Part 31. The Skin
Chapter 594. Morphology Of The Skin
Chapter 595. Evaluation Of The Patients
¡ÚWood Lamp
# *ectothrix
& some endothrix infection
;
*blue-green fluorescence
# scale, crusts
; pale yellow
# tinea versicolor
;
*golden fluorescence
; cf. dermatophyte lesions - no fluorescence
# erythrasma due to corynebacterium minutissimum
; pink-orange
# pseudomonase aeruginosa
; yellow-green
chapter 596. principle of therapy
Shampoos
# *Tar-containing
shampoos (e.g. T-Gel, Ionil-T, Sebutone, Polytar)
;
*useful for psoriasis and severe
seborrheic dermatitis
topical
corticosteroids
#
two classes
1) nonfluorinated
2) fluorinated
#
absorptionÀº ointment or gel vehicleÀÌ ´õ °ÇÏ´Ù.
#
adverse effects
; cutaneous atrophy, striae,
telangiectasia, hypopigmentation, increased hair growth
Chapter 597. Diseases Of The Neonate
Sebaceous Hyperplasia
Milia
Sucking Blisters
Cutis Marmorata
#
persistent lesions
; de Lange, Down, trisomy 18
syndrome
Harlequin Color Change
Salmon Patch (Nevus Simplex)
;
small, pale, pink, ill-defined, flat vascular lesions
;
sites
- *glabella, eyelids, upper lips, nuchal areas
Monglian Spots
Erythema Toxicum
;
evanescent eruption
;
50% of full-term
;
*firm, yellow-white, 1- to 2-
mmpapules or pustules with a surrounding erythematous flare
;
peak incidence
- 2nd day of life
Transient Neonatal Pustular Melanosis
Infantile Actropustulosis
Eosinophilic Pustular Folliculitis
Chapter 598. Cutaneous Defects
Branchial Clefts And Thyroglossal Cysts And Sinuses
#
2nd brachial cleft cyst
; *¡ãcommon
Focal Facial Dermal Dysplasia (Bitemporal Aplasia
Cutis Congenita, Ectodermal Dysplasia Of The Face)
Chapter 600. Vascular Disorders
Port-Wine Stain (Nevus Flammeus, Port-Wine Nevus)
# asso. syndrome
;
*struge-weber,
klippel-trenaunay-weber, rubinstein-taybi, cobb, beckwith-wiedemann, trisomy 13
syndrome
Capillary Hemangioma (Strawberry Nevus)
;
*more common in girl
;
favored sites
- face, scalp, back, ant.
chest
;
¡ÚClinical Course
- *60% involution by 5yr
- *90-95% involution by 9yr
- not correlated with size or
site
- *lip lesion mostly persistent
Cavernous Hamangioma
;
diffuse, ill-defined, deeply situated lesion
Kasabach-Merritt Syndrome
; *comination
of rapidly enlarging hemangioma, thrombocytopenia, acute or chronic consumption
coagulopathy
Clinical Manifestation
; usually during earyl infancy
¡ÚTreatment
; systemic steroids
; embolization
; radiation therapy
;
*aminocaproic acid - inhibits
fibrinolysis
;
*recombinant IFN-¥á
Prognosis
; mortality 20-30%
Chapter 601. Cutaneous Nevi
Congenital Melanocyte Nevus
Giant Congenital Pigmented Nevi
;
commonly on post. trunk
;
*predispositon for malignant melanoma
Chapter 602. Hyperpigmented Lesions
Ephelides Or Freckles
;
light or dark brown macules less than 3mm
;
poorly defined margins
;
occur in *sun-exposed area such as
face, upper back, arms, hands
Lentigens
;
round, dark brown macules < 3cm
;
anywhere on the body
Peutz-Jeghers Syndrome
Cafe Au Lait Spots
¢¾Table 602-1
Incontinentia Pigmenti (Bloch-Sulzberger Disease)
;
multisystem ectodermal disorder features dermatologic, dental, ocular
abnormalities
Etiology
; *gene on chromosome Xq28
; random X-inactivation of
X-linked dominant gene
-->
functional mosaicism
-->
lethal in male
Cutaneous Manifestations
#
alopecia ; 80%
#
ocular anomalies
; neovascularization,
microphthlmos, strabismus, optic nerve atrophy, cataracts, retrolenticular
masses
Chapter 603. Hypopigmented Lesions
Tuberous Sclerosis
Clinical Manifestation
#
adenoma sebaceum
; *¡ãcommon cutaneous marker
#
¡ÚShagreen Patch
; *large, skin-colored, irregularly thickened plaques with a orange
peel or cobblestone texture in lumbosacral area
#
renal angiomyiolipoma
; hematuria
Chapter 620. Tumors Of The Skin
Mucosal Neuroma Syndorme (Sippel Syndrome)
; AD
; athenic or marfanoid habitus
; scoliosis, pectus excavatum, pes cavus, muscular hypotonia
; thick patulous lips, soft tissue prognathism stimulating acromegaly
; multiple mucosal neuroma or neurofibromas
- pink, pedunculated or sessile nodules on ant. third of tongue, at commissures of lips, buccal mucos, palpebral conjunctiva
; ass. symptom
- medullary carcinoma ass. with high calcitonin levels, pheochromocytoma, hyperparathyroidism