DERMATOLOGY NEENA

KHANNA IMAGES
Papule: solid, elevated lesion <0.5 cm
Nodule: solid lesion, >0.5 cm in diameter.
discoid plaque of psoriasis
vesicles
bullae
Pustule: pus-filled hollow lesion. This one shows
a distinct level of pus.
Scales: flakes formed by collection of horny
layer; loosely attached silver scales are typical of
psoriasis.
Erosion: due to complete or partial loss
of viable epidermis with no loss of the dermis.
Ulcer:
destruction of the epidermis and at least the upper
(papillary)
dermis
Pigmentation: epidermal pigmentation
dermal pigmentation is slate gray.
Lamellar ichthyosis
Collodion baby: newborn is ensheathed in a
shiny lacquer-like membrane.
Palmoplantar keratoderma:
Acquired keratoderma: callosities: ill-defined
thickening at site of constant friction
Epidermolysis bullosa: EB simplex: bullae
on hand and feet.
Angiofibromas: dome-shaped papules with
telangiectasia in the nasolabial folds and cheeks.
Incontinentia pigmenti: broad linear bands of
lesions consisting of hyperkeratotic papules and
nodules.
In this patient, some vesicular lesions are
present—this
is unusual, as the stage is in utero. Later the girl
child
developed whorled pigmentation.
Acanthosis nigricans.
Mucosal
involvement in malignant AN.
Darier’s disease: multiple discrete, crusted
follicular
and few nonfollicular papules.
Psoriasis of palms: well-defined, erythematous
thickened plaques with silvery scales. Note the
welldefined
edge. On the palms and soles, the scales may be
adherent.
Psoriasis of nail
Generalized pustular psoriasis: lakes of pus on
a fiery red background; pustules appear in waves and
can
be easily wiped off
Lichen planus: flat topped, polygonal, violaceous
papules, characteristically on flexors of wrist and
on shins.
hypertrophic lichen planus.
actinic lichen planus.
Lichen planus:: nails show thinning, distal splitting,
tenting of nail plate and pterygium formation,
Large plaque parapsoriasis: erythematous,
scaly, indurated plaques on the covered parts of
body
Pemphigus vulgaris : flaccid blisters on normal
skin
acantholytic cells in
Tzanck
smear.
Pemphigus foliaceus: extensive areas of scaling
and crusting and no blisters. Note removal of scale-
crust
reveals a minimally moist area.
Pemphigus erythematosus: dry hyperkeratotic
scaly plaques on the malar region.
Bullous pemphigoid:
large hemorrhagic blisters some on normal skin.
Chronic bullous disease of childhood: string of
pearl appearance is typical.
Toxic epidermal necrolysis: bullae on dusky
erythema. Bullae rupture to leave large areas of
denuded
skin healing with hyperpigmentation.
Toxic epidermal necrolysis: hemorrhagic crusts
on lips and eye
involvement frequent.
Acute eczema: erythematous, edematous, exudative
crusted plaques with papulovesiculation
Infantile phase of atopic dermatitis: papulovesicular
lesions on face
Eczema herpeticum: generalized grouped
vesicles which rapidly evolve into polycyclic
erosions.
Infantile seborrheic dermatitis:
may involve other seborrheic
area.
Irritant contact dermatitis: due to overzealous
postoperative care.
Allergic contact dermatitis:
to rubber, manifesting as dermatitis to footwear.
Discoid eczema: coin shaped, vesicular,
crusted
plaques.
Acne vulgaris: A: polymorphic eruption of comedones,
papules, pustules, nodules, and cysts.
Acne vulgaris: A: polymorphic eruption of comedones,
papules, pustules, nodules, and cysts
Acne fulminans: crusted lesions in presternal
area. Patient also had fever and myalgia.
Acne conglobata:
Rosacea:
rhinophyma: bulbous nose with patulous
follicular openings.
Fordyce’s spots: multiple, symmetric, flat
topped, yellow papules.
Alopecia areata:
multiple patches
of alopecia areata of eyebrows.
leucoplakia
Pachyonychia congenita: A: tenting of nail
plate present since birth.
Tinea unguium: thick, tunneled, discolored
nail plate with onycholysis
Piebaldism: A: depigmented macules with
islands of normomelanotic macules within
the area of depigmentation
in central area of trunk
.
Melasma: brown macular lesions with scalloped
margins on the cheeks and nose.
Freckles: brown macules on photo-exposed
parts. Note variation in color.
Raynaud’s phenomenon:
: finger tip gangrene
Arterial ulcer: on dorsal aspect of foot. Ulcer
has a pale floor covered with slough. There is often no
pigmentation or lipodermatosclerosis in surrounding
skin.
Stasis ulcer:
scarring and atrophy may develop when stasis
ulcer
heals.
Erythema:
discoid erythema due to fixed drug
eruption.
SJS–TEN complex: extensive erythema and
erosions in buccal mucosa and hemorrhagic crusting
on
lips.
Photoaged skin: wrinkled, leathery, and irregularly
pigmented. Inset: note comedones.
Chronic actinic dermatitis:
sparing of
depth of skin creases and depth of upper lids.
Side effects of steroids: : Cushingoid facies:
a common side effect of systemic steroids
Discoid lupus erythematosus:
early lesion.
Discoid lupus erythematosus:
: large lesion.
Lupus profundus: deep-seated, subcutaneous
nodule with overlying skin either normal (when
termed
lupus panniculitis) or showing lesions of DLE.
Dermatomyositis: periorbital edema and faint
lilac erythema (heliotrope erythema).
Pitted keratolysis: fine, punched-out often
elongated pits which become confluent to give a
cribriform
pattern.
Staphylococcal scalded skin syndrome:
superficial peeling of skin in thin sheets in an infant
Scrofuloderma
: mouth of the sinus is
undermined and hyperpigmented.
Tuberculosis verrucosa cutis: verrucous
plaque on trauma-prone sites. There is invariably
an underlying induration.
Borderline lepromatous leprosy: multiple
plaques present almost symmetrically.
Verruca vulgaris
: subungual lesion, distorting nail.
Primary herpetic infection
: polycyclic erosions
on labial mucosa.
Kerion: boggy swelling of scalp with easy
pluckability of the hair.
Oral candidiasis:
candidal leucoplakia:
rough white-grey plaque on dorsal aspect of tongue
with
erythematous halo.
Chromoblastomycosis: verrucous plaques on lower
extremity
Filarial lymphedema: : in late stages, hypertrophic
and verrucous skin with redundant skin folds.
Nevus of Ota.
pigmentation of sclera.
Basal cell carcinoma: noduloulcerative
lesion showing rolled, pearly edge and central
ulceration.
Squamous cell carcinoma: raised ulcer
with indurated base and everted margin (cauliflower-
like)
on the lower lip
Port-wine stain: : deeply erythematous,
telangiectatic slightly bosselated lesion on the face.
Usually present at birth: involvement of eyes
Lymphangioma circumscriptum:
: lesions in buccal mucosa.
Klippel–Trenaunay syndrome: vascular malformation,
venous varicosities with soft-tissue hypertrophy.
Xanthoma:
: tuberous xanthomas: yellow-colored nodules on
pressure points.
Paraneoplastic pemphigus:
recalcitrant oral lesions.