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Tuberculosis (cutaneous) and tuberculids

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Cutaneous tuberculosis (CTB) is a chronic infection caused by Mycobacterium tuberculosis and occasionally by M. bovis and bacillus Calmette-Guérin (BCG), an attenuated strain of M. bovis. The spectrum of clinical manifestations varies depending on the host’s…

Trichotillomania

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Trichotillomania, or hair-pulling disorder, is the impulsive, repetitive action of pulling out hair, resulting in significant hair loss. Any region of the body with hair can be involved, with the eyebrows, eyelashes, and scalp comprising the…

Transient acantholytic dermatosis (Grover disease)

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Grover disease was described by the American dermatologist Ralph Grover in 1970. It is an uncommon disorder characterized clinically by discrete erythematous, edematous papulovesicles or keratotic papules, which are usually pruritic, and histologically focal acantholytic dyskeratosis.…

Toxic epidermal necrolysis and Stevens–Johnson syndrome

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) belong to the same spectrum (‘epidermal necrolysis’) of rare, potentially life-threatening conditions caused by drugs in 85% of cases (other causes may be due to autoimmunity or infections…

Tinea versicolor (pityriasis versicolor)

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Pityriasis (tinea) versicolor (PV), a superficial fungal infection of the skin, is caused by the lipophilic yeast species Malassezia , which are present in body areas rich in sebum, such as the face, back, upper trunk,…

Tinea unguium

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Onychomycosis accounts for about half of all nail abnormalities and a third of all fungal infections of the skin. It affects about 10% of the general population, with figures that vary in different areas of the…

Tinea pedis

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Tinea pedis is the most common form of cutaneous morphological pattern of superficial dermatophytosis in Western countries. Tinea pedis denotes infection of the feet, including toes, with a dermatophyte. It is colloquially known as athlete’s foot…

Tinea corporis and tinea cruris

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Tinea corporis is a dermatophyte infection of the skin of the trunk and extremities, excluding the hair, nails, palms, soles, and the groin. Tinea cruris refers to the infection of the groin. While tinea corporis and…

Tinea capitis

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Courtesy of Dr. E. E. Merika Open full size image Tinea capitis is a fungal infection of the scalp caused by dermatophyte species, most commonly Microsporum and Trichophyton , which are identified on microscopy and culture. Infections localized to the…

Syringomata

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Syringomata are benign appendageal tumors of the intraepidermal eccrine sweat duct that have a characteristic histologic appearance. Typically skin- or tan-colored papules, with a rounded or flat surface, 1–5 mm in diameter, appear around puberty. Single…

Syphilis

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Syphilis is an ancient disease that many mistakenly believe to be on the decline. The numbers and rates of infectious syphilis fell to their lowest levels in Europe in the early 1990s. In the US in…

Sweet syndrome

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Sweet syndrome is a neutrophilic dermatosis that clinically presents with the sudden onset of tender, well-demarcated, edematous, erythematous plaques or nodules on the face, neck, upper trunk, and/or extremities. A pseudovesicular or pustular morphology is possible.…

Subcutaneous fat necrosis of the newborn

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Subcutaneous fat necrosis of the newborn (SCFNN) is an uncommon, self-limiting panniculitis that affects term or postterm infants in the first weeks of life. It is characterized by firm subcutaneous nodules and plaques over areas of…

Subcorneal pustular dermatosis

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Courtesy of Frederick A. Pereira, MD Open full size image Subcorneal pustular dermatosis is a rare, chronic, neutrophilic dermatosis of unknown etiology, in which flaccid pustules and vesicopustules arise in crops on truncal and flexural skin. The condition can occur…

Subacute cutaneous lupus erythematosus

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Subacute cutaneous lupus erythematosus (SCLE) is a non-scarring, photosensitive variant of cutaneous lupus erythematosus (CLE). Patients can have annular or papulosquamous plaques or a morphologic combination that is characteristically in a sun-exposed distribution. Although SCLE does…

Striae

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Striae distensae (SD), or stretch marks, are common skin lesions that are medically benign but may lead to cosmetic and psychological morbidity. SD are dermal scars that commonly result from stretching of the skin in susceptible…

Stoma care

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Stomas are artificial openings created to maintain proper drainage from internal structures. The most common are colostomies, ileostomies, and urostomies (ileal conduits), formed as either a temporary or a permanent measure. They are ideally produced electively,…

Steatocystoma multiplex

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Steatocystoma multiplex represents a benign hamartomatous malformation of the pilosebaceous unit. Although probably genetically heterogeneous, steatocystoma multiplex often demonstrates an autosomal-dominant pattern of inheritance. Some pedigrees have demonstrable keratin 17 abnormalities. Clinically, 2–15-mm firm, white, and…

Staphylococcal scalded skin syndrome

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Staphylococcal scalded skin syndrome (SSSS) is a highly contagious, blistering condition triggered by exfoliative, toxin-producing Staphylococcus aureus, most commonly affecting neonates and children under the age of 6 years. It rarely presents in adults, although the…

Squamous cell carcinoma

Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Open full size image Cutaneous squamous cell carcinoma (cSCC) originates from keratinizing cells of the epidermis or its appendages. Most commonly it presents as an erythematous papule or nodule with scale and crust, but it may also be ulcerated, hyperpigmented,…