
Clinical Manifestations
Description of Lesions
Distribution of Lesions
Diagnosis
Figure 12.12: Postadolescent acne.
Management
Topical Treatment
Systemic Treatment
Oral Antibiotics
Hormonal Treatment
Oral Contraceptive Pills
Oral Antiandrogens
Spironolactone (Aldactone)
Other Androgen Receptor Blockers
Rosacea
Basics
Pathogenesis
Clinical Manifestations
Description of Lesions
Distribution of Lesions
Diagnosis
Figure 12.13: Rosacea.
Figure 12.14: Ocular rosacea.
Figure 12.15: Rosacea.
Figure 12.16: Facial erythema.
Management
General Principles
Topical Therapy
Metronidazoles
Azelaic Acid
Sodium Sulfacetamide and Sulfur
Brimonidine Tartrate Gel 0.33% (Mirvaso)
Ivermectin (Soolantra)
Systemic Therapy
Oral Antibiotics
Tetracycline Derivatives
Alternative Antibiotics
Other Treatment Options
Electrocautery
Pulse Dye Lasers and Intense Pulsed Light
Camouflaging Cosmetics
Table 12.6: Topical Agents for Rosacea
Rosacea Variants
Perioral Dermatitis
Topical Steroid-Induced Rosacea
Rhinophyma
Figure 12.17: Perioral dermatitis.
Figure 12.18: Periorificial dermatitis.
Figure 12.19: Topical steroid-induced rosacea.
Figure 12.20: Rhinophyma.
Efigure 12.3: Rhinophyma, severe.
Acne: Other Types
Systemic Drug-Induced (Or Drug-Exacerbated) Acne
Acne Excoriée Des Jeunes Filles
Endocrinopathic Acne
Figure 12.21: Acne excoriée des jeunes filles.
Chapter 13: Eczema and Related Disorders
Overview
Figure 13.1: Acute allergic eczematous eruption of poison ivy.
Figure 13.2: Subacute eczematous dermatitis.
Figure 13.3: Chronic eczematous dermatitis.
Figure 13.4: Chronic eczematous dermatitis.
Contact Dermatitis
Basics
Irritant Contact Dermatitis
Allergic Contact Dermatitis
Poison Ivy/Poison Oak Dermatitis
Clinical Manifestations
Other Common Examples of Allergic Contact Dermatitis
Diagnosis of ACD
Figure 13.5: Irritant contact dermatitis.
Figure 13.6: Irritant contact dermatitis.
Figure 13.7: Irritant contact dermatitis.
Figure 13.8: Allergic contact dermatitis.
Figure 13.9: Poison Ivy.
Figure 13.10: Poison oak.
Figure 13.11: Allergic contact dermatitis. Poison ivy.
Figure 13.12: Allergic contact dermatitis. Poison ivy.
Management
Figure 13.13: Allergic contact dermatitis.
Figure 13.14: Allergic contact dermatitis.
Figure 13.15: Allergic contact dermatitis.
Figure 13.16: Allergic contact dermatitis.
Figure 13.17: Allergic contact dermatitis.
Figure 13.18: Allergic contact dermatitis.
Management
Atopic Dermatitis (Atopic Eczema)
Basics
Pathogenesis (Discussed in Chapter 4)
Clinical Manifestations
Clinical Sequelae and Possible Complications
Diagnosis
Figure 13.19: Atopic dermatitis (lichen simplex chronicus).
Figure 13.20: Atopic dermatitis (lichen simplex chronicus).
Figure 13.21: Atopic cheilitis (atopic dermatitis of the lips).
Figure 13.22: Atopic dermatitis of breast and areola.
Figure 13.23: Atopic dermatitis of vulvar, perineum, and inguinal areas.
Figure 13.24: Atopic dermatitis (lichen simplex chronicus) limited to the scrotum.
Figure 13.25: Eczematous dermatitis (impetiginized).
Figure 13.26: Kaposi varicelliform eruption (eczema herpeticum).
Management
Topical Therapy (see Chapter 4, and “Introduction: Topical Therapy”)
General Principles
Face and Body Folds (Intertriginous Regions)
Body (Trunk, Arms, Legs, Scalp)
Topical Immunomodulators
Infection
Phototherapy
Systemic Treatments
General Management (see also Chapter 4)
Bathing
Bathing Tips
Prevention of Atopic Dermatitis
Hand-and-Foot Eczema
Basics
Clinical Manifestations
“Wet” Type
“Dry,” Scaly Type
Diagnosis
Figure 13.27: Atopic hand eczema, dyshidrotic or “wet” type.
Figure 13.28: Atopic hand eczema, dyshidrotic or “wet” type.
Figure 13.29: Atopic hand eczema (“dry,” scaly type).
Figure 13.30: Atopic dermatitis (nail dystrophy).
Management
Mild Cases
Severe Cases
Lichen Simplex Chronicus
Basics
Clinical Manifestations
Diagnosis
Figure 13.31: Lichen simplex chronicus.
Figure 13.32: Lichen simplex chronicus.
Management
Prurigo Nodularis
Basics
Clinical Manifestations
Figure 13.33: Prurigo nodularis.
Figure 13.34: Prurigo nodularis.
Management
Nummular Eczema
Basics
Clinical Manifestations
Diagnosis
Figure 13.35: Nummular eczema.
Figure 13.36: Nummular eczema.
Management
Asteatotic Eczema and Nonspecific Eczematous Dermatitis in the Elderly
Basics
Clinical Manifestations
Asteatotic Eczema
Nonspecific Eczematous Dermatitis in the Elderly
Figure 13.37: Asteatotic eczema (erythema craquelé).
Figure 13.38: Asteatotic eczema.
Figure 13.39: Asteatotic eczema.
Management
Seborrheic Dermatitis (“Seborrheic Eczema”)
Basics
Pathogenesis
Clinical Manifestations
Figure 13.40: Seborrheic dermatitis.
Figure 13.41: Seborrheic dermatitis.
Figure 13.42: Seborrheic dermatitis.
Figure 13.43: Seborrheic dermatitis.
Management
Scalp
Intertriginous/Body Fold Areas
Face
Table 13.1: Seborrheic Dermatitis Formulary
Stasis Dermatitis
Basics
Pathogenesis
Clinical Manifestations
Clinical Sequelae and Possible Complications
Diagnosis
Figure 13.44: Acute stasis dermatitis.
Figure 13.45: Subacute stasis dermatitis.
Figure 13.46: Chronic stasis dermatitis.
Figure 13.47: Stasis dermatitis with venous stasis ulcer.
Figure 13.48: Lipodermatosclerosis.
Figure 13.49: Stasis dermatitis with secondary impetiginization.
Figure 13.50: Cellulitis.
Management
Stasis Dermatitis (Eczematous Eruption): Topical Therapy
Edema
Infection
Stasis Ulcers
Prevention of Diminished Venous Return
Figure 13.51: Leg elevation.
Chapter 14: Psoriasis
Overview
Psoriasis
Basics
Pathophysiology
Histopathology
Clinical Manifestations
Clinical Sequelae
Pruritus
The KÖbner Reaction (Isomorphic Response)
Fissuring of Plaques
Psychosocial Problems
Triggers
Course
Diagnosis
Figure 14.1: Psoriasis.
Figure 14.2: Psoriasis.
Figure 14.3: Psoriasis.
Figure 14.4: Psoriasis.
Figure I14.1: Psoriasis.
Figure 14.5: Psoriasis.
Figure 14.6: Psoriasis.
Localized Plaque Psoriasis
Basics
Clinical Manifestations
Diagnosis
Figure 14.7: Psoriasis.
Figure 14.8: Psoriasis.
Figure 14.9: Psoriasis.
Figure 14.10: Psoriasis.
