Skin lesions

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  • For two main reasons, dermatology is one of the later medical disciplines to use imaging techniques: skin lesions are readily visible to the naked eye or through a magnifying glass, allowing clinical diagnosis with no invasive examination; skin lesions can easily be biopsied or removed for histological study. This approach has therefore remained the basis of clinicopathological diagnosis of skin diseases for a long time. There has also been a third factor.

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  • Table 52-2 Description of Secondary Skin Lesions Lichenification: A distinctive thickening of the skin that is characterized by accentuated skin-fold markings. Scale: Excessive accumulation of stratum corneum. Crust: Dried exudate of body fluids that may be either yellow (i.e., serous crust) or red (i.e., hemorrhagic crust). Erosion: Loss of epidermis without an associated loss of dermis. Ulcer: Loss of epidermis and at least a portion of the underlying dermis. Excoriation: Linear, angular erosions that may be covered by crust and are caused by scratching.

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  • Figure 52-5 Meningococcemia. An example of fulminant meningococcemia with extensive angular purpuric patches. (Courtesy of Stephen E. Gellis, MD; with permission.) Figure 52-4 Necrotizing vasculitis. Palpable purpuric papules on the lower legs are seen in this patient with cutaneous small vessel vasculitis. (Courtesy of Robert Swerlick, MD; with permission.)[newpage] APPROACH TO THE PATIENT: SKIN DISORDER In examining the skin it is usually advisable to assess the patient before taking an extensive history.

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  • Also lentigines. b Polyostotic fibrous dysplasia. c See also "Papulonodular Skin Lesions." d Late 1980s. A proliferation of melanocytes results in the following pigmented lesions: lentigo, melanocytic nevus, and melanoma (Chap. 83). In an adult, the majority of lentigines are related to sun exposure, which explains their distribution.

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  • Papulonodular Skin Lesions (Table 54-15) In the papulonodular diseases, the lesions are elevated above the surface of the skin and may coalesce to form plaques. The location, consistency, and color of the lesions are the keys to their diagnosis; this section is organized on the basis of color. Table 54-15 Papulonodular Skin Lesions According to Color Groups I. White A. Calcinosis cutis II. Skin-colored A. Rheumatoid nodules B. Neurofibromas (von Recklinghausen's disease) C. Angiofibromas (tuberous sclerosis, MEN syndrome, type 1) D. Neuromas (MEN syndrome, type 2b) E.

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  • Also associated with systemic diseases. b Reviewed in section on Purpura. cReviewed in section on Papulonodular Skin Lesions. d Favors plantar surface of the foot. Note: TEN, toxic epidermal necrolysis. Livedoid vasculopathy (livedoid vasculitis; atrophie blanche) represents a combination of a vasculopathy plus intravascular thrombosis. Purpuric lesions and livedo reticularis are found in association with painful ulcerations of the lower extremities. These ulcers are often slow to heal, but when they do, irregularly shaped white scars are formed.

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  • Systemic causes of nonpalpable purpura fall into several categories, and those secondary to clotting disturbances and vascular fragility will be discussed first. The former group includes thrombocytopenia (Chap. 109), abnormal platelet function as is seen in uremia, and clotting factor defects. The initial site of presentation for thrombocytopenia-induced petechiae is the distal lower extremity.

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  • Pemphigoid Gestationis Pemphigoid gestationis (PG), also known as herpes gestationis, is a rare, nonviral, subepidermal blistering disease of pregnancy and the puerperium. PG may begin during any trimester of pregnancy or present shortly after delivery. Lesions are usually distributed over the abdomen, trunk, and extremities; mucous membrane lesions are rare. Skin lesions in these patients may be quite polymorphic and consist of erythematous urticarial papules and plaques, vesiculopapules, and/or frank bullae. Lesions are almost always very pruritic.

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Is disturbed clearance of apoptotic keratinocytes responsible for UVB-induced inflammatory skin lesions in systemic lupus erythematosus...

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Is disturbed clearance of apoptotic keratinocytes responsible for UVB-induced inflammatory skin lesions in systemic lupus erythematosus?

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Pandemic 2009 H1N1 virus infection associated with purpuric skin lesions: a case report...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Esophageal squamous cell carcinoma presenting with extensive skin lesions: a case report

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Dermal absorption of aromatic amines in workers with different skin lesions: a report on 4 cases

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  • (BQ) Part 2 book "The mont reid surgical handbook" presents the following contents: Benign and malignant liver lesions, renal transplantation, liver transplantation, pancreas transplantation, malignant skin lesions, diseases of the breast, breast reconstruction, gastric tumors, malignant pancreas disease, colorectal cancer,... and other content.

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  • (BQ) Part 1 book "Dermatology skills for primary care - An illustrated guide" presents the following contents: Basic skills; papular, papulosquamous and papulo vesicular skin lesions; epidermal, dermal and epidermal dermal lesions; epidermal and dermal lesions, eczematous lesions and atrophies,

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  • (BQ) Part 2 book "Dermatology skills for primary care - An illustrated guide" presents the following contents: Pigmented, Pre-Malignant, and common malignant skin lesions; vesiculo - bullous and papulo pustular disorders.

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  • This account is confined to therapy directed primarily at the skin. • Pharmacokinetics of the skin • Topical preparations:Vehicles for presenting drugs to the skin; Emollients, barrier preparations and dusting powders;Topical analgesics; Antipruritics; Adrenocortical steroids; Sunscreens • Cutaneous adverse drug reactions • Individual disorders: Psoriasis.Acne, Urticaria, Skin infections It is easy to do more harm than good with potent drugs, and this is particularly true in skin diseases.

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  • Factors predisposing to colorectal cancer in UC patients consist of pancolitis, duration of disease, active disease and its severity. Early UC onset is another independent risk factor. Beside these factors, dysplasia represents the precancerous lesion from which colorectal cancer subsequently arise (Morson, 1962; Morson & Pang, 1967). In fact, 70% of patients with colorectal cancer on UC have dysplasia on colorectal mucosa (Taylor et al., 1992; Connell et al., 1994).

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  • Allergic contact dermatitis (ACD). A. An example of ACD in its acute phase, with sharply demarcated, weeping, eczematous plaques in a perioral distribution. B. ACD in its chronic phase demonstrating an erythematous, lichenified, weeping plaque on skin chronically exposed to nickel in a metal snap. (B, Courtesy of Robert Swerlick, MD; with permission.) As in other branches of medicine, a complete history should be obtained to emphasize the following features: 1. Evolution of lesions a. Site of onset b. Manner in which the eruption progressed or spread c. Duration d.

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  • Tzanck Smear A Tzanck smear is a cytologic technique most often used in the diagnosis of herpesvirus infections [herpes simplex virus (HSV) or varicella zoster virus (VZV)] (see Figs. 173-1 and 173-3). An early vesicle, not a pustule or crusted lesion, is unroofed, and the base of the lesion is scraped gently with a scalpel blade. The material is placed on a glass slide, air-dried, and stained with Giemsa or Wright's stain. Multinucleated epithelial giant cells suggest the presence of HSV or VZV; culture or immunofluorescence testing must be performed to identify the specific virus.

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