Lookingbill and Marks' Principles of Dermatology

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Self-Assessment

Case 1 – White Spots ( Fig. 24.1 ) What Is the Most Likely Diagnosis? This patient has a typical history for tinea versicolor. Scratching the affected areas elicited a fine, crumbly scale, further heightening the suspicion of tinea versicolor.…

Skin Signs of Systemic Disease

Fever and Rash Key Points 1. Characterize the rash to limit the differential diagnosis 2. Do laboratory tests based on the history and physical examination A wide spectrum of diseases can present with fever and rash, including infections, drug reactions…

Mucous Membrane Disorders

Categorization of mucous membrand disorders: 1. Erosions and ulcerations 2. White lesions Table 22.1 Mucous Membrane Disorders Etiology History Physical Examination Differential Diagnosis Laboratory Test Ulcers Aphthous stomatitis (common cause) Unknown Recurrent disease Sharply demarcated, round, yellowish erosions surrounded by…

Nail Disorders

Key Points 1. Appearance alone is usually not sufficient to make the diagnosis 2. Therapy is often difficult or unsuccessful The physical appearance of the nail cannot be used reliably to make a diagnosis. Fungal Infection Key Points 1. Confirm…

Hair Disorders

Key Points 1. Diagnosis requires a detailed history 2. Diagnose pattern as patchy or diffuse 3. Determine whether hair loss is scarring or nonscarring Observe the pattern of hair loss and whether scarring is present. Alopecia Areata Key Points 1.…

Ulcers

Key Points 1. Ulcers have many causes 2. Good wound care promotes healing 3. Cure requires resolution of the underlying etiology Definition An ulcer is an open sore that results from loss of the epidermis and part or all of…

Dermal Induration

Key Points 1. Dermal induration presents with firm and thickened skin 2. Skin biopsy is often necessary for diagnosis 3. Diseases tend to run a natural course despite treatment intervention Granuloma Annulare Key Points 1. Self-limiting, asymptomatic condition with papules…

Purpura

Key Points 1. Purpura (Latin purple) is extravasated blood outside blood vessels and therefore does not blanch 2. Distinguish palpable from nonpalpable purpura 3. Palpable purpura represents vasculitis 4. Always rule out infection first in a patient with purpura Purpura…

Specialized Erythema

Key Points 1. The distinctive morphology of the specialized erythemas is key to the diagnosis (e.g., erythema multiforme) 2. Specialized erythemas represent a reactive pattern to an underlying cause (e.g., erythema multiforme caused by herpes simplex infection) Table 16.1 Specialized…