Management
General Principles
Available Treatment Modalities
Specific Treatment of Localized Plaque Psoriasis
Topical Corticosteroids
Advantage
Disadvantages
Occlusion of Topical Corticosteroids
Advantage
Disadvantage
Intralesional Steroids
Advantages
Disadvantages
Topical Vitamin D3 Derivatives
Advantages
Disadvantages
Topical Tar Preparations
Topical Anthralin
Innovative Management Strategies
Rotational Therapy
Table 14.1: Short List of Topical Steroids used to Treat Psoriasis
Table 14.2: Other Topical Agents used to Treat Psoriasis
Generalized Plaque Psoriasis
Basics
Clinical Manifestations
Management—Generalized Plaque Psoriasis
General Principles
Topical Therapy
Phototherapy
Broadband UVB
Narrowband UVB
Excimer Laser UVB
UVA
Advantages
Disadvantages
Systemic Therapy
Methotrexate
Advantages
Disadvantages
Acitretin (Soriatane)
Advantages
Disadvantages
Cyclosporine (Neoral, Sandimmune)
Advantages
Disadvantages
Apremilast (Otezla)
Rotational Therapy
The Biologics
Etanercept (Enbrel)
Advantages
Disadvantages
Adalimumab (Humira)
Advantages
Disadvantages
Infliximab (Remicade)
Advantages
Disadvantages
Ustekinumab (Stelara)
Advantages
Disadvantages
Secukinumab (Cosentyx)
Acute Guttate Psoriasis
Basics
Clinical Manifestations
Figure 14.11: Psoriasis (acute guttate).
Management
Scalp Psoriasis
Basics
Clinical Manifestations
Figure 14.12: Psoriasis of the scalp.
Figure 14.13: Psoriasis of the scalp.
Figure 14.14: Psoriasis of the scalp and ears.
Management
Mild Cases
Topical Steroids
Topical Vitamin D Derivatives
Severe Cases
Inverse Psoriasis
Basics
Clinical Manifestations
Figure 14.15: Inverse psoriasis.
Figure 14.16: Inverse psoriasis.
Figure 14.17: Inverse psoriasis.
Figure 14.18: Inverse psoriasis.
Figure 14.19: Inverse psoriasis.
Management
Psoriasis of the Palms and Soles (Palmoplantar Psoriasis)
Basics
Clinical Manifestations
Hyperkeratotic
Pustular
Figure 14.20: Psoriasis.
Figure 14.21: Psoriasis of soles.
Figure 14.22: Pustular psoriasis/palmoplantar pustulosis.
Figure 14.23: Pustular psoriasis /palmoplantar pustulosis.
Management
Psoriatic Nails (Also Discussed in Chapter 22)
Basics
Clinical Manifestations
Figure 14.24: Nail psoriasis (pitting).
Figure 14.25: Nail psoriasis (onycholysis).
Figure 14.26: Nail psoriasis (“oil spots” or “drops”).
Figure 14.27: Nail psoriasis (subungual hyperkeratosis).
Management
Psoriatic Arthritis
Basics
Clinical Manifestations
Figure 14.28: Psoriatic arthritis.
Figure 14.29: Psoriatic arthritis (“arthritis mutilans”).
Management
Exfoliative Dermatitis Secondary to Psoriasis
Basics
Clinical Manifestations
Diagnosis
Figure 14.30: Psoriasis.
Figure 14.31: Psoriasis–exfoliative dermatitis.
Management
Chapter 15: Inflammatory Eruptions of Unknown Cause
Overview
Pityriasis Rosea
Basics
Pathogenesis
Clinical Manifestations
Distribution of Lesions
Clinical Variants
Diagnosis
Figure 15.1: Pityriasis rosea.
Figure 15.2: Pityriasis rosea.
Figure 15.3: Pityriasis rosea.
Figure 15.4: Pityriasis rosea.
Figure 15.5: Pityriasis rosea.
Figure 15.6: Pityriasis rosea.
Management
Granuloma Annulare
Basics
Pathogenesis
Clinical Manifestations
Distribution of Lesions
Diagnosis
Figure 15.7: Granuloma annulare.
Figure 15.8: Granuloma annulare.
Figure 15.9: Granuloma annulare.
Efigure 15.1: Granuloma annulare.
Figure 15.10: Granuloma annulare.
Figure 15.11: Granuloma annulare.
Management
Lichen Planus
Basics
Pathophysiology
Clinical Manifestations
Distribution of Lesions
Associated Clinical Features
Clinical Variants
Diagnosis
Figure 15.12: Lichen planus.
Figure 15.13: Lichen planus.
Efigure 15.2: Lichen planus.
Figure 15.14: Lichen planus.
Figure 15.15: Lichen planus.
Figure 15.16: Lichen planus.
Figure 15.17: Lichen planus.
Figure 15.18: Lichen planus.
Figure 15.19: Lichen planus.
Figure 15.20: Lichen planus, hypertrophic.
Figure 15.21: Lichen planus, linear.
Efigure 15.3: Lichen planus/linear.
Figure 15.22: Lichen planus, atrophic.
Figure 15.23: Normal bite line.
Management
Chapter 16: Superficial Bacterial Infections, Folliculitis, and Hidradenitis Suppurativa
Overview
Impetigo
Basics
Clinical Manifestations
Distribution of Lesions
Secondary Impetigo (Impetiginization)
Clinical Sequelae
Diagnosis
Figure 16.1: Impetigo.
Figure 16.2: Impetigo.
Figure 16.3: Impetigo.
Figure 16.4: Impetigo gladiatorum.
Figure 16.5: Ecthyma.
Figure 16.6: Impetigo.
Figure 16.7: Impetigo of axilla.
Figure 16.8: Secondary impetiginization of eczematous dermatitis.
Management
Bacterial Folliculitis
Basics
Staphylococcal Folliculitis
Clinical Manifestations
Distribution of Lesions
Clinical Variants
Diagnosis
Pseudomonas Folliculitis (“Hot Tub Folliculitis”)
Clinical Manifestations
Diagnosis
Figure 16.9: Axillary folliculitis.
Figure 16.10: Facial folliculitis.
Figure 16.11: Folliculitis.
Management
Initial Episode
Chronic and Recurrent Cases
Figure 16.12: Hot tub folliculitis (“hot tub buns”).
Management
Folliculitis: Other Types
Irritant, Frictional, or Chemical Folliculitis
Steroid-Induced Acne and Rosacea (Also Discussed in Chapter 12)
Eosinophilic Pustular Folliculitis (Also Discussed in Chapters 2 and 33)
Fungal Folliculitis
Pityrosporum Folliculitis
Majocchi Granuloma (Also Discussed in Chapter 18)
Figure 16.13: Systemic steroid-induced folliculitis.
Figure 16.14: Eosinophilic pustular folliculitis.
Furunculosis (“Boils”)
Basics
Clinical Manifestations
Distribution of Lesions
Diagnosis
Figure 16.15: Furunculosis.
Figure 16.16: Furuncle.
Figure 16.17: Abscess.
Figure 16.18: Carbuncle.
Management
Hidradenitis Suppurativa (Acne Inversa)
Basics
Pathophysiology
Clinical Manifestations
Distribution of Lesions
Diagnosis
PROGNOSIS
Figure 16.19: Acute hidradenitis suppurativa.
Figure 16.20: Chronic hidradenitis suppurativa.
Efigure 16.1: Hidradenitis suppurativa (acne inversa).
Management
Preventive Measures During Remissions
Topical Therapy
Systemic Therapy
Surgical Measures
Chapter 17: Mucocutaneous Manifestations of Viral Infections
Overview
Warts (Nongenital)
Basics
Clinical Variants
Common Warts (AKA Verruca Vulgaris)
Plantar Warts
Flat Warts
Filiform Warts
Genital Warts (Condyloma Acuminata)
Diagnosis
Figure 17.1: Common warts (verruca vulgaris).
Figure 17.2: Common warts (verruca vulgaris).
Figure 17.3: Common wart (verruca vulgaris).
Figure 17.4: Common wart (verruca vulgaris).
Figure 17.5: Common warts (verruca vulgaris).
Figure 17.6: Mosaic plantar warts.
Figure 17.7: Mosaic plantar warts.
Figure 17.8: Plantar wart.
Figure 17.9: Flat warts (verruca planae).
Figure 17.10: Flat warts (verruca planae).
Figure 17.11: Flat warts (verruca planae).
Figure 17.12: Flat warts (verruca planae).
Figure 17.13: Filiform wart.
Figure 17.14: Filiform wart.
Figure 17.15
Figure 17.16: Corn (clavus).
Management of Warts (Discussed in Chapter 6)
General Principles
Molluscum Contagiosum
Basics
Clinical Manifestations
Diagnosis
Figure 17.17: Molluscum contagiosum.
Figure 17.18: Molluscum contagiosum.
Figure 17.19: Molluscum contagiosum.
Figure 17.20: Molluscum contagiosum.
Figure 17.21: Molluscum contagiosum.
Figure 17.22: Molluscum contagiosum.
