Manual of Dermatology in General Practice Md Rokon Uddin
INDEX
Page numbers followed by f refer to figure and t refer to table.
A
Abscess 97, 98f
Acanthosis nigricans 68f, 70, 70f
Acne 98f
common 189
complications of 191f
cystic 98f, 189, 191f
inflammatory 189
keloidalis 193, 194f
mild 189
moderate-to-severe 192
nodulocystic 3f
noninflammatory 189
rosacea 192, 193f
sterile 5f
vulgaris 189
Acquired ichthyoses 81
Acquired immunodeficiency syndrome 81, 104
Acral ischemia 131
Acrochordons 69f
Acrodermatitis enteropathica 76, 91
Addison's disease 70, 75, 75f
Adenosine triphosphate 61
Adenovirus 54
Adverse cutaneous drug eruption 71
Alanine aminotransferase 189
Aldose 184
Allergens, common 41
Allergic contact dermatitis 35, 40, 45
Allopurinol 54
Alström syndrome 68
Amyloidosis 77
Ancylostoma braziliense 134
Angioedema 51, 52f, 170
Angiofibroma 88f
Angioid streaks 88
Angiotensin-converting enzyme inhibitors 24
Angular cheilitis 154
Anorectum 108
Antibiotics 194
Antibody serum 184
Antihistamine 34
Anti-inflammatory agents, topical 34
Antimalarials 24
Antinuclear antibody 166, 172, 175
Antiphospholipid antibody syndrome, cutaneous signs of 170
Antipruritic antidepressants 12
Anti-ribosomal ribonucleoprotein 172
Anti-tumor necrosis factor-alpha 184
Aphthous ulcer 91
Apocrine gland 189
bearing skin, chronic suppurative disorder of 194
Aquagenic pruritus 53
Areola, scaling of 38f
Arsenic poisoning, chronic 61, 62
Arsenicosis, chronic 1f, 61
Arthritis 19, 175
Ashy dermatosis 27
Aspartate aminotransferase 189
Aspirin 52
Asteatotic dermatitis 35
Atherosclerosis 175
Atopic dermatitis 30
triggering factors of 33
triggers of 30
Atrophic blanche 170
Atrophic scar 7f
Atrophy 6, 123f, 191f
Atropic candidiasis 154
Auricular nerve, thick greater 114f
Autoimmune connective tissue disease 79
Azathioprine 166
B
Bacillus Calmette–Guérin 130
Bacterial infection 93, 93f
secondary 31f
Balanitis 156
Balanoposthitis 156
Barbiturate 54
Bardet–Biedl syndrome 68
Bartholin gland abscess 109
Basal cell carcinoma 63f, 89
Basic skin care 34
Becker's nevus 2f
Behçet's disease 186
Belimumab 172
Beta-blocker 24, 175
Biliary cirrhosis, primary 92
Biopsy 169, 179, 184
Blanching erythema 8f
Bleomycin 175
Body mass index 68
Body, parts of 32f
Borrelia burgdorferi 130
Bowen's disease 63f
Bowenoid papulosis 130
Brain, computed tomography of 106f
Breast eczema 38
Brugia
malayi 135
timori 135
Bulla 4, 42f, 43f, 59f, 67f
spread phenomenon 165
Bullous disease 160
chronic 93
Bullous impetigo 95f
Bullous pemphigoid 4f, 166, 167f
Burns 4f, 7f, 8f
Butenafine 143
Butterfly rash 170
Butylphenol 81
C
Café-au-lait macules and patches 86f
Calcineurin inhibitor, topical 172
Calcinosis cutis 79
Calciphylaxis 71, 71f
Candida
albicans 85, 99, 154
leukoplakia 154
Candidiasis 72f, 154, 155f
Cantharidin 129
Carbon dioxide 129
fractional 192
Carbuncles 71f, 97
Carpal tunnel syndrome 175
Cellulitis 72f, 98f, 100, 101f
Central dusky purpura 54
Central nervous system 86, 179
Cerebellar ataxia 121
Cetirizine 52, 53
Chancre 141f
Chancroid 106, 107f
Chemotherapy 59
Chickenpox 119
Chikungunya 131, 132f
Chlamydia 54
Chlamydophila 54
Chloroquine 172
Cholesterol levels 189
Ciclopirox 35, 143
Ciprofloxacin 59, 60f
Cirrhosis 91
Clotrimazole 143
