Skin Deep - A Dermatology Blog Skin Deep - A Dermatology Blog A Dermatology Blog with a huge collection of clinical photos. 
Articles
Speckled lentiginous nevus
2008-05-09 09:34:00 Speckled lentiginous nevus is a patch of hyperpigmentation representing a localized defect in neural crest melanoblasts. Several black or brown macules are seen within a patch of brown hyperpigmentation. Some consider this a variant of Congenital melanocytic naevus.
DermaMan: A dermatology calculator for PDAs
2008-01-06 19:44:00 I have recently made a simple application to bring basic dermatology related calculations to hand held devices in Java. It includes modules for frequently used dermatological calculations like PASI, MASI, SCORAD and for PUVA and Botox (R) related calculations.DermaMan is a freeware which can be downloaded from http://www.gulfdoctor.net/derm/dermaman.h tm if you are accessing from a PC and http://www.gulfdoctor.net/mobile/derm.htm if you are accessing from your hand held device for over-the-air installation. All modules are packaged as a single JAR file. Specific instructions for installation depend on your device and are usually available from the manufacturer’s user-guide. General instructions are available from the web pages mentioned above.A more detailed description of the software is in print in the ‘Resident’s corner’ section of IJDVL, March-2008 issue. Please read the disclaimer before you download the software. Use this thread for support, bug report and feature reque... More About: Calculator , Dermatology
Fixed Drug Eruptions (FDE)
2007-12-02 14:24:00 Hands, feet, and genitalia are the most common locations for Fixed Drug Eruptions (FDE) and lesions recur in the same area when the offending drug is given.
Hansens Disease (Leprosy)
2007-09-13 19:15:00 First Hansen’s I have seen after coming here. The treatment was hindered by the non availability of Dapsone and clofazamine. With the emergence of latest bactericidal drugs it is not much of a problem any more. More About: Disease , Leprosy
Sclerotic patch
2007-08-02 20:19:00 This 35 year old Asian male patient presented with this unilateral hyperpigmented sclerotic patch over the face for 20 years. What is your diagnosis? More About: Patch
Periorificial crusting and acral desquamation
2007-06-02 06:56:00 This poorly nourished 2-year-old girl developed asymptomatic erythema and crusting of the periorificial areas of the face over last one month. Desquamation of the distal phalanges of the fingers and the toes was also noted. Please take a look at the images and share your comments regarding the differential diagnosis.
A recurrent vesicular eruption
2007-01-26 13:34:00 This 4-year-old boy had a recurrent vesicular eruption on the sun exposed areas for three years. The eruption would heal with varioliform scarring. The boy's father and one of the siblings had similar problem since early childhood. What would be the ddx?
Hyper pigmentation in neonate
2006-12-14 08:17:01 This 17 days old baby girl developed such mottled hyper pigmentation on face and rest of the body since last 2 days. There is no h/o prior rash. There is h/o fever on day 5 after birth for which baby was admitted by pediatrician and she received 5 days course of ampicillin, Inj.Gentamycin and Inj.Ceftrioxone. It was normal delivery but at 36th week of gestation. Except for pigmentation she was otherwise normal. More About: Men , Hype , Menta , Neon , Nate
Acute generalised exanthematous pustulosis (AGEP)
2006-12-02 20:13:01 This patient presented to me with sudden onset of widespread non follicular pustules over his body. He did not give personal or family history of psoriasis. My diagnosis was Acute generalised exanthematous pustulosis (AGEP). AGEP is a condition characterised by sudden onset of non-follicular aseptic pustules all over the body. Among drug-induced skin eruptions, AGEP is remarkable by its short time to onset after the administration of the suspected drug (less than 24 hours) and the great predominance (80%) of antibiotics as causative agents. Though it is generally easy to elicit a drug history in AGEP, I did not succeed. After 2 days patient called me and told that he remembered taking an Ayurvedic concoction called arishtam on the previous day of erruption. A literature search showed that, after drug reactions, the most common causes of AGEP are acute infections with enteroviruses, and hypersensitivity to mercury. Without taking sides, let me refer you to this article here:http://fa... More About: Cute , General , Them , Genera , Gene
