Xem 1-20 trên 98 kết quả Common skin
  • Our skin may just feel like a mere shield that protects us from the world outside. But, the fact is, it’s more than just the “mask” that keeps your insides in. It is a very unique and remarkable complex organ that reflects our general health. Thus, it is worth protecting from the outside and inside forces. It is commonly said that for a young, good looking skin, we must provide it with essential nutrients and protect it from external damage. Thanks to some pros out there that making this aim possible is not at all difficult to make. ...

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  • Sensitive skin is becoming a common clinical condition that dermatologists should be prepared to recognize, understand, and treat. Subjects experiencing this condition report exaggerated reactions when their skin is in contact with cosmetics, soaps, and other substances, and they often report worsening after exposure to dry and cold climates. Sensitive skin and subjective irritation are widespread in western countries, but still far from being completely defined and understood.

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  • Other Nonmelanoma Cutaneous Malignancies Neoplasms of cutaneous adnexa and sarcomas of fibrous, mesenchymal, fatty, and vascular tissues make up 1–2% of NMSC (Table 83-6). Some can portend a poor prognosis such as Merkel cell carcinoma, which is a neural crestderived, highly aggressive malignancy that exhibits a metastatic rate of 75% and a 5-year survival rate of 30–40%. Others, such as the human herpes virus 8-induced, HIV-related Kaposi's sarcoma, exhibit a more indolent course.

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  • Table 52-4 Selected Common Dermatologic Conditions Dia gnosis mmon Co ual Us is Diagnos mmon Co al Usu Distributi on Morpholo gy Distributio Morpholog n y Ac ne vulgaris e, back Fac upper en closed Op Seborrh Tru nk, face Bro wn plaques with adherent, greasy and eic keratosis comedone s, erythemat ous papules, pustules, cysts scale; "stuck on" appearance Ros acea Blu sh area of thema, cheeks, nose, forehead, chin Ery Folliculi tisImpetigo hair- Any cular Folli telangiecta ses, papules, pustules bearing pustulesPap areaAnywh ules, ere vesicles, pustules, often...

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  • A–D. The distribution of some common dermatologic diseases and lesions Figure 52-7 Psoriasis. This papulosquamous skin disease is characterized by small and large erythematous papules and plaques with overlying adherent silvery scale.

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  • Dermatitis herpetiformis. This disorder typically displays pruritic, grouped papulovesicles on elbows, knees, buttocks, and posterior scalp. Vesicles are often excoriated due to associated pruritus. The shape of lesions is also an important feature. Flat, round, erythematous papules and plaques are common in many cutaneous diseases. However, targetshaped lesions that consist in part of erythematous plaques are specific for erythema multiforme (Fig. 52-9). In the same way, the arrangement of individual lesions is important.

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  • Erythroderma (Table 54-2) Erythroderma is the term used when the majority of the skin surface is erythematous (red in color). There may be associated scale, erosions, or pustules as well as shedding of the hair and nails. Potential systemic manifestations include fever, chills, hypothermia, reactive lymphadenopathy, peripheral edema, hypoalbuminemia, and high-output cardiac failure. The major etiologies of erythroderma are (1) cutaneous diseases such as psoriasis and dermatitis (Table 54-3); (2) drugs; (3) systemic diseases, most commonly CTCL; and (4) idiopathic.

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  • White Lesions In calcinosis cutis there are firm white to white-yellow papules with an irregular surface. When the contents are expressed, a chalky white material is seen. Dystrophic calcification is seen at sites of previous inflammation or damage to the skin. It develops in acne scars as well as on the distal extremities of patients with scleroderma and in the subcutaneous tissue and intermuscular fascial planes in DM. The latter is more extensive and is more commonly seen in children.

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  • Harrison's Internal Medicine Chapter 83. Cancer of the Skin Melanoma Pigmented lesions are among the most common findings on skin examination. The challenge is to distinguish cutaneous melanomas, which may be lethal, from the remainder, which with rare exceptions are benign. Examples of malignant and benign pigmented lesions are shown in Fig. 83-1. Figure 83-1 Atypical and malignant pigmented lesions. The most common melanoma is superficial spreading melanoma (not pictured). A.

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  • Treatment of Metastatic Disease Melanoma can metastasize to any internal organ, the brain being a particularly common site. Metastatic melanoma is generally incurable, with survival in patients with visceral metastases generally

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  • To date, FDA-approved for men. b May also be scarring. Exposure to various drugs can also cause diffuse hair loss, usually by inducing a telogen effluvium. An exception is the anagen effluvium observed with antimitotic agents such as daunorubicin. Alopecia is a side effect of the following drugs: warfarin, heparin, propylthiouracil, carbimazole, vitamin A, isotretinoin, acitretin, lithium, beta blockers, colchicine, and amphetamines. Fortunately, spontaneous regrowth usually follows discontinuation of the offending agent.