Cocaine 46f, 52
Common cold 123
Complete blood count 51
Condyloma accuminata 130
Condylomata lata 141f
Congenital white spots 86
Conjunctivitis 19, 117
Connective tissue disease 175
mixed 81
Contact irritation 123
Coronal sulcus 24f
Coronavirus disease 2019 131, 133f
Corynebacterium minutissimum 102
Coryza 117
Cough 117
Coxsackievirus 130
Creamy-yellow pustule 16f
Creatine phosphokinase 184
Crohn's disease 91
Crust 5, 37f
Cryosurgery 129
Cryotherapy 129
Cushing disease 68, 70
Cushing syndrome 68, 73
Cutaneous amyloidosis 77
Cutaneous blood vessels 10f
Cutaneous candidiasis 154
Cutaneous hemorrhage 92
Cutaneous hepatology 91
Cutaneous larva migrans 134, 135f
Cutaneous leishmaniasis 134, 134f
Cutaneous lesions 68
Cutaneous lupus erythematosus 170
Cutaneous necrosis 170
Cutaneous tuberculosis 110
Cyclophosphamide 166
Cyclosporine 166
Cytomegalovirus 54, 130
D
Dapsone 166, 167, 172
Darier disease 83
Deep fungal infections 142
Degos-like lesion 170
Dehydroepiandrosterone sulfate 189
Dengue 9f, 131
Dennie–Morgan sign 33, 33f
Deoxyribonucleic acid 89
Dermatitis 30, 35f, 39f
acute 41f
chronic 41f
herpetiformis 91, 167, 168f
unspecified 45
Dermatomal vesiculobullous eruption 122f
Dermatomyositis 81, 175, 182, 183f
cutaneous of 183f
systemic manifestations of 183f
Dermatophytes 54, 72f, 142
infection 143f
Dermatophytosis 142
Dermatoses, pregnancy-induced 65
Dermopathy 74
Diabetes mellitus 35, 70, 92, 100
type 2 70
Diabetic bullae 73, 73f
Diabetic dermopathy 70
Diabetic foot 73
Diabetic neuropathy 73
Diaper dermatitis 154, 155f
Diarrhea 75
Diffuse goiter 74
Diffuse hyperkeratosis 83f
Diffuse macules 29f
Diffuse palmoplantar keratoderma 83
Diffuse waxy hyperkeratosis 21f
Digital gangrene 170
Dilated abdominal veins 91
Diphtheria 130
Dirty brown scales 81f
Diskoid lupus 175
erythematosus 170, 172f
Disseminated gonococcal infection 109f
Dixyrazine 81
Doxycycline 59, 192
Dry face 30f
Dysesthesia 11, 12
Dyshidrotic eczema 38
Dyspigmentation 59
Dystrophic epidermolysis bullosa 160, 161, 162f
E
Ecchymosis 7, 9, 9f
Eccrine glands 189
Econazole 143
Ecthyma 96
gangrenosum 103, 104f
Ectopic pregnancy 109
Eczema 30
chronic 15f
nipple 38
nummular 35
sign of chronic 36f
Edema 41f, 42f, 95f
Edematous erythematous plaques 119f
Edematous pale ring 54
Ehlers–Danlos syndrome 79
Electrocardiogram 184
Emollients 80
Encephalitis 121
Encephalomyelitis 117
Endocrine
disease 65
disorders 70
Engorged leg veins 36f
Environmental dermatoses 61
Eosinophilic fasciitis 81
Epidermodysplasia verruciformis 130
Epidermolysis bullosa 160, 161f
acquisita 91
simplex 160, 160f
subtypes 160
Epididymorchitis 109
Epstein–Barr virus 130
Ergotamine 175
Erosion 5, 6f, 37f, 79f
Erysipelas 99, 100f
Erythema 34f, 36f, 41f, 42f, 47f, 170
acute phase 40f
dyschromicum perstans 27
infectiosum 119
multiforme 54
major 55
minor 54
nodosum 91, 186f
syndrome 185
Erythematotelangiectatic rosacea 193
Erythematous candidiasis 154
Erythematous confluent macules-papules 118f
Erythematous nodules 186
Erythematous papule 65, 66f, 67f, 135f
Erythematous papule-plaque 15f, 66f, 185f
bilateral symmetrical 14f
Erythematous plaque 14f, 17f
Erythrasma 72f, 100, 102f
Erythroderma 6f
Etanercept 166
Excoriation 6, 6f
Extensor forearm 14f, 15f
F
Face 176
