Dermatologic Differential Diagnosis.pdf. - Famona Site

METABOLIC
Acromegaly – hirsutism in females Rook p.2704, 1998,
Sixth Edition
Adrenal hirsutism Bolognia p.1054, 2003
Chronic illnesses – liver disease, malnutrition
Cushing’s syndrome – hirsutism Semin Dermatol 3:287–294,
1984; iatrogenic Cushing’s syndrome – lanugo hair of cheeks
Rook p.2705, 1998, Sixth Edition
Hirsutism – hormonal (congenital adrenal hyperplasia,
polycystic ovarian disease, excess ovarian androgen release
syndrome), racial, pregnancy (androgen secreting tumor,
luteoma, lutein cysts) Bolognia, p.1054, 2003; Rook
p.2895–2899, 1998, Sixth Edition; Obstet Gynecol 44:511–521,
1974; NEJM 288:118–122, 1973
Hyperandrogenism – ovarian source – polycystic ovarian
disease, ovarian tumors; adrenal source – congenital adrenal
hyperplasia – 21-hydroxylase deficiency most common
J Clin Endocrinol Metab 63:418–423, 1986; Cushing’s disease,
adrenal carcinoma, adrenal adenoma Cancer 44:239–249,
1979; prolactinoma; gonadal dysgenesis (46 XY) – female
genitalia with male skeletal characteristics Obstet Gyncecol
58:17–23, 1981; androgen therapy, idiopathic hirsutism
Metabolism 37:281–286, 1988; Am J Obstet Gynecol
146:602–610, 1983; Rook p.2897–2899, 1998, Sixth Edition;
Steroids 63:308–313, 1998; Q Med J 43:603–614, 1974
Hyperprolactinemia Bolognia p.1053, 2003
Hypothyroidism, childhood – hypertrichosis of upper back and
shoulders Rook p.2708, 1998, Sixth Edition
Liver disease, chronic – trichomegaly
Malnutrition
Menopause – hirsutism Ghatan p.68, 2002, Second Edition
Multiple sclerosis Ghatan p.69, 2002, Second Edition
Polycystic ovarian disease NEJM 352:1223–1236, 2005;
Clin Endocrinol 30:459–464, 1989
Porphyria – porphyria cutanea tarda – decreased hepatic
uroporphyrinogen decarboxylase in sporadic and toxic forms,
and decreased enzyme in all tissues in the hereditary form;
accumulation of water soluble 8-, 7-, 6-, 5-, and
4-carboxylporphyrins; hypertrichosis of cheeks, forehead,
and periorbital regions in about 2/3 of patients with PCT
JAAD 48:161–179, 2003; Rook p.2590, 1998, Sixth
Edition; hepatoerythropoietic porphyria AD 116:307–313,
1980; variegate porphyria – protoporphyrinogen oxidase
deficiency JAAD 48:161–179, 2003; Wien Klin Wochenschr
50:830–831, 1937; BMJ ii:89, 1955, hereditary coproporphyria
BJD 96:549–554, 1977; Q J Med 46:229–241, 1977;
BJD 84:301–310, 1971; congenital erythropoietic porphyria –
lanugo hair on extremities, terminal hair on face Semin Liver
Dis 2:154–63, 1982
Precocious puberty – premature adrenarche with molecular
defects of CYP21 gene J Clin Endocrinol Metab 84:1570–1574,
1999; 37 patients with NF I – optic chasm tumors J Pediar
126:364–367, 1995
Pregnancy – hirsutism Ghatan p.68,297, 2002, Second Edition
Pretibial myxedema JAAD 46:723–726, 2002; Rook p.2707,
1998, Sixth Edition; AD 122:85–88, 1986
Starvation Ghatan p.69, 2002, Second Edition
Thyrotoxicosis
NEOPLASTIC
ACTH-producing non-endocrine tumors – Ghatan p.68, 2002,
Second Edition
Adrenal adenoma – hirsutism Ghatan p.68, 2002,
Second Edition
Adrenal carcinoma – hirsutism Ghatan p.68, 2002,
Second Edition
Becker’s nevus – occurs in 0.5% of young men Derm Surg
24:1032–1034, 1998; AD 92:249–251, 1965
Dermal dendrocyte hamartoma with stubby white hair
JAAD 32:318–21, 1995
Dermatofibroma
Eccrine angiomatous nevus (hamartoma) JAAD 51:301–304,
2004
Epidermal nevus – secreting LHRH – hirsutism – AAD 97;
Ped Derm section
Hairy Pacinian neurofibroma (nerve sheath myxoma)
JAAD 18:416–419, 1988
Melanocytic nevus – compound, intradermal, congenital
Neurofibromas, periorbital Ophthalmology 103:942–948, 1996
Nevoid hypertrichosis (hair follicle nevus, hairy nevus)
Ovarian tumors – arrhenoblastoma, granulosa-theca cell tumor,
hilus cell tumor, metastatic ovarian carcinoma – hirsutism
Ghatan p.68, 2002, Second Edition
Smooth muscle hamartoma
Trichofolliculoma
Unilateral nevoid hypertrichosis
PARANEOPLASTIC DISEASES
Hypertrichosis lanuginosa acquisita (malignant down) – in
mild forms, confined to face; lung, colon carcinomas most
common; also breast, gall bladder, uterus, urinary bladder if
accompanied by acanthosis nigricans; the malignancy is always
an adenocarcinoma Can Med Assoc 118:1090–1096, 1978;
circumscribed in acute myelogenous leukemia Dtsch Med
Wochenschr 126:845–846, 2001; synophrys JAAD 37:295–297,
1997
PRIMARY CUTANEOUS DISEASE
HYPERTRICHOSIS, LOCALIZED 275
Atopic dermatitis – friction JAAD 48:161–179, 2003
Distichiasis – isolated anomaly; autosomal dominant Am J Med
Genet 65:109–112, 1996
Epidermolysis bullosa, dystrophic types Ann Ital Dermatol
10:195–196, 1995
Hairy elbows/hypertrichosis cubitus Clin Exp Dermatol
24:497–498, 1999; Ped Derm 13:303–305, 1996; AD 132:589,
1996; AD 131:858–859, 1995
Hairy malformation of the palms and soles
Hairy neck – anterior cervical hypertrichosis; posterior cervical
hypertrichosis
Hairy nose tip
Hairy palms and soles AD 111:1146–1149, 1975
Hairy pinnae – Indians, Mediterraneans; autosomal dominant
sex-linked trait; acquired hairy pinna and eyebrows in HIV
disease JAAD 28:513, 1993; Hum Hered 20:486–492, 1970;
AIDS, XYY, babies of diabetic mothers, diabetes mellitus
JAAD 48:161–179, 2003; carried on Y chromosome Rook
p.3014, 1998, Sixth Edition
Hypertrichosis singularis (single long hair) JAAD 48:161–179,
2003
Lichen sclerosus et atrophicus – hypertrichosis of labia majora
in children Trans St John’s Hosp Dermatol Soc 57:9–30, 1951;
Rook p.2549–2551, 1998, Sixth Edition
Lichen simplex chronicus JAAD 48:161–179, 2003; Rook
p.2895, 1998, Sixth Edition