Management (Discussed in Chapter 6)
Herpes Simplex (Nongenital)
Basics
Pathogenesis
Clinical Manifestations
Clinical Variants
Primary Orolabial Herpes Simplex (Discussed in Chapter 6)
Recurrent Orolabial Herpes Simplex
Herpetic Whitlow
Eczema Herpeticum
Herpes Gladiatorum
Disseminated Herpes Simplex
Herpetic Sycosis
Ocular Herpes Simplex
Diagnosis
Figure 17.23: Herpes simplex virus.
Figure 17.24: Herpes simplex virus.
Figure 17.25: Herpes simplex virus.
Figure 17.26: Primary herpes simplex virus infection.
Figure 17.27: Recurrent herpes simplex virus infection (herpes labialis).
Figure 17.28: Herpetic whitlow.
Figure 17.29: Eczema herpeticum (Kaposi varicelliform eruption).
Figure 17.30: Positive Tzanck preparation.
Management
Topical Therapy
Systemic Therapy
Primary Herpes Simplex
Recurrent Herpes Simplex
Herpes Zoster
Basics
Pathogenesis
Clinical Manifestations
Distribution of Lesions
Complications
Diagnosis
Figure 17.31: Herpes zoster.
Figure 17.32: Herpes zoster.
Figure 17.33: Herpes zoster.
Figure 17.34: Herpes zoster ophthalmicus.
Figure 17.35: Herpes zoster (disseminated).
Management
Topical Therapy
Systemic Therapy
Adjunctive Corticosteroids
Treatment of Postherpetic Neuralgia (PHN)
Prevention
Chapter 18: Superficial Fungal Infections
Overview
Dermatophyte Infections
Tinea Pedis (“Athlete’S Foot”)
Basics
Clinical Variants
Diagnosis
Tinea Cruris (“Jock Itch”)
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Tinea Corporis (“Ringworm”)
Basics
Clinical Manifestations
Diagnosis
Onychomycosis (Tinea Unguium)
Basics
Clinical Variants
Diagnosis
Figure 18.1: Interdigital tinea pedis (toe web infection).
Figure 18.2: Interdigital tinea pedis.
Figure 18.3: Tinea pedis.
Figure 18.4: Tinea pedis.
Figure 18.5: “Two feet, one hand” variant of tinea pedis.
Figure 18.6: Acute vesicular tinea pedis.
Management
Type 1: Interdigital
Type 2: Chronic Plantar
Type 3: Acute Vesicular
Table 18.1: Topical Antifungal Drug Formulary
Figure 18.7: Tinea cruris.
Management
Figure 18.8: Tinea corporis.
Figure 18.9: Extensive tinea corporis.
Figure 18.10: Tinea faciale.
Management
Figure 18.11: Positive KOH examination. Dermatophyte.
Figure 18.12: Positive KOH examination. Dermatophyte. Close-up.
Figure 18.13: Tinea corporis (tinea incognito).
Figure 18.14: Distal subungual onychomycosis.
Figure 18.15: Superficial white onychomycosis.
Figure 18.16: Proximal white subungual onychomycosis.
Management
Oral Therapy
Terbinafine (Lamisil) Tablets
Dosage
Itraconazole (Sporanox) Capsules
Dosage
Fluconazole (Diflucan) Tablets
Dosage
Other Treatment Methods
Yeast Infections
Cutaneous Candidiasis
Basics
Clinical Manifestations
Clinical Variants
Diagnosis
Tinea Versicolor
Basics
Clinical Manifestations
Diagnosis
Figure 18.17: Cutaneous candidiasis (inframammary).
Figure 18.18: Cutaneous candidiasis of the groin.
Figure 18.19: Cutaneous candidiasis (web spaces).
Figure 18.20: Cutaneous candidiasis (glans penis).
Figure 18.21: Cutaneous candidiasis (thrush).
Figure 18.22: Positive KOH examination.Candida.
Management
Figure 18.23: Tinea Versicolor.
Figure 18.24: Tinea Versicolor.
Figure 18.25: Tinea Versicolor.
Figure 18.26: Positive KOH examination.Tinea Versicolor.
Figure 18.27: Positive KOH examination.Tinea Versicolor (close up).
Management
Topical Agents
Systemic Therapy
Table 18.2: Formulary for Tinea Versicolor
Chapter 19: Hair and Scalp Disorders Resulting in Hair Loss
Overview
Overview
Types of Hair
Hair Texture and Shape
Cycles of Hair Growth
Hair Loss
Figure I19.1: Cycles of hair growth.
Androgenic Alopecia
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 19.1: Male-pattern alopecia.
Figure 19.2: Female-pattern alopecia.
Figure 19.3: Female-pattern alopecia.
Management
Women
Men
Men and Women
Alopecia Areata
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 19.4: Alopecia areata.
Figure 19.5: Alopecia areata.
Efigure 19.1: Alopecia areata.
Figure 19.6: Alopecia areata.
Figure 19.7: Alopecia areata, alopecia universalis.
Figure 19.8: Alopecia areata, regrowing hair.
Figure 19.9: Alopecia areata, ophiasis pattern.
Figure 19.10: Trichotillomania.
Management
Further Treatment Modalities
Diffuse Alopecia
Basics
Telogen Effluvium
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Laboratory Tests
Anagen Effluvium
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Senescent Alopecia
Basics
Clinical Manifestations
Figure 19.11: Telogen effluvium, acute.
Figure 19.12: Diffuse alopecia.
Management
Figure 19.13: Anagen effluvium.
Management
Prognosis
Scarring Alopecia
Basics
Pathogenesis
Clinical Manifestations
Chronic Cutaneous Lupus Erythematosus (See Also Chapter 34)
Basics
Clinical Manifestations
Diagnosis
Lichen Planopilaris
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Central Centrifugal Cicatricial Alopecia
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Traction Alopecia
Basics
Clinical Manifestations
Diagnosis
Cutaneous Sarcoidosis (See Chapter 34)
Basics
Clinical Manifestations
Diagnosis
Folliculitis Decalvans
Basics
Clinical Manifestations
Diagnosis
Figure 19.14: Chronic cutaneous lupus erythematosus.
Figure 19.15
Management
Figure 19.16: Lichen planopilaris (LPP).
Figure 19.17: Frontal fibrosing alopecia.
Management
Figure 19.18: Central centrifugal cicatricial alopecia.
Management
Figure 19.19: Traction alopecia.
Management
Management (see Chapter 34 for Other Treatment Modalities)
Figure 19.20: Folliculitis decalvans.
Management
Pseudofolliculitis Barbae and Acne Keloidalis Nuchae
Basics
Pseudofolliculitis Barbae (PFB)
Pathogenesis
Clinical Manifestations
Diagnosis
Acne Keloidalis Nuchae
Basics
Clinical Manifestations
Figure I19.2: Pseudofolliculitis barbae, or “razor bumps,” showing extrafollicular and transfollicular
penetration.
Figure 19.21: Pseudofolliculitis barbae.
Figure 19.22: Pseudofolliculitis barbae.
Management
Preventive Measures
Treatment
Figure 19.23: Pseudofolliculitis barbae.
Figure 19.24: Acne keloidalis nuchae.
Figure 19.25: Acne keloidalis nuchae.
Management
Chapter 20: Hirsutism
Overview
Hirsutism
Basics
Pathogenesis
Clinical Manifestations
Clinical Variants
Familial Hirsutism
Ovarian Hirsutism
Adrenal Hirsutism
Hyperprolactinemic Hirsutism
Drug-Induced Hirsutism
Idiopathic Hirsutism
Other Associated Disorders
Diagnosis
Figure 20.1: Familial hirsutism.
Figure 20.2: Hirsutism.
Figure 20.3: Hirsutism in late-onset congenital adrenal hyperplasia.
Figure 20.4: Drug-induced hypertrichosis.
Management
General Principles
Hair Removal
Depilation
Temporary Epilation
Permanent Epilation
Laser Epilation
Pharmacologic Treatment
Other Treatments
Chapter 21: Disorders of the Oral Cavity, Lips, and Tongue
Overview
Oral Cavity
Aphthous Stomatitis
Clinical Manifestations
Diagnosis
Oral Lichen Planus (See Also Chapter 15)
Clinical Manifestations
Diagnosis
Systemic Lupus Erythematosus (Discussed in Chapter 34)
Clinical Manifestations
Figure 21.1: Aphthous stomatitis.