dystrophic calcification on 79f
Facial pilosebaceous units 192
Factitious dermatitis 44
Fever 117, 123, 172
Filaggrin deficiency 80
Filariasis 135, 136f
Fingernail clubbing 91
Fissures 6, 6f, 83f, 91
Fistula 91
Fixed drug eruption 28, 54, 59
Flaccid bulla 58f
Flavivirus 131
Fluconazole 59, 59f, 143, 150
Fluorescent treponemal antibody absorption 142
Follicular candidiasis 154
Follicular papules, orange-red 21f
Folliculitis 96, 96f
Foot, dorsum of 15f
Fractional erbium 192
laser 192
therapy 25f
Freckles 1f
Fungal infections 93, 142
superficial 142
Fungi causing infections 142
Furuncles 71f, 97, 97f
G
Gastrointestinal tract 176
abnormalities 91
hemorrhage 88, 91
Genital candidiasis 156, 157f
Genitalia 108
Genodermatosis 80
German measles 118
Gianotti–Crosti syndrome 92, 130, 130f
Gigantism 70
Glistening plaque 15f
Glomerulonephritis, acute 93
Gonococcal arthritis 108
Gonorrhea 108, 108f
uncomplicated 109
Gottron's papules 184f
Gout 77
Graft-versus-host disease 81
Gram-positive cocci 93
Granuloma inguinale 106, 109, 110
Graves’ disease 74
Guttate psoriasis 14f
Gynecomastia 68f, 117f
H
Haemophilus ducreyi 106
Haemophilus influenzae type B 130
Hailey–Hailey disease 84, 85f
Hair 92, 76
dye 39f
follicle, infection of 96f
fungal infections of 142
Hand dermatitis
acute 38
recurrent 38
Hand eczema 45f
Hand, foot, and mouth disease 119, 120f
Hansen's disease 110
Hard palate 24f
Head lice 140, 140f
Heliotrope erythema 184f
Hematologic disorders 175
Hemochromatosis 92
Hemorrhagic fever 9f
Henna, chemical component of 41f
Hepatic disease 11
Hepatitis
virus 54
A 130
B 92, 130
C 92, 130
Hereditary angioedema 53
Hereditary hemorrhagic telangiectasis 91
Herpes simplex 4f
virus 54, 123
Herpes zoster 5f, 121, 122f
complications of 122
Heterozygous filaggrin 80
Hidradenitis suppurativa 194, 195f
Histoplasma capsulatum 54
Hodgkin's disease 81
Human immunodeficiency virus 54, 104, 130
infection 80
Human papillomavirus 126
type with disease, correlation 126t
Hydroxychloroquine 172
Hyperandrogenic states 70
Hypercorticism 73
Hyperhidrosis 145
Hyperkeratosis 62f
Hyperkeratotic papules-plaque 23f
Hyperlipidemia
primary 76
secondary 76
Hyperpigmentation 92
Hyperplastic candidiasis 154
Hypertension 88
Hyperthyroidism 74
Hypertrophic lesion 26f
Hypertrophic lichen planus 3f, 24f
lesions 27f
Hypertrophic scar 123f
Hypertrophy 6, 7f, 191f
Hypogonadal syndrome 70
Hypopigmented face 30f
Hypopigmented macules 33f
Hypopigmented patches 18f
Hypopigmented plaque 47f
Hypothyroidism 70, 74, 80
I
Ichthyoses 80
vulgaris 80
Immunoglobulin 184
Immunotherapy, topical 129
Impetigo 93
Index finger, right 54f
Infections 71
primary 123
reactivation 123
Infertility 109
Inflammatory acneiform, chronic 192
Inflammatory bowel disease 91
Inflammatory cutaneous disease, severe 172
Infliximab 166
Influenza 130
Insulin 71
resistance 68, 70
Intertrigo 69f, 102, 103f, 154
Intralesional corticosteroid 172
Intralesional immunotherapy 129
Intravenous immunoglobulin 38, 172
high dose of 166
Irritant contact dermatitis 35, 38, 45
Itraconazole 143, 150
J
Jaundice 92
Joint 18f
Junctional epidermolysis bullosa 160, 161f
K
Keloid 6, 7f, 8f, 191f
Keratoderma 83
blennorrhagicum 19f
Keratolytic agents 80
Keratosis pilaris 2f, 30
Keratotic follicular papule 30, 33f
