Some inflammatory, infectious, metabolic, neoplastic, and genetic skin conditions have a predilection for particular areas of the body. This chapter addresses the diagnosis and treatment of regional dermatoses affecting the hands, feet, intertriginous regions, diaper area, lips, and eyelids. Dermatitis of the Hands and Feet An approach to the classification of hand dermatitis is presented in Fig. 13.1 , and the differential diagnosis of foot dermatitis…

Key Points Irritant contact dermatitis (ICD) – Accounts for 80% of all causes of contact dermatitis – Secondary to a local toxic effect caused by a topical substance or physical insult Allergic contact dermatitis (ACD) – Accounts for 20% of all causes of contact dermatitis – A delayed-type hypersensitivity reaction to a substance to which the individual has been previously sensitized – Compared to ICD, more…

The major forms of dermatitis include atopic (see Ch. 10 ), contact (see Ch. 12 ), seborrheic, asteatotic (xerotic), stasis, and nummular. Dermatitis of special sites – i.e. hands, feet, lips, eyelids, diaper area, and major body folds – is reviewed in Chapter 13 , and pityriasis alba is reviewed in Chapter 10, Chapter 54 . Seborrheic Dermatitis Common disorder with both an infantile and an…

Introduction Common inflammatory skin disease that affects 10–25% of children and 2–10% of adults in most high-income and some low-income countries. Eczematous dermatitis characterized by intense pruritus and a chronic or chronically relapsing course. Sequelae often include sleep disturbances, psychological distress, disrupted family dynamics, and impaired functioning at school or work. Onset usually in infancy or early childhood, with development in the first year of life…

Lichen Planus Idiopathic disorder that can affect the skin, hair, nails, and/or mucosae (oral, vulvovaginal) and most commonly affects adults. May represent a T-cell-mediated autoreactive disorder against keratinocytes whose self-antigens have been altered by trauma or infection (e.g. HCV). Flat-topped (lichenoid) papules that are often polygonal in shape and purple in color may coalesce into plaques ( Fig. 9.1 ); lesions usually resolve with hyperpigmentation (…

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Parapsoriasis Chronic, usually asymptomatic patches or thin plaques with fine scale whose color varies from pink to red-brown; may have associated epidermal atrophy and occasionally poikiloderma (large plaque parapsoriasis). Two major forms of parapsoriasis are small plaque (lesions usually <5 cm in diameter) and large plaque (usually >5 cm); digitate dermatosis is a form of the former, whereas retiform parapsoriasis is a variant of the latter…

Key Points Affects up to 2% of the population. Chronic disorder in those with a polygenic predisposition combined with triggering factors such as infections (especially streptococcal infection, but also HIV infection) or medications (e.g. interferon, β-blockers, lithium, or oral CS taper). Koebner phenomenon – elicitation of psoriatic lesions by traumatizing the skin. Common sites ( Fig. 6.1 ) – Scalp – Elbows and knees – Nails,…

Introduction Psychodermatology refers to any aspect of dermatology in which psychological factors play a significant role. Psychodermatologic disorders can be classified in two ways: (1) by the specific psychodermatologic condition or (2) by the underlying psychopathology ( Fig. 5.1 ). Treatment is simplified by basing the choice of psychotropic medication or therapy on the underlying psychopathology ( Table 5.1 ). Table 5.1 Psychotropic medications most commonly…

Definitions Pruritus: an unpleasant sensation of the skin that elicits a desire to scratch. Dysesthesia: an unpleasant, abnormal sensation that can be either spontaneous or evoked; abnormal, unpleasant sensations may include pain, pruritus (“neuropathic itch”), tingling, burning, “pins and needles”. Pruritus The most common skin-related symptom in dermatology; can have a profound negative impact on a patient’s quality of life. Results from the activation of the…

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A range of bedside diagnostic procedures are performed to assist in the diagnosis of skin disorders. The most commonly performed procedures include microscopic examination of skin scrapings mounted in either potassium hydroxide (KOH) or mineral oil and microscopic examination of hair shafts. Potassium Hydroxide (KOH) Preparation of Scale Microscopic examination of scale (stratum corneum), obtained via scraping with a metal blade or glass slide and mounted…

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