Figure 21.2: Aphthous stomatitis.
Figure 21.3: Aphthous stomatitis.
Figure 21.4: Aphthous stomatitis in Behçet syndrome.
Management
Figure 21.5: Aphthous stomatitis.
Figure 21.6: Oral lichen planus, erosive.
Management
Management
Tongue
Mucous Patches of Secondary Syphilis
Clinical Manifestations
Geographic Tongue
Clinical Manifestations
Black Hairy Tongue
Clinical Manifestations
Pigmentation due to Drugs and Artifacts
Clinical Manifestations
Oral Leukoplakia
Clinical Manifestations
Oral Hairy Leukoplakia
Clinical Manifestations
Oral Candidiasis (“Thrush”)
Clinical Manifestations
Diagnosis
Figure 21.7: Mucous patches of secondary syphilis.
Figure 21.8: Geographic tongue.
Figure 21.9: Black hairy tongue.
Management
Figure 21.10: Antimalarial hyperpigmentation.
Figure 21.11: Pigment artifact.
Figure 21.12: Pigment artifact (amalgam tattoo).
Figure 21.13: Leukoplakia.
Figure 21.14: Oral hairy leukoplakia.
Figure 21.15: Oral candidiasis (thrush).
Management
Lips and Oral Cavity
Perlèche (Angular Cheilitis)
Clinical Manifestations
Actinic Keratosis (Solar Keratosis, Actinic Cheilitis) (See Chapter 31)
Clinical Manifestations
Squamous Cell Carcinoma
Erythema Multiforme Minor (See Chapter 27)
Clinical Manifestations
Erythema Multiforme Major (See Chapter 27)
Clinical Manifestations
Pyogenic Granuloma (See Chapter 30)
Venous Lake
Labial Melanotic Macule
Oral Mucous Cyst (Mucocele)
Clinical Manifestations
Oral Fibroma
Oral Warts (See Chapters 6, 17, and 28)
Odontogenic Sinus (Dental Sinus)
Figure 21.16: Perlèche (angular cheilitis) and atopic cheilitis.
Figure 21.17: Perlèche (angular cheilitis).
Management
Figure 21.18: Actinic keratosis.
Figure 21.19: Actinic cheilitis.
Figure 21.20: Squamous cell carcinoma.
Figure 21.21: Squamous cell carcinoma.
Efigure 21.1: Squamous cell carcinoma of the palate.
Figure 21.22: Erythema multiforme minor caused by herpes simplex virus.
Figure 21.23: Erythema multiforme major.
Figure 21.24: Pyogenic granuloma.
Figure 21.25: Venous lake.
Figure 21.26: Labial melanotic macule.
Figure 21.27: Mucocele.
Management
Figure 21.28: Oral fibroma.
Figure 21.29: Intraoral warts.
Figure 21.30: Intraoral wart.
Figure 21.31: Odontogenic sinus.
Management
Normal Variants
Fordyce Spots
Torus Palatinus
Normal Bite Line
Figure 21.32: Fordyce spots.
Figure 21.33: Torus palatinus.
Chapter 22: Diseases and Abnormalities of Nails
Overview
Common Nail Problems
Longitudinal Ridging (Onychorrhexis)
Basics
Brittle Nails (Onychoschizia)
Basics
Onycholysis
Basics
Pathogenesis
Green Nail Syndrome
Basics
Pathogenesis
Figure 22.1: Longitudinal ridging.
Management
Figure 22.2: Onychoschizia.
Management
Figure 22.3: Onycholysis.
Management
Figure 22.4: Green nail syndrome.
Management
Traumatic Nail Lesions
Basics
Subungual Hematoma
Median Nail Dystrophy
Diagnosis
Figure 22.5: Acute subungual hematoma.
Management
Figure 22.6: Median nail dystrophy.
Management
Inflammatory Nail Disorders
Basics
Psoriasis
Figure 22.7: Psoriasis.
Management (see Discussion in Chapter 14)
Eczematous Dermatitis with Secondary Nail Dystrophy
Figure 22.8: Eczematous dermatitis.
Management
Infections of the Nail and Surrounding Tissues
Basics
Acute Paronychia
Pathogenesis
Clinical Manifestations
Diagnosis
Chronic Paronychia
Pathogenesis
Clinical Manifestations
Diagnosis
Onychomycosis
Figure 22.9: Acute paronychia.
Management
Figure 22.10: Chronic paronychia.
Management
Miscellaneous Nail Disorders
Basics
Digital Mucous (Myxoid) Cyst
Leukonychia Striata
Yellow Nail Syndrome
Increased Transverse Nail Curvature (Pincer Nails)
Koilonychia
Trachyonychia
Melanonychia
Diagnosis
Junctional Nevus
Subungual Verruca
Sarcoidosis
Dermatomyositis
Terry Nails
Half-and-Half Nails
Dystrophy from Preformed Artificial Nails
Figure 22.11: Digital mucous (myxoid) cyst.
Figure 22.12: Digital mucous (myxoid) cyst over the distal interphalangeal joint.
Management
Figure 22.13: A, B: Digital mucous (myxoid) cyst.
Figure 22.14: Leukonychia striata.
Figure 22.15: Yellow nail syndrome.
Figure 22.16: Pincer nails.
Figure 22.17: Koilonychia.
Figure 22.18: Trachyonychia.
Figure 22.19: Melanonychia.
Management
Figure 22.20: Junctional nevus.
Figure 22.21: Melanoma.
Figure 22.22: Subungual warts.
Figure 22.23: Sarcoidosis.
Figure 22.24: Dermatomyositis.
Figure 22.25: Terry nails.
Figure 22.26: Half-and-half nails.
Figure 22.27: Nail dystrophy from artificial nails.
Chapter 23: Pigmentary Disorders
Overview
Melanogenesis
Disorders of Hypopigmentation
Vitiligo Vulgaris
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Postinflammatory Hypopigmentation
Basics
Clinical Manifestations
Idiopathic Guttate Hypomelanosis
Basics
Clinical Manifestations
Other Types of Hypomelanosis
Figure 23.1: Vitiligo.
Figure 23.2: Vitiligo with leukotrichia.
Figure 23.3: Vitiligo.
Figure 23.4: A, B: Vitiligo.
Figure 23.5: Chemical leukoderma.
Management
Topical Therapy
Phototherapy
Surgery
Cosmetic Cover-ups
Depigmentation
Figure 23.6: Vitiligo.
Figure 23.7: Pityriasis alba.
Figure 23.8: Postinflammatory hypopigmentation.
Management
Figure 23.9: Idiopathic guttate hypomelanosis.
Efigure 23.1: Idiopathic guttate hypomelanosis.
Disorders of Hyperpigmentation
Melasma
Basics
Clinical Manifestations
Postinflammatory Hyperpigmentation
Basics
Clinical Manifestations
Phytophotodermatitis and Berloque Dermatitis
Basics
Clinical Manifestations
Poikiloderma of Civatte
Basics
Clinical Manifestations
Confluent and Reticulated Papillomatosis (Gougerot–Carteaud Disease)
Basics
Clinical Manifestations
Diagnosis
Acanthosis Nigricans
Basics
Clinical Manifestations
Carotenemia
Basics
Clinical Manifestations
Figure 23.10: Melasma of cheeks.
Figure 23.11: Melasma.
Management
Figure 23.12: Postinflammatory hyperpigmentation.
Figure 23.13: Nummular eczema, postinflammatory hyperpigmentation.
Figure 23.14: A, B: Postinflammatory hyperpigmentation.
Management
Figure 23.15: Berloque dermatitis.
Figure 23.16: Poikiloderma of Civatte.
Management
Figure 23.17: Confluent and reticulated papillomatosis.
Efigure 23.2a: Confluent and reticulated papillomatosis (Gougerot-Carteaud disease).
Efigure 23.2b: Confluent and reticulated papillomatosis (Gougerot-Carteaud disease).
Figure 23.18: Confluent and reticulated papillomatosis.
Management
Figure 23.19: Acanthosis nigricans.
Figure 23.20: Acanthosis nigricans.
Management
Figure 23.21: Carotenemia.
Management
Chapter 24: Pruritus: The “Itchy” Patient
Overview
Pruritus of Unknown Origin
Basics
Clinical Manifestations
Diagnosis
Figure 24.1: Chronic pruritus.
Figure 24.2: Chronic pruritus.