Keratotic papules 84f
Ketoconazole 143
Klebsiella granulomatis 109
Koebner phenomenon 28f
Koenen tumors 87
Koplik spot 117
Kytococcus sedentarius 102
L
Lamellar ichthyoses 81
Langer's lines 20f
Laryngitis 117
Left palm 21f, 55f
Leg ulcer 69f
Leishmania
aethiopica 134
major 134
tropica 134
Leishmaniasis 134
Lepra reactions 117
Lepromatous leprosy 113, 116f
Leprosy 80
Lesions
primary 1
secondary 5
Levocetirizine 52
Lichen nitidus 27
Lichen planus 2f, 22, 24, 25f
pigmentosus 28
Lichen sclerosus 179
et atrophicus 179, 181f
Lichen simplex chronicus 47
Lichen striatus 26
Lichenification 31f, 32f, 47f
chronic phase 40f
Lichenoid
amyloidosis 78f
dermatoses 22
drug eruption 24, 27f
Linear flat topped papules 27f
Lip licking dermatitis 45f
Lipodermatosclerosis 69f
Livedo reticularis 92, 131, 170, 175
Livedoid vasculopathy 170
Liver
cirrhosis of 92
disease 91
Lower extremity 48f
Lower legs, anterior 70f
Lues 141
Lupus erythematosus 170
drug-induced 170
Lupus profunda 170
Lupus tumidus 170
Lupus vulgaris 110, 112f
Lymphoma 80
M
Macular amyloidosis 78f
Macular erythema 54
Maculopapular rash 131f, 141f
Maduromycosis 142, 158f
Malar rash 170, 175
Malassezia furfur 156
Malnutrition 80
Measles 117
infection 117
Medical prescription 162
Mehndi 41f
Meningococcal infection 9f
Meningococcemia 105, 105f
Mental retardation 86
Metabolic disease 65
Metastatic nodule 92
Methotrexate 19, 60f, 166, 167, 172
Miconazole 143
Microhemagglutination assay 142
Milia 79f
Mimic tinea cruris 15f
Minocycline 59, 192
Molluscum contagiosum 2f, 130
Moon face 74f
Morbilliform eruption 131
Morphea 179, 180f
Morphine 52
Mucocutaneous candidiasis, chronic 85, 85f
Mucosa, viral diseases of 117
Mucosal erosion 55f, 58f, 60f, 77f
Mucosal lesions 91
Mucous membrane 22f, 23f, 76, 179
fungal infections of 142
scarring of 23f
Multiple papulonodular lesions 48f
Multiple sterile pustules 67f
Multiple subungual splinter hemorrhage 170
Multisystem autoimmune disease 172
Myalgias 117
Mycetoma 156
Mycobacterial diseases 110
Mycobacterium tuberculosis 54, 110
Mycophenolate mofetil 166, 172
Mycoplasma 186
pneumonia 54, 130
Myxedema 74
N
Nafoxidine 81
Naftifine 143
Nail 18f, 76, 91
fold
repeat injury of 99f
telangiectasias 170
fungal infections of 142
plate, thickening of 16f
Nalfurafine 12
Naltrexone 12
Naproxen 59f
Necrobiosis lipoidica 71, 71f
Necrotizing fasciitis 100, 101f
Neisseria gonorrhoeae 108
Neoplasm, malignant 11
Neurofibromatosis 85, 87f
nodule in 4f
Neurologic disorder 175
Neurotic excoriation 47, 49f
Neutrophilic dermatosis 185
Nicotinic acid 81
Nikolsky sign 165
Nodule 3
scabies 3f
Noduloulcerative lesions 134
Nonbullous impetigo 95f
Non-Hodgkin's lymphoma 81, 82f
Nonpalpable purpura 8f
Nonsedative antihistamine, long acting 52
Nonsteroidal anti-inflammatory drug 52, 186
Nutritional disease 65
O
Obesity 68
Obstructive arterial disease 175
Occupational dermatoses 61
Onycholysis 16f
Onychophagia 44f
Ophthalmia neonatorum 109f
Ophthalmology 74
Opioid antagonists 12
Oral cimetidine 130
Oral hypoglycemic agents 71
Oral isotretinoin 192, 194
Oral retinoids 130
Oral ulcer 175
Orchitis 109
Oropharyngeal candidiasis 154, 156f
Otitis media 117
Oxiconazole 143
P
Palm 55f, 62f
Palmar erythema 91, 170