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  • Becoming less common. Poikiloderma is a term used to describe a patch of skin with (1) reticulated hypo- and hyperpigmentation, (2) wrinkling secondary to epidermal atrophy, and (3) telangiectasias. Poikiloderma does not imply a single disease entity—although becoming less common, it is seen in skin damaged by ionizing radiation as well as in patients with autoimmune connective tissue diseases, primarily dermatomyositis (DM), and rare genodermatoses (e.g., Kindler syndrome). In scleroderma, the dilated blood vessels have a unique configuration and are known as mat telangiectasias.

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  • In tuberous sclerosis, the earliest cutaneous sign is an ash leaf spot. These lesions are often present at birth and are usually multiple; however, detection may require Wood's lamp examination, especially in fair-skinned individuals. The pigment within them is reduced but not absent. The average size is 1–3 cm, and the common shapes are polygonal and lance-ovate.

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  • Also systemic. f In adults, associated with renal failure and immunocompromised state. Vesicles and bullae are also seen in contact dermatitis, both allergic and irritant forms (Chap. 53). When there is a linear arrangement of vesicular lesions, an exogenous cause should be suspected. Bullous disease secondary to the ingestion of drugs can take one of several forms, including phototoxic eruptions, isolated bullae, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) (Chap. 56).

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  • Several metabolic disorders are associated with blister formation, including diabetes mellitus, renal failure, and porphyria. Local hypoxia secondary to decreased cutaneous blood flow can also produce blisters, which explains the presence of bullae over pressure points in comatose patients (coma bullae). In diabetes mellitus, tense bullae with clear viscous fluid arise on normal skin. The lesions can be as large as 6 cm in diameter and are located on the distal extremities. There are several types of porphyria, but the most common form with cutaneous findings is PCT.

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  • Table 54-14 Causes of Urticaria and Angioedema I. Primary cutaneous disorders A. Acute and chronic urticariaa B. Physical urticaria 1. Dermatographism 2. Solar urticariab 3. Cold urticariab 4. Cholinergic urticariab C. Angioedema (hereditary and acquired)b II. Systemic diseases A. Urticarial vasculitis B. Hepatitis B or C infection C. Serum sickness D. Angioedema (hereditary and acquired) a A small minority develop anaphylaxis. b Also systemic. The common physical urticarias include dermographism, solar urticaria, cold urticaria, and cholinergic urticaria.

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  • Common causes of erythematous subcutaneous nodules include inflamed epidermoid inclusion cysts, acne cysts, and furuncles. Panniculitis, an inflammation of the fat, also presents as subcutaneous nodules and is frequently a sign of systemic disease. There are several forms of panniculitis, including erythema nodosum, erythema induratum/nodular vasculitis, lupus profundus, lipodermatosclerosis, α1-antitrypsin deficiency, factitial, and fat necrosis secondary to pancreatic disease. Except for erythema nodosum, these lesions may break down and ulcerate or heal with a scar.

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  • Palpable purpura are further subdivided into vasculitic and embolic. In the group of vasculitic disorders, cutaneous small-vessel vasculitis, also known as leukocytoclastic vasculitis (LCV), is the one most commonly associated with palpable purpura (Chap. 319). Underlying etiologies include drugs (e.g., antibiotics), infections (e.g., hepatitis C virus), and autoimmune connective tissue diseases. Henoch-Schönlein purpura is a subtype of acute LCV that is seen primarily in children and adolescents following an upper respiratory infection.

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  • Most patients with trichotillomania, pressure-induced alopecia. The most common causes of nonscarring alopecia include telogen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, and some cases of traumatic alopecia (Table 54-5). In women with androgenetic alopecia, an elevation in circulating levels of androgens may be seen as a result of ovarian or adrenal gland dysfunction. When there are signs of virilization, such as a deepened voice and enlarged clitoris, the possibility of an ovarian or adrenal gland tumor should be considered.

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  • Pink Lesions The cutaneous lesions associated with primary systemic amyloidosis are often pink in color and translucent. Common locations are the face, especially the periorbital and perioral regions, and flexural areas. On biopsy, homogeneous deposits of amyloid are seen in the dermis and in the walls of blood vessels; the latter lead to an increase in vessel wall fragility. As a result, petechiae and purpura develop in clinically normal skin as well as in lesional skin following minor trauma, hence the term pinch purpura.

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