Management
Neurotic Excoriations/Factitial Dermatitis
Basics
Clinical Manifestations
Diagnosis
Figure 24.3: Neurotic excoriations.
Figure 24.4: Factitial ulcerations.
Management
Delusions of Parasitosis
Basics
Clinical Manifestations
Diagnosis
Management
Clinical Variants of Pruritus
Aquagenic Pruritus
Notalgia Paresthetica
Brachioradial Pruritus
Pruritus from Systemic Disease
Figure 24.5: Notalgia paresthetica.
Management
For Renal Disease
For Liver Disease
For Hypothyroidism
For Hyperthyroidism
For Hodgkin Disease
Chapter 25: Xerosis: The “Dry” Patient
Overview
Xerosis
Basics
Pathogenesis
Clinical Variants
Asteatotic Eczema
Atopic Dermatitis
Figure 25.1: Asteatotic eczema.
Figure 25.2: Asteatotic eczema.
Figure 25.3: Atopic cheilitis.
Figure 25.4: Atopic dermatitis, hand eczema.
Figure 25.5: Atopic dermatitis, hand eczema.
Management
Moisturizers
Other Strategies
Chapter 26: Adverse Cutaneous Drug Eruptions
Overview
Drug Eruptions
Basics
Clinical Manifestations
Clinical Variants
Exanthematous Eruptions
Urticarial Eruptions
Photosensitive and Phototoxic Eruptions
Vasculitic Eruptions (See Discussion in Chapter 27)
Erythroderma (Exfoliative Dermatitis)
Stevens–Johnson Syndrome
Toxic Epidermal Necrolysis (TEN; See Discussion in Chapter 33)
Erythema Nodosum (See Discussion in Chapter 34)
Acneiform Eruptions (See Discussion in Chapter 12)
Fixed Drug Eruptions
Miscellaneous Drug Eruptions
Drug Reaction with Eosinophilia and Systemic Symptoms (Dress Syndrome)
Acute Generalized Exanthematous Pustulosis (AGEP)
Hemorrhagic Onycholysis due to Docetaxel
Hand–Foot Syndrome (Palmar–Plantar Erythrodysesthesia)
Cocaine/Levamisole-Induced Vasculitis
Diagnosis
Table 26.1: Commonly Implicated Drugs for Different Drug Reactions
Figure 26.1: Drug eruption.
Figure 26.2: Drug eruption.
Figure 26.3: Urticarial/figurate drug eruption.
Figure 26.4: Drug photosensitivity eruption.
Figure 26.5: Phototoxic drug eruption.
Figure 26.6: Stevens–Johnson syndrome.
Figure 26.7: Toxic epidermal necrolysis.
Figure 26.8: Acneiform eruption caused by oral corticosteroids.
Figure 26.9: Topical steroid-induced rosacea.
Figure 26.10: Atrophy secondary to a potent topical steroid.
Figure 26.11: Fixed drug eruption.
Figure 26.12: Fixed drug eruption.
Figure 26.13: Acute generalized exanthematous pustulosis (AGEP).
Figure 26.14: Hemorrhagic onycholysis due to docetaxel.
Figure 26.15: Cocaine/levamisole-induced vasculitis.
Figure 26.16: Cocaine/levamisole-induced vasculitis.
Management
Chapter 27: Diseases of Cutaneous Vasculature
Overview
Urticaria and Angioedema
Basics
Pathogenesis
Urticaria—Clinical Variants
Acute Urticaria
Chronic Urticaria
Dermatographism (“Skin Writing”)
Cold Urticaria
Light-Induced (Solar) Urticaria
Cholinergic Urticaria
Diagnosis
Figure 27.1: Urticaria.
Figure 27.2: Urticaria.
Figure 27.3: Acute urticaria.
Figure 27.4: Urticaria.
Figure 27.5: Dermatographism (“skin writing”).
Figure 27.6: A and B: Cold urticaria.
Figure 27.7: A and B: Solar urticaria induced by ultraviolet A light.
Figure 27.8: Cholinergic urticaria induced by exercise.
Management
Erythema Multiforme
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 27.9: Erythema multiforme.
Figure 27.10: Erythema multiforme minor.
Management
Purpura
Basics
Figure 27.11: Purpura.
Purpura—Clinical Variants
Nonpalpable Purpura
Benign Pigmented Purpuras
Schamberg Purpura
Majocchi Purpura (Purpura Annularis Telangiectodes of Majocchi)
Diagnosis
Palpable Purpura
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 27.12: Senile, or actinic, purpura.
Figure 27.13: Schamberg purpura.
Figure 27.14: Schamberg purpura.
Figure 27.15: Majocchi purpura (purpura annularis telangiectodes).
Efigure 27.1: Majocchi purpura (purpura annularis telangiectodes).
Management
Figure 27.16: Palpable purpura.
Figure 27.17: Vasculitis.
Figure 27.18: Atrophie blanche (livedoid vasculopathy).
Management
Chapter 28: Sexually Transmitted Diseases
Overview
Anogenital Warts
Basics
Risk Factors
Clinical Manifestations
Anogenital Warts and Cancer
Distribution of Lesions
Diagnosis
Acetowhite Test on Mucous Membranes
Biopsy
Figure 28.1: Condyloma acuminatum.
Figure 28.2: Condyloma acuminatum.
Figure 28.3: Condyloma acuminatum.
Figure 28.4: Condyloma acuminatum.
Figure 28.5: Condyloma acuminatum.
Figure 28.6: Cervical warts.
Figure 28.7: Vestibular papillae (vulvar papillomatosis).
Figure 28.8: Pearly penile papules.
Figure 28.9: Pearly penile papules.
Figure 28.10: Giant condyloma acuminatum.
Management
Counseling
Surgical Therapy
Topical Therapy
Patient-applied Therapy
Provider-applied Therapies
HPV Vaccination
Figure 28.11: Perianal warts in an infant.
Herpes Simplex Genitalis
Basics
Risk Factors
Description of Lesions
Distribution of Lesions
Primary Herpes Simplex
Recurrent Herpes Simplex
Complications
Diagnosis
Figure 28.12: Herpes simplex genitalis.
Figure 28.13: Herpes simplex genitalis.
Figure 28.14: Herpes simplex.
Management
Patient Education
Topical Therapy
Systemic Antiviral Therapy
Primary Herpes Simplex
Recurrent Herpes Simplex: Episodic Therapy
Recurrent Herpes Simplex (with more than Six Recurrences per Year) or Chronic Recurrent Erythema Multiforme
(Daily Suppressive Therapy)
Acyclovir-Resistant Herpes Simplex
Herpes Simplex in Pregnant Women
Syphilis
Basics
Primary Syphilis
Clinical Manifestations
Diagnosis
Secondary Syphilis
Clinical Manifestations
Diagnosis (See Discussion above for Primary Syphilis)
Latent Syphilis
Tertiary Syphilis
Congenital Syphilis
Figure 28.15: Chancre of primary syphilis.
Management
Non–Penicillin-Allergic Patients
Penicillin-Allergic Nonpregnant Patients
Penicillin-Allergic Pregnant Patients
HIV-Infected Patients
Figure 28.16: Secondary syphilis.
Figure 28.17: Secondary syphilis.
Figure 28.18: Secondary syphilis.
Figure 28.19: Secondary syphilis. Condyloma latum.
Figure 28.20: Secondary syphilis.
Management
Chancroid
Basics
Clinical Manifestations
Diagnosis
Figure 28.21: Chancroid.
Figure 28.22: Chancroid.
Management
Drug Therapy
Lymphogranuloma Venereum
Basics
Clinical Manifestations
Diagnosis
Figure 28.23: Lymphogranuloma venereum.
Management
Granuloma Inguinale (Donovanosis)
Basics
Clinical Manifestations
Diagnosis
Management
Chapter 29: Bites, Stings, and Infestations
Overview
Insect Bite and Sting Reactions
Fleas, Mosquitoes, Biting Flies, Bees
Basics
Clinical Manifestations
Description of Lesions
Distribution of Lesions
Diagnosis
Bed Bugs
Basics
Clinical Manifestations
Diagnosis
Prevention
Figure 29.1: Angioedema caused by a bee sting.
Figure 29.2: Flea bites.
Figure 29.3: Bullous arthropod bite reaction.
Management
Figure 29.4: Bed bug (Cimex lenticularis).
Arachnid Bite Reactions
Brown Recluse Spider Bites
Basics
Clinical Manifestations
Figure 29.5: Brown recluse spider.