Palmoplantar keratodermas 83
Palpable purpura 131
Pancreatic disease 92
Panniculitis 92
Papular acrodermatitis 130
Papules 2, 67f
small 37f
Papulopustular rosacea 193
Parainfluenza virus 130
Parasitosis, delusions of 44, 49, 50f
Paronychia 71f
acute 99f
chronic 99f
Parvovirus 130
B19 54
Patches 33f
Pediculosis capitis 140
Pellagra 76
Pelvic inflammatory disease 109
Pemphigoid gestationis 65
Pemphigus 162
erythematosus 166, 166f
foliaceus 162, 165, 165f, 166
vulgaris 5f, 162, 165f, 166
Penicillin 54
allergy 109
Perforating disorders 73, 73f
Perianal dermatitis 102, 102f
Periareolar skin 38f
Perifollicular abscess, multiple groups of 97f
Periorificial dermatitis 195, 196f
Periorificial tuberculosis 110, 113f
Peripheral vascular disease 73f
Periungual fibromas 88f
Persistent livedo reticularis 170
Petechiae 7, 8f, 9f
Petechial hemorrhage 8f, 131
Pethidine 46f
Pharynx 108
Phenylbutazone 54
Phenytoin 54
Photophobia 117
Phymatous rosacea 193
Pitted keratolysis 104f
Pitted keratosis 102
Pitting 16f
Pityriasis
alba 18f, 30f, 31
rosea 20
rubra pilaris 20, 21f
versicolor 156, 158f
Plantar hyperkeratosis 68f
Plantar psoriasis 17f
Planter lesions 19f
Plaque 3, 67f
amyloidosis 78f
around neck 77f
psoriasis, chronic 15f
Plasmapheresis 166
Platelet-rich plasma 28
Plate-like scales, large 82f
Plewig and Kligman classification 193
Plexiform neurofibroma 87f
Pneumonia 117
Pneumonitis 121
Podophyllotoxin 129
Poikiloderma 184
Poliovirus 130
Polyarteritis nodosa 170
Polycystic ovarian syndrome 68, 189
Polymorphic eruption 65
Polymorphonuclear leukocytes 108
Porphyria 53, 78
cutanea tarda 78
Portal hypertension 91
Postherpetic neuralgia 122
Postinflammatory hyperpigmentation 28, 192
Post-kala-azar dermal leishmaniasis 134, 135f
Poxvirus 130
Prader–Willi syndrome 68
Prednisone 194
Pregnancy, cholestasis of 66, 67f
Pretibial myxedema 74
Prostatic abscess 109
Prostatitis 109
Protozoal infections 134
Prurigo 66
Prurigo nodularis 47
Pruritic evanescent plaque 5f
plaques 65
Pruritus 11, 92
ani 45
causes of 11
primary generalized 12
scroti 45
treatment of 11
vulvae 45
Pseudomembranous candidiasis 154
Pseudomonas 103
aeruginosa 103
Pseudo-orange appearance 91
Pseudovesiculation 185
Pseudoxanthoma elasticum 79, 87, 88f, 91
Psoriasis 3f, 5f, 13, 13f, 16f
common sites of 13
Psoriatic arthropathy 13
changes 18f
Psoriatic nail change 16f
Psoriatic plaque 14f, 16f, 17f
Psychiatric illness, skin signs of 44
Psychogenic excoriations 44, 47
Psychoneurodermatitis 44
Punctate erosion 6f
Punctate hyperkeratosis 63f
Purpura 7, 9f
Purpuric hemorrhage 131f
Pustular psoriasis 65
Pustular vasculitis 91
Pyoderma gangrenosum 91, 186, 187f
Pyogenic paronychia 97
Q
Quinacrine 172
Quinidine 24
R
Radiation therapy 43f
Radiodermatitis 42
Rain-drop
hypopigmentation 1f
melanosis 62f64f
Raynaud phenomenon 170, 175, 176f
Reactive arthritis 19
Red purple papule 8f
Reiter's disease 19
Removing hair, diode laser for 194
Renal itch 12
Retinal hemorrhage 88
Retinoids, topical 172
Rheumatologic dermatology 170
Right periareolar region 17f
Rituximab 166, 167
Rotavirus 130
Rubella 118
Rubeola 117
S
Salicylates 186
Salicylic acid 129
Salmonella 54
Sarcoidosis 80, 81
Sarcoptes scabiei hominis 136
Scabies 136, 140f
Scaly face 30f
Scar 192
on face 79f
