Dermatology

thin-walled vesicle on an erythematous base, then,

the vesicles rupture so rapidly that it is rarely seen as such.

• The exuding serum dries to form yellowish-brown, honey-colored, stuck on

crusts 

initial lesion is a vesicle with an erythematous base and surrounding halo that

enlarges to 0.5-3 cm in size and then ruptures leaving a dark adherent crust

surrounded by a rim of erythematous indurated area

• Removal of the crust shows a saucer (dish) shaped ulcer with raised, indurated,

violaceous margin. The base extends deeply in the dermis.

 initial lesion is thin walled yellowish-white pustule at the follicular orifices,

pierced at its center by a hair. It heals without scarring 

initial lesions are single or multiple painful, erythematous, often

fluctuant, nodules and may have suppurative drainage 

deep, painful cluster of interconnected boils (furuncles) that extends into the

subcutaneous tissue and discharges pus through multiple follicular openings 

Initial lesion is in the form of recurrent discrete inflammatory papules or

pustules in the beard area pierced by hairs

Papules and pustules commonly occur on the

anterolateral aspect of the neck or on the angle of the jaw

The lesion is in the form of a well-demarcated red area. The lesion has an advancing

edge, and the surface may show vesicles, pustules or bullae

Ill-defined, indurated, red, tender hot area of skin appears at the affected site

Streptococcal intertrigo: Longitudinal painful fissure at the angle of the skin

folds. The skin around is red, moist & may be crusted

 Well-defined reddish- b r o w n patches with no active edge,

covered with fine scales that affect the intertriginous areas. It may be asymptomatic

or associated with mild itching 

The affected digit is red, swollen and painful. Compression of the nail fold may drain pus.

One or several fingernails are affected. There is inflammation of the proximal nail

fold with erythema, edema and absence of the cuticle. Damage to the nail matrix results

in nail plate changes

Characterized by

maceration, erythema and fissuring of the oral commissures 

asymptomatic grayish papules which are few mm in diameter with

verrucous (irregular) rough surface

multiple skin-colored small

papules with flat smooth surface that affect mostly the face or

extensor surface of hands.

Skin-colored or grayish small papules or

pedunculated grayish cauliflower mass.

Skin colored lesion solid border with black dots &

distracted creases

*Creases is an important point to differentiate planter

wart (distracted) from callus (normal crossed creases)

a group of vesicular eruption on an erythematous base usually around

the mouth . Burning sensation may precede or accompany the eruption.

The eruption is itchy macules, papules, vesicles, pustules and crusts. The eruption

is polymorphic and centripetal in distribution together with mucous membrane

affection (eye, mouth, gingiva). The extremities are less involved.

A group of vesicular eruption on an erythematous base appearing along the pathway

of cutaneous nerve (dermatome) . The vesicles contents dry up in 1-2

weeks forming crusts. Most uncomplicated lesions heal without scarring.

Highly contagious lesions.

- The primary lesion is painless, shiny, pearly white papule, usually umbilicated

in the center 

Pleomorphic lesion including pustules & crusts with characteristic barrow

+/- scratch mark

Nets & lice presentation stuck on the hair

symptomatic single or multiple areas of sudden onset of hair loss.

• Characteristically, the scalp skin is completely normal with no crusts or scales.

Compulsive habit that induces the individual to pluck his or her own hairs.

• Occurs in neurotic individuals.

Skin lesions are in the form of "milky or chalk white", well-defined macules or

patches of variable sizes

Asymptomatic, light-to-dark brown macules or patches with irregular borders.

erythematous (salmon red) papule covered with laminated silvery

scales, which may coalesce to form sharply defined plaques. asymptomatic, bilateral, and symmetrical.

Small rounded drop-like lesion, red salmon

erythematous papule

Partial or complete red, dry and

thickened palms and/or soles, often with deep painful fissures. The skin

changes tend to have a sharp border and are often symmetrical

Diffuse scale or solitary plaques with no hair loss 

Nail pitting,

subungual hyperkeratosis, onycholysis, oil drop sign, splinter hemorrhages or

leukonychia.

characterized by absent or decreased scales due to moisture and continuous

friction. There is usually considerable itching.

Napkin psoriasis (Figure 9.8): affection of napkin area in infants as a

presentation of Köebner phenomenon.

primary lesion is an itchy flat-topped polygonal papule. It is violet or

purple in color and shows whitish striations called Wickham’s striae, which

can be seen by a magnifying lens.

affects

buccal mucosa and lips in the form of white lines, streaks, or patches. Ulcers

may occur and can turn into squamous cell carcinoma in 1-2% of the cases.

Longitudinal ridging, pitting. Partial

or complete destruction of the nail may occur.

 begins with a solitary macule or patch, that heralds the

eruption and thus is commonly referred to as the herald patch.