Figure 29.6: Pyoderma gangrenosum.
Management
Tick Bites
Lyme Disease (Lyme Borreliosis)
Basics
Clinical Manifestations
Description of Lesions
Distribution of Lesions
Diagnosis
Laboratory Testing
Figure 29.7: Lyme disease, erythema migrans.
Figure 29.8: Lyme disease.
Figure 29.9: Lyme disease.
Figure 29.10: Lyme disease.
Management
Tick Recognition
Tick Removal
Treatment of Erythema Migrans (Early Lyme Borreliosis)
Prevention
Figure 29.11: Ixodes tick.
Figure 29.12: Dog tick.
Mite Infestations
Scabies
Basics
Pathogenesis
Clinical Manifestations
Description of Lesions
Distribution of Lesions
Diagnosis
Figure 29.13: Scabies.
Figure 29.14: Fecal pellets (scybala).
Figure 29.15: Scabies.
Figure 29.16: Scabies.
Figure 29.17: Scabies.
Figure 29.18: Scabies.
Figure 29.19: Norwegian scabies.
Figure 29.20: Scabies.
Management
Management of Institutional Scabies
Permethrin (Elimite and Acticin)
Precipitated Sulfur Ointment (5% to 10%)
Ivermectin
Lindane
Table 29.1: Ivermectin Dosage for Treatment of Scabies with 6-Mg Tablets
Lice Infestations (Pediculosis)
Basics
Head Lice (Pediculosis Capitis) (See Discussion in Chapter 9)
Body Lice (Pediculosis Corporis)
Pubic Lice
Clinical Manifestations
Description and Distribution of Lesions
Diagnosis
Figure 29.21: Head louse.
Figure 29.22: Head louse nits.
Figure 29.23: Pubic lice.
Management
Head Lice
Pubic Lice
Body Lice
Waterborne Stings and Seashore Infestations
Jellyfish Stings
Basics
Clinical Manifestations
Description of Lesions
Distribution of Lesions
Diagnosis
Seabather’s Eruption (“Sea Lice”)
Basics
Clinical Manifestations
Diagnosis
Cutaneous Larva Migrans (“Creeping Eruption”)
Basics
Clinical Manifestations
Diagnosis
Figure 29.24: Jellyfish sting.
Figure 29.25: Portuguese man-of-war sting.
Management
Figure 29.26: Seabather’s eruption.
Figure 29.27: Cutaneous larva migrans.
Management
Chapter 30: Benign Cutaneous Neoplasms
Overview
Melanocytic Nevi
Basics
Junctional Melanocytic Nevus
Compound Melanocytic Nevus
Dermal Melanocytic Nevus
Clinical Manifestations of Dermal and Compound Nevi
Diagnosis
Blue Nevus
Halo Nevus
Spitz Nevus
Congenital Melanocytic Nevus (See Chapter 1)
Atypical Melanocytic Nevus (Dysplastic Nevus, Clark Nevus)
Basics
Clinical Manifestations
Clinical Variants
Sporadic Atypical Nevi
Multiple Atypical Nevi
Familial Atypical Mole Syndrome
Figure 30.1: Junctional melanocytic nevi.
Figure 30.2: Junctional melanocytic nevus (congenital).
Figure 30.3: Compound melanocytic nevi.
Figure 30.4: Compound melanocytic nevi.
Figure 30.5: Dermal melanocytic nevus.
Figure 30.6: Blue nevus.
Figure 30.7: Halo nevus.
Management of Melanocytic Nevi
Indications for Removal
Methods of Removal
Figure 30.8: Multiple dysplastic nevi.
Figure 30.9: Atypical nevus (dysplastic nevus). Close-up of Figure 30.8.
Management
Prevention
Solar Lentigo and Lentigo Simplex
Basics
Solar Lentigo (Plural: Lentigines)
Lentigo Simplex
Figure 30.10: Solar lentigines.
Figure 30.11: Solar lentigines.
Seborrheic Keratosis
Basics
Clinical Manifestations
Distribution of Lesions
Clinical Variants
Stucco Keratoses
Dermatosis Papulosa Nigra
Sign of Leser–Trélat
Diagnosis
Figure 30.12: Seborrheic keratoses.
Figure 30.13: Seborrheic keratoses.
Figure 30.14: Seborrheic keratoses.
Figure 30.15: Seborrheic keratoses.
Figure 30.16: Seborrheic keratoses.
Figure 30.17: Stucco keratoses.
Figure 30.18: Dermatosis papulosa nigra.
Management
Treatment
Skin Tags
Basics
Clinical Manifestations
Distribution of Lesions
Diagnosis
Figure 30.19: Skin tags (acrochordons).
Figure 30.20: Skin tag (acrochordon).
Management
Figure 30.21: A and B: Pedunculated fibroepithelioma (skin tag).
Figure 30.22: Skin tags (acrochordons).
Sebaceous Hyperplasia
Basics
Clinical Manifestations
Diagnosis
Figure 30.23: Sebaceous hyperplasia.
Figure 30.24: Sebaceous hyperplasia.
Figure 30.25: Sebaceous hyperplasia.
Management
Cysts
Basics
Clinical Manifestations
Distribution of Lesions
Diagnosis
Clinical Variants
Milia (See also in Chapter 2)
Figure 30.26: Epidermoid cyst.
Figure 30.27: Pilar cyst.
Figure 30.28: Scrotal cysts.
Figure 30.29: Epidermoid cyst, inflamed.
Figure 30.30: A and B: Clinical diagnosis of an epidermoid cyst.
Figure 30.31: Milia.
Figure 30.32: Milia.
Management
Epidermoid and Pilar Cysts
Options
Milia
Lipoma
Basics
Clinical Manifestations
Diagnosis
Figure 30.33: Lipomas.
Figure 30.34: Angiolipomas.
Management
Chondrodermatitis Nodularis Helicis
Basics
Clinical Manifestations
Figure 30.35: Chondrodermatitis nodularis chronica helicis.
Figure 30.36: Chondrodermatitis nodularis chronica helicis.
Management
Figure 30.37: Chondrodermatitis nodularis chronica helicis.
Dermatofibroma
Basics
Clinical Manifestations
Diagnosis
Figure 30.38: Dermatofibroma.
Figure 30.39: A and B: Dermatofibroma.
Management
Fibrous Papule of the Nose
Basics
Clinical Manifestations
Diagnosis
Figure 30.40: Fibrous papules (angiofibromas, fibrous papules of the nose).
Management
Common Angiomas
Basics
Clinical Variants
Cherry Angiomas
Venous Lakes
Angiokeratoma (Fordyce Angiokeratoma)
Spider Angioma (Spider Telangiectasia)
Diagnosis
Figure 30.41: Multiple cherry angiomas.
Figure 30.42: Venous lake.
Figure 30.43: Venous lake.
Figure 30.44: Angiokeratomas.
Figure 30.45: Angiokeratomas.
Figure 30.46: Spider angioma.
Management
Pyogenic Granuloma
Basics
Clinical Manifestations
Diagnosis
Figure 30.47: Pyogenic granuloma.
Figure 30.48: Pyogenic granuloma.
Figure 30.49: Pyogenic granuloma.
Management
Hypertrophic Scars and Keloids
Basics
Pathogenesis
Clinical Manifestations
Diagnosis
Figure 30.50: Hypertrophic scars.
Figure 30.51: Keloid.
Figure 30.52: Keloid.
Figure 30.53: Keloid.
Management
Prevention
Treatment
Hypertrophic Scars
Keloids
Figure 30.54: Treatment of keloids with intralesional cortisone.
Figure 30.55: Keloid after intralesional cortisone injection.
Chapter 31: Premalignant and Malignant Cutaneous Neoplasms
Overview
Actinic Keratosis
Basics
Histopathology
Clinical Manifestations
Diagnosis
Figure 31.1: Actinic keratosis.
Figure 31.2: Actinic keratoses.
Figure 31.3: Actinic keratoses.
Figure 31.4: Actinic keratosis.
Figure 31.5: Actinic keratosis.
Figure 31.6: Actinic keratoses.
Figure 31.7: Actinic keratoses.
Figure 31.8: Actinic keratosis.
Figure 31.9: Actinic cheilitis.
Figure 31.10: Actinic keratoses, hypertrophic.
Figure 31.11: Actinic keratosis/cutaneous horn.