Scleredema diabeticorum 73
Scleroderma 176
Sclerodermoid disorders 176
SCORTEN scale 58, 58t
Screen test 75
Scrofuloderma 110, 113f
Sebaceous glands 189
Seborrheic dermatitis 34
Seizures 86
Senile purpura 9f
Serological tests 142
Serositis 175
Shagreen patch 87
Silvery white scale 14f
Skin 18f, 46f, 91, 176
atrophy 74f
biopsy 13
disease 12
erosion 58f, 60f
fragile 79f
fungal infections of 142
genetic diseases of 80
lesions 121, 133f, 172, 184
normal 21f
viral diseases of 117
Slapped cheek disease 119
Slit-skin smear 117
Small vessel vasculitis 170
Solar urticaria 53
Spider angiomas 91
Sporotrichosis 142
Squamous cell carcinoma 27f, 64f, 84f, 89, 147f, 182
cutaneous 161
Staphylococcal infections 93
Staphylococcal scalded skin syndrome 106, 107f
Staphylococcal ulcer 98f
Staphylococcus
abscess 98f
aureus 93
infections 95f
Stasis dermatitis 35, 69f
Stasis ulcer 37f
Steatocystoma multiplex 3f
calcification in 79f
Sterile abscess 98f
Stevens–Johnson syndrome 54, 56
Streptococcal infections 93, 95f
Streptococcus 130
aureus 99
pyogenes 93, 99
Stress 123
Striae 74f
distensae 66f, 69f
gravidarum 68f
pregnancy-induced 67
Subacute cutaneous lupus erythematosus 170
Submammary region 17f
Sulconazole 143
Sulfonamide 54, 59
Sweet's syndrome 91, 185, 185f
Syphilis 141
secondary 141f
Systemic agents 19
Systemic antifungal drugs 143
Systemic corticosteroid 186
Systemic disease, skin signs of 91
Systemic fungal infections 142
Systemic lupus erythematosus 81, 170, 172, 175f
Systemic sclerosis 176, 178f
T
Telangiectasis 9
Terbinafine 143, 150
Tetanus 130
Tetracycline 59, 60f
Thalidomide 12, 172
Thiazide diuretics 24
Thick nail plate 16f
Thick plaque 15f
Thrombocytopenic purpura 117
Thromboembolism 175
Thrombophlebitis, migratory 92
Thyroid stimulating hormone 52
Tinea
barbae 150, 153f
capitis 150, 153f
corporis 142, 145f
cruris 147, 150f
facialis 150, 151f
manuum 147, 148f
pedis 145, 146f
Togavirus 131
Tolnaftate 143
Topical agents 19
Topical antibiotics 189
Topical imiquimod 172
Topical steroid 7f
Toxic epidermal necrolysis 54, 56, 57f, 58
Trauma 123
Treponema pallidum 141
Trichloroacetic acid 28, 192
Trichotillomania 44, 49, 50f
Tricyclic antidepressants 53
Triglyceride 189
Triparanol 81
Tubal scarring 109
Tuberculoid leprosy 113, 114f
Tuberculosis verrucosa cutis 110, 111f
Tuberculous abscess 98f
Tuberous sclerosis 86
Twenty-nail dystrophy 25f
Typical infraorbital fold 33, 33f
U
Ulcer 6, 6f
anesthetic 72f
formation, self-induced 46f
infection 72f
self-induced 50f
Ulcerative lesion 24f
Ulcerative pyoderma 96f
Ultraviolet
B-rays 12
radiation 123
therapy 12
Umbilicated papule 2f
Ungual fibromas 87
Upper respiratory tract infections 51
Urethritis 19
Urinary tract infection 51
Urticaria 51, 91, 92
acute 51, 131
Urticarial plaque 170
Urticarial vasculitis 53, 170
V
Vaccines 130
Vaginal discharge 109f
Varicella 4f, 54, 119, 120f
zoster virus 119
Vascular hyperpigmentation 60f
Vascular lesions 91
Vasculitis 91, 92, 170, 175
common presentations of 9
Venereal disease research laboratory 142
Venous hypertension, chronic 35
Vesicle 4, 37f, 42f, 43f, 58f, 59f, 67f
bulla
on tongue 55f
type of 59f
on lips 55f
Vesicobullae 79f
Viannia subgenus 134
Violaceous erythema 184f
Violaceous flat topped papule-plaque 26f