§ This initial lesion enlarges over a few days to become a patch with a collarette of

fine scale just inside the well-demarcated border.

secondary eruption is more generalized and symmetrical. as macules or maculo-papules,

erythematous and covered by fine scales. They enlarge gradually, become oval and

acquire the same appearance of the herald patch.

Lesions are pleomorphic: comedones (the characteristic primary lesion of acne),

papules, pustules, nodules and cysts. Post-acne erythema and scars may also

occur.

 occlusion of the eccrine duct at the skin surface

resulting in accumulation of sweat under the stratum corneum. The lesion appears as

a clear drop or vesicles with little or no erythema.

rom occlusion of the intraepidermal part of the

eccrine sweat duct, resulting in extremely pruritic erythematous papules.

cclusion of the eccrine sweat duct at

the dermoepidermal junction. produces

asymptomatic flesh-colored papules

-Ophiasis: alopecia areata involving the hair line

compulsive habit that induces the individual to pluck his or her own

hairs and occurs in neurotic individuals 

radual hair loss caused by repeated or prolonged pulling tension on hair

roots. 

Acute stage: Ill-defined erythematous patches, papulovesicular eruption with

exudation of serum

Subacute stage: Erythema and scaling

 Chronic stage: Dryness and lichenification

Allergic contact dermatitis is an example of type IV hypersensitivity

reaction and is diagnosed by patch test.

Lesions most frequently start on the cheeks, sparing perioral and para-nasal areas.

§ Lesions consist of intensely itchy and dry erythematous and edematous lesions. It

may become vesicular with oozing and crustations . Secondary

infection and lymphadenopathy are common.

Lesions consist of itchy erythematous, edematous papules which tend to be

replaced by lichenification

characterized by circular or oval coin shaped lesions with a well

demarcated edge

Lesions are present on the lower part of legs as an erythematous scaly o r

oozing area surrounded by small slate blue macules resulting from hemosiderin

deposits

Diffuse or localized scaly erythematous macules and patches, covered with

yellowish greasy scales

The lesions appear as rounded or oval erythematous, ill-defined patches with

fine white scales . Later, it subsides to leave areas of hypopigmentation. 

characterized by itchy, transient (evanescent),

erythematous swellings of the dermis or subcutaneous tissues (wheals). Individual

lesions usually last less than 24 hours

special type of urticaria of sudden onset involving the

subcutaneous tissue leading to edema of the eyelids, lips, hands and genitalia. It

might/might not be associated with urticarial wheals elsewhere 

Initially, an extremely itchy edematous papule develops at the site of the

insect bite, followed by a firm pruritic papule which usually persists for several

days. Lesions are often grouped in clusters and develop in crops at irregular

intervals and may vesiculate. Lesions are accompanied by scratch marks and may

be complicated by secondary infection.

characterized by sudden

onset of symmetrical multiforme lesions including erythematous macules, papules

vesicles and sometimes bullae. Some of the lesions evolve into target or iris lesion

The onset is sudden with extensive typical maculopapular rash

• generalized bullous eruption with affection of oral mucus membrane.

Exanthematous (morbilliform) eruption

is the most frequent type; causes a widespread, measles-like red rash mainly on the trunk

and arms 

Sharply demarcated, round or oval red-to-violaceous macules, patches, or plaques

that consistently recur in the exact same location(s) upon re-exposure to a culprit

medication. Sometimes bullae on top.

Scaly patches with hair broken off appears as black dots

It presents as single or multiple scaly patches with the hairs cut into short stumps

1-2 mm above scalp level.

a single or multiple painless soft swellings of the scalp.

The hair is easily detached, and the surface of the swelling is studded with few

pustules.

Affected hair is surrounded by thick yellow adherent crust that is

characteristically cup shaped (sulfur cups or scutula).

Soft swelling in the beard area hair easily detached with presented pustule

Well defined erythematous patch with raised active edges which

is severely itchy circinate lesion

Well defined erythematous patch with raised active edges with

healed center

Itchy interdigital maceration

of the 4th /5th toe-web space

Squamous/Chronic Hyperkeratotic: chronic plantar erythema with slight scaling to

diffuse hyperkeratosis. It can be asymptomatic or pruritic. Both feet are usually affected.

Typically, the dorsal surface of the foot is clear, but in severe cases, the condition may extend

onto the sides of the foot

intensely itchy or painful vesicles and bullae filled with clear

or purulent fluid, typically overlying areas of erythema on the instep or soles of the feet

Brittle, friable, nails with subungual hyperkeratosis with distracted nail plate

Well-defined hypo/hyper macules & patches

covered by fine scales

hitish curd-like patches (pseudo-

membrane) on tongue and buccal mucosa characterize it . The

patches can be scrubbed and leave erythematous base. 

The

lesion is well-defined, moist and erythematous. The edge is festooned and small

satellite lesions (papules & pustules) are seen outside the edge

olds are involved. The edge is festooned and small

satellite lesions (papules & pustules) are seen outside the edge