Dermatologic Differential Diagnosis.pdf. - Famona Site

294 A CLINICIAN’S GUIDE TO DERMATOLOGIC DIFFERENTIAL DIAGNOSIS, VOLUME 1
Syphilis – congenital, secondary – late secondary submammary
lesions, interdigital toe lesions – secondary (noduloulcerative)
(lues maligna) in AIDS Clin Inf Dis 25:1343,1447, 1997; Rook
p.1248, 1998, Sixth Edition; Treponema pallidum discovered by
Schaudinn and Hoffmann in 1905
Tinea versicolor (Malassezia intertrigo) Mycoses 31:558–562, 1988
Vaccinia – auto-inoculation vaccinia JAAD 50:139–141, 2004
Varicella Ghatan p.108, 2002, Second Edition
Viral exanthems – accentuated or limited to diaper area
Ghatan p.108, 2002, Second Edition
Yaws
INFILTRATIVE DISEASES
Benign non-X histiocytosis JAAD 18:1289, 1988
Juvenile xanthogranuloma JAAD 14:405–411, 1986
Langerhans cell histiocytosis – cutaneous findings include crops
of red–brown or red–yellow papules, vesicopustules, erosions,
scaling, and seborrheic dermatitis-like papules, petechiae,
purpura, solitary nodules AD 137:1241–1246, 2001; Curr
Prob Derm VI Jan/Feb 1994; Clin Exp Derm 11:183–187,
1986; JAAD 13:481–496, 1985; in adult – ulcerated red plaque
of groin Rook p.2320, 1998, Sixth Edition
Mastocytosis (urticaria pigmentosa) – flexural hyperpigmented
reticulated plaques AD 139:381–386, 2003; xanthelasmoidea
Med Chir Trans 66:329–347, 1883
Xanthoma disseminatum (Montgomery’s syndrome) –
red–yellow–brown papules and nodules; become confluent into
xanthomatous plaques; verrucous plaques NEJM
338:1138–1143, 1998; JAAD 23:341–346, 1990; AD Syphilol
37:373–402, 1938
INFLAMMATORY DISORDERS
Crohn’s disease – metastatic granulomatous nodules and
ulcers, perianal extension with papules, nodules, ulcers, sinus
tracts, and intertriginous ulcers, nodules, and plaques JAAD
36:986–988, 1996; Gastroenterology 86:941–944, 1984
Dermatitis psoriasiformis of Jadassohn
Granuloma gluteale infantum – reddish–brown, purple nodules
Ped Derm 17:141–143, 2000; AD 125:1703–1708, 1989; AD
111:1072–1073, 1975
Hidradenitis suppurativa Derm Surg 26:638–643, 2000;
BJD 141:231–239, 1999; Rook p.1176–1179, 1998, Sixth Edition
Post-inflammatory hyperpigmentation
Pyoderma gangrenosum – ulcerative diaper dermatitis
Ped Derm 11:10, 1994
METABOLIC
Acrodermatitis enteropathica Textbook of Neonatal
Dermatology, p.254, 2001; Rook p.3167, 1998, Sixth Edition;
acquired zinc deficiency
Calcinosis cutis – calcified intertrigo Ann DV 122:789–792,
1995; JAAD 8:103–106, 1983; plaque-type intertriginous
calcinosis cutis Cutis 49:289–291, 1992
Cystic fibrosis
Essential fatty acid deficiency – severe xerosis with underlying
erythema, hair loss with hypopigmentation, and weeping
intertrigenous rash Ped Derm 16:95–102, 1999
Kwashiorkor – crusting and superficial erosions in the diaper
area AD 137:630–636, 2001; Ann DV 113:657–659, 1977
Maple syrup urine disease
Miliaria
Multiple carboxylase deficiency (biotin-responsive) – pyruvate
carboxylase, propionyl-coenzyme A carboxylase, and
3-methylcrotohyl-CoA carboxylase; accumulation of urinary
organic acids; neonatal – holocarboxylase synthetase
deficiency; juvenile or late-onset from – biotinidase deficiency –
erythematous scaly eruption interdigital webs, groin, axillae
Ped Derm 21:231–235, 2004; Ped Derm 16:95–102, 1999;
Adv Pediatr 38:1–21, 1991; AD 123:1696–1698, 1987
Riboflavin deficiency – component of coenzymes flavin
mononucleotide, and flavin-adenine dinucleotide involved
in oxidative phosphorylation; deficiency produces dermatitis
similar to glucagonoma syndrome with a prominent
periorificial component; angular stomatitis which often
bleeds, vertical fissuring of lips, smooth magenta tongue,
seborrheic dermatitis-like rash, scrotal dermatitis; riboflavin
deficiency seen in hypothyroidism, acute boric acid ingestion,
chlorpromazine use and neonatal phototherapy for
hyperbilirubinemia Semin Derm 10:293–295, 1991;
JAAD 21:1–30, 1989
Xanthomas, eruptive Ghatan p.66, 2002, Second Edition
NEOPLASTIC
Acrochordons with acanthosis nigricans
Basal cell carcinoma – red plaque in inguinal crease; shiny pink
axillary plaque Derm Surg 27:966–968, 2001
Bowen’s disease
Epidermal nevus – intertrigenous and perigenital
Extramammary Paget’s disease – the clinical picture of Paget’s
disease may change daily and may even become subclinical;
underlying adnexal carcinoma or carcinoma of the rectum,
urethra, cervix, or distant carcinoma of the breast JAAD
51:492–493, 2003; Sem Cut Med Surg 21:159–165, 2002;
unilateral axillary Paget’s disease J Dermatol 25:260–263, 1998;
Plast Reconstr Surg 100:336–339, 1997; AD 127:1243, 1991;
red plaque of inguinal crease and scrotum BJD 153:676–677,
2005
ILVEN – intertrigenous and perigenital
Kaposi’s sarcoma
Lentiginosis profusa – intertrigenous pigmentation
Lymphoma – cutaneous T-cell lymphoma with axillary intertrigo;
poikiloderma vasculare atrophicans with CTCL
Melanoma JAAD 51:492–493, 2003
Metastatic gastric carcinoma – condyloma-like lesions in axilla
and groin Pathology of Unusual Malignant Cutaneous Tumors,
New York, Marcel Dekker pp.357–397, 1985
Porokeratosis BJD 140:553–555, 1999; BJD 132:150–151, 1995
Syringomas
PARANEOPLASTIC
Acanthosis nigricans BJD 153:667–668, 2005
Paraneoplastic annular erythema – perigenital dermatitis
PRIMARY CUTANEOUS DISEASE
Acantholytic dermatosis of the vulvo-crural area – vulvar
papules, cobblestoning of the vulva and thighs Cutis
67:217–219, 2001; Am J Dermatopathol 6:557–560, 1984
Acanthosis nigricans – velvety plaques, intertriginous
pigmentation Rook p.1583–1585,3168, 1998, Sixth Edition