Violaceous papules 26f
plaques 22f
Violaceous scarring 24f
Viral 54
hepatitis 92
infection 93
warts 2f
Vitiligo 2f, 91
Vomiting 75
Vulvitis 156
Vulvovaginitis 156
W
Wart 128f
common 126
flat 126, 129f
oral 130
palmar 126, 129f
recalcitrant 129
treatment of 129
Waxy hyperkeratosis 21f
Wickham's striae 26f
Wilson–Turner syndrome 68
Wound infection 72f
Wuchereria bancrofti 135
X
Xanthelasma 76f
Xanthema 75, 92
Xeroderma pigmentosum 89, 90f
Xerosis 30, 32f, 35f
Xerotic eczema 35
X-linked ichthyoses 81
X-linked recessive disorder 81
Y
Yellowish papules coalescence 91
Z
Ziehl–Neelsen staining 117
Zinc deficiency 76
×
Chapter Notes

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Basic Principles and Cutaneous Signs and SymptomsCHAPTER 1

 
APPROACH TO DERMATOLOGICAL DIAGNOSIS
  • History taking: Onset and course
    • Exacerbating or relieving factors.
    • History of skin disease, atopy, autoimmune disease, diabetes mellitus or any immunosuppressive conditions.
    • Occupational, social history.
    • Psychological history.
    • Allergy history.
    • Drug history: Both topical and systemic drug including over-the- counter preparation.
  • Closer inspection: Use magnifying lens or dermatoscope.
  • Examination of skin, hair, nail and mucous membrane
    • Type of lesion.
    • Distribution pattern.
    • Morphology pattern.
  • General examination: Includes lymph node examination
    • Skin findings for systemic disease.
 
CUTANEOUS SIGNS
 
Primary Lesions
Initial lesions those are not altered by natural evolution, infection, trauma or manipulations.
Macules: They are ≤1 cm sized flat skin lesions with color change (Figs. 1 and 2).
Patches: Flat skin lesions with color change greater than 1 cm (Figs. 3 and 4).
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FIG. 1: Freckles.
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FIG. 2: Rain drop hypopigmentation in chronic arsenicosis.
2
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FIG. 3: Becker's nevus.
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FIG. 4: Vitiligo.
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FIG. 5: Keratosis pilaris.
Papules: They are circumscribed, discrete, solid, epidermal elevation varying in size from a pinhead to 1 cm (0.5 mm–1 cm) (Figs. 5 to 8).
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FIG. 6: Flat top-lichen planus.
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FIG. 7: Verrucous-viral warts.
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FIG. 8: Umbilicated papule–molluscum contagiosum.
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Plaques: They are circumscribed, elevated solid lesion due to increased thickness of epidermis and/or cells or deposits within the dermis >1 cm in diameter. May be distinct lesion or formed by a confluence of papules (Figs. 9 and 10).
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FIG. 9: Hypertrophic lichen planus.
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FIG. 10: Psoriasis.
Nodules: Dome shaped, elevated, circumscribed lesions involving dermis and may extent to the subcutis; diameter greater than 1 cm and on palpation can be compressible, soft, rubbery or firm (Figs. 11 to 14).
