Color Atlas of Skin Diseases, Završni rad' predlog Dermatovenerologija
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nebojsa-djukanovic

Color Atlas of Skin Diseases, Završni rad' predlog Dermatovenerologija

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Dermatology color atlas, skin diseases...
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Color Atlas of Skin Diseases

Table of Contents

1.Acne Rosacea

2.Bacterial Infections Folliculitis Impetigo

3.Benign Neoplasms Seborrheic Keratoses Granuloma Pyogenicum Lentigo Simplex

4.Childhood Infectious Disea­ ses/skin Lesions Varicella (Chicken Pox) Hand, Foot and Mouth Disease Verruca Plana

5.Eczematous Dermatitis Pityriasis Rosea Vesicular Hand Dermatitis Seborrheic Dermatitis Nummular Dermatitis

6.Fungal Infections Tinea Capitis Tinea Versicolor Candidiasis

7.Gyrate Erythema Erythema Chronicum Migrans (Lyme Disease)

8.Pre-malignant and Malignant Les­ ions Actinic Keratoses Basal Cell Carcinoma Squamous Cell Carcinoma Malignant Melanoma Atypical Mole (Dysplastic) Atypical Mole Atypical Mole Atypical Mole

9.Psoriasis Psoriasis of the Nails Intertriginous Psoriasis Psoriasis of the Scalp Pustular Psoriasis Guttate Psoriasis

10.Sexually Transmitted Diseases Herpes Simplex, Penis Herpes Simplex, Vulva Herpes Simplex, Perineum Herpes Simplex in AIDS Condyloma Acuminatum (Genital Warts) Secondary Syphilis

11.Stings and Insect Bites Scabies Pediculosis (Lice)

12.Urticaria Papular Urticaria Urticaria

13.Viral Infections Molluscum Contagiosum Herpes Simplex Herpes Zoster

Rosacea

Rosacea is a congestive blushing and flushing reaction of the central areas of the face. It is usually associated with an acneiform component (papules, pustules, and oily skin). It usually occurs in middle-aged and older people. The cheeks, nose, and chin, on the entire face, may have a rosy hue. Burning or stinging of ten accompanies episodes of flushing. It is much more common than lupus erythematosus, with which it is often confused. Rosacea is distinguished from acne by age, the presence of the vascular component, and the absence of comedones.

Folliculitis

Folliculitis is characterized by red-ringed papules and pustules at hair follicles. Gram­ negative folliculitis may be spread by contaminated hot tubs. Gram stain and culture will help to differentiate bacterial from non­ bacterial folliculitis. History is important for pinpointing the cause of non-bacterial folliculitis.

Impetigo

Superficial honey-colored serous crusts are characteristic of this disorder. It is usually caused by a staphylococcus infection. Culture is rarely reliable.

Seborrheic Keratoses

These lesions are benign overgrowths of epithelium, largely appearing on the torso, face, and neck. They are seen on almost every­ one over the age of 50. The borders are typically irregular, and they range in color from beige or gray-white to very dark brown. These "barnacles" of older skin can number only a few to as many as hundreds. Although often raised and dry, they can be flatter and greasier (seborrheic) in texture.

Granuloma Pyogenicum

This is a vascular reactive nodule that develops as a response to a minor injury. The overgrowth of capillaries leads to a raised red lump which bleeds profusely when torn.

Lentigo Simplex These lesions occur on sun-exposed skin, especially face, arms, and hands. Lesions are flat, and pigmented in shades of brown, with characteristically sharp borders. They tend to fade with sun avoidance.

Varicella

Chicken Pox The rash is pruritic and most prominent on the face, scalp and trunk. It appears as multitudes of red­ ringed papules and vesicles in varying stages of development. Crusts eventually form and slough off in 7 to 14 days. Nondermatomal distribution and lesions of varying stages distinguish primary varicella from herpes zoster. Fever and malaise may be mild in children and much more severe in adults.

Hand, Foot, and Mouth Disease The disorder is characterized by stomatitis and vesicular rash on palms of hands and soles of feet. It is caused by Coxsackieviruses A5, 10, 16. The development of mouth sores is most troublesome to adults. The skin lesions are vesicopustules, 0.5 to 5 mm, red-ringed, more oval than round, on palms, sides of fingers and soles.

Verruca Plana

The numerous discrete lesions, closely set, usually occur on face, dorsa of hands and shins. Lesions are flat-topped, slightly elevated, well demarcated, generally flesh-colored, with a matte-smooth surface. Lesions tend to spontaneously disappear.

Pityriasis Rosea

This disorder is a common, but unexplainable, reaction. The initial lesion, "herald patch", is red and scaly, followed in 1 to 2 weeks by widespread, oval, scaling, fawn-colored macules 4 to 5 mm in diameter over the trunk and proximal extremities. Pityriasis rosea is usually an acute self-limiting illness that lasts 4 to 8 weeks. It is not highly infectious.