Progressive Palmo Plantar Keratoderma of Greither
2006-11-21 20:00:04 Today an old patient of mine came with his brother who had severe palmo plantar keratoderma since childhood which worsened after coming to Gulf. The most striking feature was the transgrediens. They said several members of their family have this problem. With my broken Hindi, I managed to elicit sufficient history to draw a crude pedigree chart. Based on the livid transgrediens, I came to a diagnosis of Prog ressive PPK (Greither disease or PPK of Sybert). I started him on 50% urea and 0.05% tretinoin. Before leaving my old patient (A in the chart) asked me about the chances of this condition developing in his children. What is your answer? More About: Palm , Progress , Erma
Polymorphous Light Eruption (PLE / PMLE)
2006-11-16 19:51:01 Differentiation of PLE on pigmented skin from Actinic LP can be tricky without a biopsy as the second condition is also fairly common in India and Gulf. On fair skin PLE is described as ?pink or red raised spots? [ http://dermnetnz.org/reactions/pmle.html ] but the pink hue is never appreciable on pigmented skin. PLE is generally pruritic and involves photo exposed areas, often sparing the face as in the above case. Actinic LP is non-pruritic and commonly involves the face as the case posted below (http://www.gulfdoctor.net/blog/2006/01/d iagnosis.html ). More About: Light , Poly , Morph
Follicular Lesions
2006-11-07 19:42:01 A 36 year old male patient with these unilateral follicular lesions of 4 months duration over the shin. What is your diagnosis? More About: Sion
Ichthyosis Linearis Circumflexa (ILC) of Netherton Syndrome
2006-10-31 19:30:04 This 4 year old female patient presented with history of congenital erythroderma (without Colloidal membrane), which was evident during the first weeks of life and severe pruritic dermatosis. History of hair loss was given though it was not severe when she presented to me. Though lesions where predominantly ichthyosiform with a predilection for extremities, she also had eczematous peri-oral lesions characteristic of NS. However flexural lichenification was not prominent. ILC is a characteristic serpiginous migratory annular/polycyclic rash with double-edged scale. More on the genomic and molecular aspects of this disease in my Applied - Bimatics (http://gulfdoctor.net/bioblog/2006/02/pl asmin.html) Blog. More About: Rome , Syndrome , Near , Flex , Line
Lupus Vulgaris
2006-10-26 20:24:01 This 18 yr girl was brought for asymptomatic lesion on left elbow since last 3 months.It was a small papule to begin with, then grew slowly but steadily to attain present size. There is spontaneous healing with atrophy in the upper half .Secondary infection at the lower border is since last 5 days,Another small lesion inferior to the main lesion is post traumatic ecthyma (since 10 days.)There is no h/o injury prior to the main lesion.She also developed slightly tender matted epitrochlear lymphadenopathy 1month after the onset of the lesion.She had taken Anti tubercular treatment for 9 months(1 yr back )for pulmonary Kochs.Her father also had pulmonary Kochs. More About: Lupus , Vulgar
Nodulocystic Acne
2006-10-23 20:18:01 Nodulocystic acne is a severe form of acne affecting the face, chest and back characterised by multiple inflamed and uninflamed nodules and frequently, scars. It is more common in males. Acne conglobata is an uncommon form of nodulocystic acne in which there are interconnecting abscesses and sinuses. Nodulocystic acne may very rarely be a manifestation of a genetic disorder, PAPA syndrome (Pyogenic Arthritis, Pyoderma gangrenosum and Acne. Autosomal Dominant). This patient was treated with isotretinoin, but lesions recurred after few months of stoping therapy.
Forehead Lesions
2006-10-02 19:48:02 A 30 year old male patient with these hyperpigmented hyperkeratotic lesions over the forehead since 2 years. What is your diagnosis? More About: Head , Sion , Fore
Geographic tongue
2006-09-29 19:42:02 Geographic tongue is a relatively common benign condition which may cause significant psychological morbidity. Though often asymptomatic, some may complain of burning sensation or irritation with hot or spicy food as in this patient. He also had a median fissure which is a frequent association. He also gave history of recurrent oral ulcers. More About: Graphic , Graph , Tongue , Tong , Geographic
Hyperpigmented Patches.