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FIG. 11: Nodule–Scabies.
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FIG. 12: Steatocystoma multiplex.
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FIG. 13: Nodulocystic acne.
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FIG. 14: Nodule in neurofibromatosis.
Vesicle: Elevated, circumscribed fluid containing lesion <1 cm diameter (Figs. 15 and 16).
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FIG. 15: Herpes simplex.
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FIG. 16: Varicella.
Bulla: Elevated, circumscribed fluid containing lesion >1 cm diameter (Figs. 17 and 18).
Pusule: Elevated, circumscribed pus (infectious-neutrophil or sterial) containing lesion <1 cm diameter (Figs. 19 and 20).
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FIG. 17: Bullous pemphigoid.
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FIG. 18: Burn.
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FIG. 19: Infectious–boil.
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FIG. 20: Sterial-acne.
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FIG. 21: Pruritic evanescent plaque.
Wheals: Evanescent, edematous, pruritic elevated lesion of various sizes (Fig. 21).
 
Secondary Lesions
Lesions those are altered by natural evolution, infection, trauma or manipulations.
Crust: Dried serum, pus, blood mixed with epithelial and sometimes bacterial debris. When crusts become detached, the base may be dry or red and moist (Figs. 22 and 23).
Scale: They are dry or greasy, laminated masses of keratin (Figs. 24 and 25).
Erosion: Partial or full loss of epidermis. Heals without a scar (Fig. 26).
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FIG. 22: Pemphigus vulgaris.
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FIG. 23: Herpes zoster.
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FIG. 24: Psoriasis.
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FIG. 25: Erythroderma.
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FIG. 26: Erosion.
Excoriation: Linear or punctuate abrasion by trauma (Fig. 27).
Fissures: Vertical loss of epidermis and partial or full thickness of dermis (Fig. 28).
Ulcers: Rounded or irregularly shaped complete loss of epidermis plus partial or complete loss of dermis (Fig. 29).
Atrophy: Diminution of some or all layers of skin (Figs. 30A and B).
Hypertrophy: Deposition of excessive amounts of collagen which are confined in wound area (Fig. 31A and B).
Keloid: Deposition of excessive amounts of collagen which are not confined in wound area and are extended in normal surrounding area in claw like fashion (Fig. 32).
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FIG. 27: Excoriation–punctate erosion.
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FIG. 28: Fissures.
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FIG. 29: Ulcers.
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FIGS. 30A AND B: Atrophic scar. (A) Due to topical steroid. (B) Due to burn.
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FIGS. 31A AND B: Hypertrophy.
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FIG. 32: Keloid at the site of incision.
 
Petechiae, Purpura, and Ecchymosis
 
Petechiae
Pinpoint spots that appear on the skin due to extravasation of RBC.
  • ≤3 mm diameter.
  • Occurs in significant thrombocytopenia <20,000–40,000/cumm (Figs. 33 and 34).
 
Purpura
Nonpalpable purpura are extravasation of blood in skin and mucous membrane <1 cm in diameter (Figs. 35 and 36).
Palpable purpura occur due to vasculitis (Figs. 37A and B).8
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FIG. 33: Keloid on burns.
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FIG. 34: Petechiae.
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FIG. 35: Petechial hemorrhage.
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FIG. 36: Nonpalpable purpura.
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FIGS. 37A AND B: Red purple papule with a blanching erythema.
 
9Common Presentations of Vasculitis
Ecchymoses: Extravasation of blood usually >1 cm (Figs. 38 to 41).
Causes are:
  • Defective coagulation: anticoagulant use, hepatic insufficiency and vitamin k deficiency.
  • Poor dermal support of blood vessels.
  • Platelet dysfunction.
Telangiectasis: Permanent dilatation of cutaneous blood vessels (Figs. 42A and B).
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FIG. 38: Ecchymosis in disseminated intravascular coagulation.
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FIG. 39: Petechiae, purpura, ecchymosis in dengue hemorrhagic fever.
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FIG. 40: Ecchymosis in meningococcal infection.
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FIG. 41: Senile purpura and ecchymosis.
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FIGS. 42A AND B: Permanent dilatation of cutaneous blood vessels due to topical steroid.