Vesicular Hand Dermatitis

This disorder is a severely pruritic reaction in individuals with a personal or family history of allergic manifestations. It is characterized by flares of congestion resulting in deep and superficial blisters, followed by peeling, scaling, and a dry, reddened surface. Flares generally result from contact with irritants, but stress is also a significant factor.

Seborrheic Dermatitis

Seborrheic dermatitis is generally limited to the scalp; however, dry scales and underlying erythema can occur on the face, ears, chest, back, and body folds. Skin may be dry or oily. In infants, a widespread reaction is associated with minimal discomfort. The yeast organism, Pityrosporum, may be a factor. Mild scaling without any erythema is often termed simple dandruff. Tinea capitis may simulate dandruff or seborrheic dermatitis, and scrapings should be taken for KOH examination and fungal culture, especially in children, if hair loss is present.

Nummular Dermatitis

A pruritic dermatosis, characterized by round to oval (coin-shaped) areas of vesiculation, superficial crusting, and redness. Number of lesions varies from few to many. More often this is a symmetrical pattern in young adults. Not related to atopic dermatitis.

Tinea Capitis Along with hair loss, the scalp surface shows seborrheic dermatitis-like scaling, impetigo-like crusting, pustules, inflammatory nodules or kerion. Identify tinea with KOH culture onto a fungal media. No longer a disease confined to children. If infection suspected, all family members should be examined.

Tinea Versicolor

Asymptomatic to mildly itchy macules that scale readily on scraping. Lesions, usually occur on the trunk, but may appear on upper arms, neck, face, and groin. Caused by a yeast organism, Pityrosporum orbiculare. Altered pigmentation can be very subtle to obvious, both hypo and hyperpigmented. KOH shows characteristic spores and hyphae. Fungal culture is not useful.

Candidiasis

Common normal flora, but it may become an opportunistic pathogen widespread in patients with AIDS and other immunosuppressed patients. Mucocutaneous candidiasis occurs on the vulva, anus, breast or groin folds. Superficial denuded beefy red areas with or without scattered satellite vesicopustules with marginal scaling. Microscopic examination with 10% KOH reveals budding spores and short hyphae.

Erythema Chronicum Migrans

Lyme Disease Caused by the spirochete Borrelia burgdorferi, which is transmitted to humans by a deer tick bite, infection, is characterized by erythema migrans. A flat or slightly raised red lesion appears at the site. The reaction can become quite large, is generally circular in shape, and can show several concentric rings (target pattern). Erythema migrans is often accompanied by flu-like illness with fever, chills, and myalgias. At this stage, laboratory tests are not reliable.

Actinic Keratoses

Actinic keratoses are single or multiple, flesh­ colored or slightly hyperpigmented, dry, rough, scaly lesions which occur on skin exposed to the sun. Cells are atypical, and they are considered to be pre-malignant because some may eventually become squamous cell cancers.

Basal Cell Carcinoma

This lesion represents 90% of skin cancers. Basal cell carcinoma is the most common cancer. On the face, it usually starts as a reddened papule or nodule with a smooth surface and a translucent, pearly quality. Because of a poorly formed stroma, it is fragile and often bleeds. On the torso, the lesion has an irregular surface, bright red color, sometimes scaly, with a distinct edge. Histologic examination is required.

Squamous Cell Carcinoma

This lesion usually appears on skin that shows other significant changes of chronic sun exposure. Especially prevalent in fair-skinned people who sunburn easily and tan poorly. It may arise out of actinic keratoses. Characteristically, the lesion appears fairly rapidly as a small red, conical, hard nodule. Should it appear on the mucus membrane or lip area, it behaves much more aggressively and can be fatal. Histologic examination is required.

Malignant Melanoma

Recognized through the mnemonic, "A-B-C-D:" Asymmetry of contour, irregularity of Border and Color, and Diameter larger than 6 mm. Melanomas vary from macules to nodules. Color ranges from flesh tints to pitch black and mixtures of white, blue, purple, and red. Any pigmented skin lesion with recent change in appearance should be suspected.

Malignant melanoma can exist in a superficial spreading mode for years and still be curable by excision with 1 to 2 cm margins. Once a vertical growth phase develops, rapid spread through blood and lymph vessels occurs. Histologic examination is required.

Atypical Moles

Dysplastic change implies abnormal cell development, which does not necessarily imply precancerous change. These atypical moles, show irregular outlines, and different shades and patterns of brown color. If they appear in a person with a family history of melanoma and are multiple in number, the incidence of cancer developing reaches 100%. If they are sporadic in pattern and number, they should be photographed and reexamined regularly. Histopathologic examination is required.

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