Management
Destructive Methods
Patient Applied
Other Treatments
Figure 31.12: Actinic keratoses.
Cutaneous Squamous Cell Carcinoma
Basics
Histopathology
Risk of Metastasis
Clinical Manifestations
Clinical Variants
Intraepithelial Squamous Cell Carcinoma
Squamous Cell Carcinoma of Mucous Membranes
Figure 31.13: Squamous cell carcinoma.
Figure 31.14: Squamous cell carcinoma.
Figure 31.15: Squamous cell carcinoma.
Figure 31.16: Bowen disease (squamous cell carcinoma in situ).
Figure 31.17: Bowen disease in an African-American woman.
Figure 31.18: Erythroplasia of Queyrat. SCC in situ.
Figure 31.19: Squamous cell carcinoma of the lip.
Management
Treatment
Immunotherapy
Surgery/Other Procedures
Prevention
Keratoacanthoma
Basics
Clinical Manifestations
Distribution of Lesions
Diagnosis
Figure 31.20: Keratoacanthoma.
Figure 31.21: Keratoacanthoma.
Management
Basal Cell Carcinoma
Basics
Histopathology
Risk Factors
Clinical Manifestations
Distribution of Lesions
Clinical Variants
Superficial Basal Cell Carcinoma
Morpheaform Basal Cell Carcinoma
Diagnosis
Figure 31.22: Basal cell carcinoma.
Figure 31.23: Basal cell carcinoma.
Figure 31.24: Basal cell carcinoma.
Figure 31.25: Basal cell carcinoma, pigmented.
Figure 31.26: Basal cell carcinoma, pigmented.
Figure 31.27: Superficial basal cell carcinoma.
Figure 31.28: Morpheaform basal cell carcinoma.
Management
Prevention
Treatment
Melanoma
Basics
Risk Factors
Histopathology
Clinical Manifestations
Warning Signs
Distribution of Lesions
Superficial Spreading Melanoma
Diagnosis
Clinical Variants
Lentigo Maligna and Lentigo Maligna Melanoma
Nodular Melanoma
Acral Lentiginous Melanoma
Prognosis of Melanoma
Figure 31.29: Superficial spreading melanoma.
Figure 31.30: Superficial spreading melanoma.
Figure 31.31: Superficial spreading melanoma/evolving.
Figure 31.32: Superficial spreading melanoma/evolving.
Figure 31.33: Superficial spreading melanoma.
Figure 31.34: Superficial spreading melanoma.
Figure 31.35: Lentigo maligna.
Figure 31.36: Lentigo maligna melanoma.
Figure 31.37: Nodular amelanotic melanoma.
Figure 31.38: Nodular melanoma.
Figure 31.39: Acral lentiginous melanoma.
Figure 31.40: Acral lentiginous melanoma.
Figure 31.41: Junctional nevus.
Figure 31.42: Acral lentiginous melanoma.
Management
Workup for Patients with Melanoma
Sentinel Lymph Node Biopsy
Surgical Treatment
Long-Term Management
Metastatic Melanoma
Figure 31.43: Metastatic melanoma.
Figure 31.44: Metastatic melanoma.
Table 31.1: Breslow Measurement
Table 31.2: Clark’s Levels
Figure 31.45: In situ melanoma/“ugly duckling” lesion.
Figure 31.46: In situ melanoma/“ugly duckling” lesion.
Paget Disease of the Breast
Basics
Paget Disease of the Breast
Pathophysiology
Clinical Manifestations
Diagnosis
Figure 31.47: Paget disease of the breast.
Figure 31.48: Atopic dermatitis on the nipples and areolae (bilateral).
Extramammary Paget Disease
Basics
Pathophysiology
Clinical Manifestations
Diagnosis
Figure 31.49: Extramammary Paget disease.
Management
Merkel Cell Carcinoma
Basics
Clinical Manifestations
Diagnosis
Figure 31.50: Merkel cell carcinoma.
Management
Part Three: Systemic Conditions and the Skin
Chapter 32: Cutaneous Manifestations of Pregnancy
Overview
Physiologic Changes during Pregnancy
Hyperpigmentation
Connective Tissue Changes
Vascular Phenomena
Hair Changes
Other Findings
Figure 32.1: Linea nigra and striae gravidarum.
Management
Figure 32.2: Keloids.
Management
Figure 32.3: Spider telangiectasias.
Figure 32.4: Palmar erythema.
Management
Management
Figure 32.5: Pyogenic granuloma.
Efigure 32.1: Pyogenic granuloma.
Figure 32.6: Erythema nodosum.
Management
Pregnancy Gingivitis
Pyogenic Granulomas
Erythema Nodosum
Erythema Multiforme
Dermatoses of Pregnancy
Basics
Pruritic Urticarial Papules and Plaques of Pregnancy
Clinical Manifestations
Diagnosis
Pruritus Gravidarum
Clinical Manifestations
Recurrent Cholestasis of Pregnancy
Clinical Manifestations
Pemphigoid Gestationis
Clinical Manifestations
Diagnosis
Figure 32.7: Pruritic urticarial papules and plaques of pregnancy.
Figure 32.8: Pruritic urticarial papules and plaques of pregnancy.
Efigure 32.2: Pruritic urticarial papules and plaques of pregnancy (PUPPP).
Management
Figure 32.9: Pemphigoid gestationis.
Chapter 33: Cutaneous Manifestations of HIV Infection
Overview
HIV-Associated Herpes Simplex
Basics
Clinical Manifestations
Distribution of Lesions
Diagnosis
Figure 33.1: Herpes simplex.
Figure 33.2: Herpes simplex.
Figure 33.3: Herpes simplex.
Management
Recalcitrant Herpes Simplex
Acyclovir Resistance
HIV-Associated Herpes Zoster
Basics (See Chapter 17)
Clinical Manifestations
Distribution of Lesions
Figure 33.4: Herpes zoster.
Figure 33.5: Disseminated herpes zoster.
Management
Recalcitrant Herpes Zoster
Acyclovir Resistance
HIV-Associated Molluscum Contagiosum
Basics (See Chapter 17)
Clinical Manifestations
Distribution of Lesions
Figure 33.6: Molluscum contagiosum.
Figure 33.7: Molluscum contagiosum.
Figure 33.8: Disseminated cryptococcosis.
Management
HIV-Associated (Epidemic) Kaposi Sarcoma
Basics
Clinical Manifestations
Distribution of Lesions
Figure 33.9: Epidemic Kaposi sarcoma.
Figure 33.10: Epidemic Kaposi sarcoma.
Management
Disseminated Cutaneous Kaposi Sarcoma
Lymphangitic Kaposi Sarcoma
Localized Cutaneous or Mucosal Kaposi Sarcoma
HIV-Associated Bacillary Angiomatosis
Basics
Clinical Manifestations
Diagnosis
Figure 33.11: Bacillary angiomatosis.
Management
HIV-Associated Condyloma Acuminatum
Basics
Clinical Manifestatations
Diagnosis
Figure 33.12: Condyloma acuminata.
Management
HIV-Associated Syphilis
Basics (See Also Chapter 28)
Clinical Manifestations
HIV-Associated Norwegian Scabies
Basics (Also See Chapter 29)
Clinical Manifestations
Diagnosis
Figure 33.13: Norwegian scabies in a patient with AIDS.
Figure 33.14: Norwegian scabies in a patient with AIDS.
Figure 33.15: Scabies.
Management
Scabicides
Keratolytic Agents
HIV-Associated Eosinophilic Folliculitis
Basics
Clinical Manifestations
Distribution of Lesions
Diagnosis
Figure 33.16: HIV-associated eosinophilic folliculitis.
Management
HIV-Associated Oral Hairy Leukoplakia
Basics
Clinical Manifestations
Distribution of Lesions
Figure 33.17: Oral hairy leukoplakia.
Management
HIV-Associated Oral Candidiasis and Aphthous Ulcers
HIV-Associated Oral Candidiasis
Basics
HIV-Associated Aphthous Ulcers
Basics
Figure 33.18: Oral candidiasis.
Management
Figure 33.19: Aphthous ulcer in a patient with AIDS.
Management
HIV-Associated Drug Eruptions and Pruritus
HIV-Associated Drug Eruptions
Basics
HIV-Associated Pruritus
Basics
Management
HIV-Assoc. Seborrheic Dermatitis and Psoriasis
HIV-Associated Seborrheic Dermatitis
Basics
HIV-Associated Psoriasis
Basics
HIV-Associated Lipoatrophy
Basics
Clinical Manifestations
Distribution of Lesions
Figure 33.20: Lipodystrophy.