2006-09-04 19:12:01 This 25 year old male welder presented to me with well demarcated asymptomatic hyperpigmented spots over the face, neck, back and extremities since 4-6 months. What is your diagnosis? More About: Men , Patches , Hype , Patch , Hyper
Chronic Folliculitis of Legs (CFL / DCPA)
2006-08-30 19:06:02 Chronic folliculitis of legs, though not uncommon in India, is not frequently seen in the same expatriate population in Gulf. This is a case I saw few days back. However he complained that lesions appeared only when he is in gulf and disappeared completely while in India! PUVA and Co-Trimoxazole have found to be useful in reducing recurrence. Co-Trimoxazole retains high sensitivity in this region probably because of decreased use. More About: Legs
Tumid lesion on the nose with scarring alopecia.
2006-08-16 18:57:01 36 year old male patient presented with this tumid lesion on the nose since few months. On examination he also had this violaceous patch of scarring alopecia which he had not noticed. He also complained of similar lesions on his earlobe which spontaneously disappeared. No other significant history could be elicited and he did not have similar lesions elsewhere. What is your diagnosis? More About: With , The N , Carr , Ring , Nose
Confluent and reticulate papillomatosis of Gougerot & Cartea
2006-08-10 18:51:04 This patient had hyperpigmented, hyperkeratotic, patches and plaques with scale on the neck, upper-back, arms and sternal area. CRP occurs predominantly in young adults and teenagers, with cosmetically displeasing brown scaling patches and plaques affecting the neck, upper trunk and axillae. Clinically, the eruption is most often confused with tinea versicolor. It is important to recognize this disorder, because minocycline therapy is highly effective in most patients. More About: Arte , Late , Cart , Matos
Thinner Dermatitis
2006-08-10 18:51:04 Paint Thinner is an effective diluent, helping painters achieve the optimal varnish or paint consistency. Contact and inhalation can cause eye, nose, and throat irritation, dizziness, and dermatitis. This patient presented with acute irritant dermatitis due to exposure to thinner. It is important to dispose of such chemicals properly, as they can contaminate our groundwater too. There is even a report of Exfoliative dermatitis from exposure to paint thinner. More About: Erma , Dermatitis
Chest Lesion
2006-08-10 18:51:04 A 31 year old male patient with this lesion of 4 years duration on the chest. He also developed a swelling as seen in the picture since 1 week. He did not have similar lesions any where else in the body. What is your diagnosis? More About: Chest , Sion
Trichotillomania
2006-08-10 18:51:04 Trichotillomania consists of repetitive, uncontrollable pulling of one?s body hair. In most cases it is related to an increased stress level at home or school. Treatment involves self-monitoring of hair-pulling episodes as well as the feelings and situations that are most likely to lead to hair pulling. Children are then systematically taught a new behaviour, for example, squeezing a ball or tightening their fist that they are to do whenever they feel the urge to pull. From a dermatological standpoint, it is one of traumatic alopecia. Newly growing short hairs with tapered ends and broken short hairs are visible in this 12 year old girl. Trichogram may be needed for diagnosis in some cases. More About: Rich , Mani , Oman , Mania
Erythema Multiforme due to Herpes Labialis.
2006-08-10 18:51:04 Herpes Labialis (Herpes Simplex Virus infection on the lips) may some times result in erythema multiforme minor with target lesions. In this patient lesion 1 is the healing herpes lesion and lesions 2 are due to erythema multiforme.The mucosal involvement gives the appearance of Stevens-Johnson syndrome. Erythema multiforme is a mild, self-limited, often recurrent condition, whereas Stevens-Johnson syndrome is a severe, potentially life-threatening reaction. In the past, the two forms were believed to represent ends of a spectrum of disease, but now both are regarded as distinct entities. Stevens-Johnson syndrome is usually related to medication use.Recurrent episodes, single mucosal involvement, lack of drug history and evidence of herpes labialis indicates that the patient is having EM Minor and is unlikely to proceed to the severe form in spite of mucosal involvement. This entry linked to Wikispaces page (Erythema Multi forme) More About: Them , Form , Herpes |
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