Management
Chapter 34: Cutaneous Manifestations of Systemic Disease
Overview
Cutaneous Manifestations of Diabetes Mellitus
Basics
Diabetes Mellitus–Associated Lesions
Necrobiosis Lipoidica Diabeticorum
Basics
Clinical Manifestations
Diagnosis
Figure 34.1: Necrobiosis lipoidica diabeticorum.
Figure 34.2: Necrobiosis lipoidica diabeticorum.
Management
Diabetic Bullous Disease
Basics
Clinical Manifestations
Diagnosis
Figure 34.3: Diabetic bullous disease.
Management
Diabetic Neuropathic Ulcers
Basics
Clinical Manifestations
Diagnosis
Other Findings in Diabetic Patients
Diagnosis
Laboratory Evaluation
Figure 34.4: Diabetic ulcer of the heel (mal perforans).
Management
Figure 34.5: Acanthosis nigricans.
Figure 34.6: Diabetic dermopathy.
Cutaneous manifestations of Thyroid Disease
Basics
Clinical Manifestations
Diagnosis
Laboratory Evaluation
Figure 34.7: Pretibial myxedema, Graves disease.
Figure 34.8: Pretibial myxedema, Graves disease.
Figure 34.9: Exophthalmos.
Management
Figure 34.10: Elephantiasis nostras verrucosa.
Cutaneous Manifestations of Lipid Abnormalities
Xanthomas
Basics
Clinical Variants
Distribution of Lesions
Diagnosis
Laboratory Evaluation
Figure 34.11: Eruptive xanthomas.
Figure 34.12: Eruptive xanthomas.
Figure 34.13: Xanthelasma.
Figure 34.14: Tuberous xanthomas.
Management
Systemic Lupus Erythematosus
Basics
Clinical Manifestations
Systemic Signs of SLE
Diagnosis
Laboratory Evaluation
Figure 34.15: Systemic lupus erythematosus.
Figure 34.16: Systemic lupus erythematosus (discoid lupus erythematosus).
Figure 34.17: Systemic lupus erythematosus.
Figure 34.18: Systemic lupus erythematosus.
Figure 34.19: Systemic lupus erythematosus.
Figure 34.20: Systemic lupus erythematosus.
Drug-Induced Lupus Erythematosus
Basics
Management
Sun-related Symptoms
Severely Ill Patients
Subacute Cutaneous Lupus Erythematosus
Basics
Clinical Manifestations
Diagnosis
Figure 34.21: Subacute cutaneous lupus erythematosus.
Management
Chronic Cutaneous Lupus Erythematosus
Basics
Clinical Manifestations
Distribution of Lesions
Diagnosis
Figure 34.22: Chronic cutaneous lupus erythematosus.
Figure 34.23: Chronic cutaneous lupus erythematosus.
Figure 34.24: Chronic cutaneous lupus erythematosus in patient with SLE.
Management
Dermatomyositis
Basics
Clinical Manifestations
Diagnosis
Figure 34.25: Dermatomyositis.
Figure 34.26: Dermatomyositis.
Efigure 34.1: Dermatomyositis/Gottron papules.
Figure 34.27: Dermatomyositis or “shawl sign.”
Figure 34.28: Dermatomyositis or “shawl sign.”
Figure 34.29: Dermatomyositis.
Figure 34.30: Dermatomyositis or “ragged cuticles.”
Management
Skin
For Systemic Symptoms
Morphea (aka Localized Scleroderma)
Basics
Clinical Manifestations
Clinical Variants
Diagnosis
Figure 34.31: Morphea.
Figure 34.32: Linear morphea.
Management
Limited and Diffuse Systemic Sclerosis
Basics
Pathogenesis
Clinical Manifestations
Diffuse Systemic Sclerosis
Diagnosis
Figure 34.33: Raynaud phenomenon in patient with CREST syndrome.
Figure 34.34: Progressive systemic sclerosis with acrosclerosis and sclerodactyly.
Figure 34.35: Progressive systemic sclerosis or sclerodactyly.
Figure 34.36: Progressive systemic sclerosis.
Management
Erythema Nodosum
Basics
Clinical Manifestations
Diagnosis
Laboratory Evaluation
Figure 34.37: Erythema nodosum.
Figure 34.38: Erythema nodosum.
Management
Cutaneous Sarcoidosis
Basics
Clinical Manifestations
Distribution of Lesions
Diagnosis
Figure 34.39: Cutaneous sarcoidosis.
Figure 34.40: Cutaneous sarcoidosis.
Figure 34.41: Cutaneous sarcoidosis.
Management
Cutaneous Manifestations of Reactive Arthritis
Basics
Clinical Manifestations
Diagnosis
Laboratory Evaluation
Figure 34.42: Reactive arthritis/keratoderma blennorrhagicum.
Figure 34.43: Reactive arthritis/circinate balanitis.
Management
Mild Cases
Severe Cases
Pyoderma Gangrenosum
Basics
Clinical Manifestations
Diagnosis
Laboratory Evaluation
Figure 34.44: Pyoderma gangrenosum.
Figure 34.45: Pyoderma gangrenosum.
Management
Topical and Intralesional Therapy
Systemic Therapy
Other Therapies
Exfoliative Dermatitis
Basics
Clinical Manifestations
Diagnosis
Laboratory Evaluation
Figure 34.46: Exfoliative erythroderma (exfoliative dermatitis).
Figure 34.47: Exfoliative erythroderma.
Management
Exfoliative Dermatitis Secondary to Psoriasis
Prognosis
Part Four: Dermatologic Procedures
Chapter 35: Diagnostic and Therapeutic Techniques
Overview
Potassium Hydroxide Test and Fungal Culture*
Basics
Technique
Collection of Specimen
Preparation
Observation
Fungal Culture
Figure 35.1: Potassium hydroxide examination.
Figure 35.2: Potassium hydroxide examination.
Figure 35.3: Potassium hydroxide examination.
Figure 35.4: Potassium hydroxide examination.
Figure 35.5: Potassium hydroxide examination. Dermatophyte.
Figure 35.6: Potassium hydroxide examination (40×). Dermatophyte.
Figure 35.7: Potassium hydroxide examination. Candida.
Figure 35.8: Potassium hydroxide examination (40×). Candida.
Figure 35.9: Potassium hydroxide examination. Tinea versicolor.
Figure 35.10: Potassium hydroxide examination. Ectothrix.
Figure 35.11: Potassium hydroxide examination. Endothrix.
Figure 35.12: Fungal culture using the Dermatophyte Test Medium.
Skin Biopsy
Basics
Choosing Site to Biopsy
Local Anesthesia
Shave Biopsy and Shave Removal
Advantages
Disadvantages
Technique
Scissor (SNIP) Biopsy and Snip Excision
Advantages
Disadvantages
Technique
Punch Biopsy
Advantages
Disadvantages
Technique
Figure 35.13: A: Shave biopsy.
Figure 35.14: Snip excision.
Figure 35.15: Punch biopsy.
Simple Elliptical Excision
Basics
Advantages
Disadvantages
Technique
Undermining Technique
Wound Closure
Suture Material
Suturing
Figure 35.16: Excision.
Figure 35.17: Suturing.
Electrodesiccation and Curettage
Basics
Advantages
Disadvantages
Curettage
Technique
Electrodesiccation
Technique
Figure 35.18: Curettage.
Cryosurgery
Basics
Advantages
Disadvantages
Technique
Cotton Tip Applicator Technique
Cryospray Technique
Postoperative Course and Wound Care
Figure 35.19: Cryosurgery.
Figure 35.20: Cryosurgery.
Figure 35.21: Cryosurgery.
Figure 35.22: Cryosurgery.
Figure 35.23: Cryosurgery.
Figure 35.24: Cryosurgery.
Mohs Micrographic Surgery
Basics
Advantages
Disadvantages
Indications
Technique
Wound Care and Healing
Dressings and Wound Management
Figure 35.25: Mohs micrographic surgery.
Other Procedures
Comedo Extraction
Simple Punch Biopsy Method to Remove Cysts
Technique
Figure 35.26: Comedo extraction.
Figure 35.27: Punch biopsy removal of a cyst.
Appendix
Remarks