Dermatology in Clinical Practice (eBook)

Preface 6
Acknowledgments 8
Contents 9
Morning Prayer of Maimonides 23
Maimonides (1135–1204) 24
Skin: Structure and Function 25
1.1 Structure 25
1.2 Functions 38
Immune System of the Skin 40
2.1 The Stratum Corneum 41
2.2 Cellular Components 41
2.3 Molecular Components 43
2.4 Hypersensitivity Reactions 46
Diagnosis of Skin Disease 48
3.1 Approach to a Skin Patient 48
3.2 Primary and Secondary Lesions of the Skin 54
Bacterial Infections 59
4.1 Impetigo 59
4.2 Folliculitis/Furunculosis/Carbuncle 61
4.3 Recurrent Furunculosis 64
4.4 Erysipelas/Cellulitis 64
4.5 Ecthyma 66
4.6 Necrotizing Fasciitis 67
4.7 Erythrasma 68
4.8 Pitted Keratolysis 69
4.9 Trichomycosis Axillaris 70
4.10 Tuberculosis 70
4.11 Leprosy (Hansens Disease) 74
4.12 Pseudomonas Infections 79
4.13 Rocky Mountain Spotted Fever (RMSF) 81
4.14 Lymes Disease (Erythema Chronicum Migrans) 82
4.15 Sexually Transmitted Diseases (Bacterial) 84
Superficial Fungal Infections 95
5.1 Clinical Features 96
5.2 Diagnosis 106
5.3 Differential Diagnosis 107
5.4 Treatment 108
5.5 Pityriasis Versicolor (Furfuracae) 110
5.6 Pityrosporum Folliculitis ( Malassezia Folliculitis) 112
5.7 Candidiasis 113
5.8 Subcutaneous Fungal Infections 117
5.9 Deep Fungal Infections 120
Viral Infections 122
6.1 Herpes Simplex 122
6.2 Herpes Zoster (Shingles) 126
6.3 Varicella (Chickenpox) 129
6.4 Warts 131
6.5 Molluscum Contagiosum 137
6.6 Hand Foot and Mouth Disease 140
6.7 Erythema Infectiosum (Fifth Disease) 140
6.8 HIV Infection (AIDS) 141
Parasitic Infestations and Diseases Caused by Arthropods 145
7.1 Scabies 145
7.2 Pediculosis 151
7.3 Leishmaniasis 156
7.5 Myiasis 160
7.6 Filariasis 162
7.7 Onchocerciasis (River Blindness) 164
7.9 Insect Bites 165
7.10 Papular Urticaria 168
Eczema 170
8.1 Classification 170
8.2 Clinical Features 171
8.3 Treatment 173
8.4 Types of Eczema 176
Keratinizing and Papulosquamous Disorders 197
9.1 Psoriasis 197
9.2 Parapsoriasis 206
9.3 Lichen Planus 207
9.4 Pityriasis Rosea 213
9.5 Pityriasis Rubra Pilaris (PRP) 215
9.6 Parapsoriasis 216
9.7 Follicular Keratoses 216
9.8 Hyperkeratosis of the Palms and Soles 218
9.9 Corns 219
9.10 Congenital Disorders of Keratinization 221
Diseases of Connective Tissue 228
10.1 Lupus Erythematosus 228
10.2 Dermatomyositis (DM) 235
10.3 Scleroderma 238
10.4 Miscellaneous Disorders of Connective Tissue 243
10.5 Hereditary Disorders of Connective Tissue 246
Bullous Disorders: Autoimmune and Childhood Bullous Dermatoses 249
11.1 Pemphigus 250
11.2 Pemphigoid 255
11.3 Dermatitis Herpetiformis (DH): Duhring Brocq Disease 258
11.4 Acquired Epidermolysis Bullosa ( Epidermolysis Bullosa Acquisita) 261
11.5 Congenital Bullous Disorders 262
Vasculitis, Common Erythemas, and Lymphatic Disorders 269
12.1 Approach to a Patient with Vasculitis 270
12.2 Diagnosis 270
12.3 Treatment 270
12.4 Leucocytoclastic Vasculitis 271
12.5 Henoch–Schonlein Purpura (HSP) 272
12.6 Polyarteritis Nodosa 274
12.7 Pyoderma Gangrenosum 275
12.8 Giant Cell Arteritis 276
12.9 Erythema Multiforme 276
12.10 Erythema Nodosum (EN) 279
12.11 Common Localized Erythemas 281
12.12 Generalized Nonspecific Erythemas 282
12.13 Pigmented Purpuric Dermatosis (PPD) 282
12.14 Lymphatic Disorders 284
Exanthems and Hypersensitivity Syndromes 287
13.1 Exanthems 287
13.2 Hypersensitivity Syndromes ( Toxic Erythemas) 291
Urticaria 297
14.1 Investigations 299
14.2 Treatment 300
14.3 Mastocytosis 302
Pruritus 303
15.1 Etiology 303
15.2 Evaluation of the Itching Patient 305
15.3 Investigations 306
15.4 Treatment 306
15.5 General Guidelines 310
Leg Ulcers 311
16.1 Venous Ulcers 311
16.2 Arterial Ulcers 315
16.3 Decubitis Ulcers (Bedsore) 318
16.4 Neuropathic Ulcers 318
Disorders of Pigmentation 320
17.1 Albinism 320
17.2 Vitiligo 322
17.3 Melasma (Chloasma) 326
17.4 Freckles 328
17.5 Acanthosis Nigricans (AN) 329
17.6 Periocular Hyperpigmentataion 330
Disorders of Ultraviolet Radiation and Injuries Due to Cold 332
18.1 Sites of Photosensitive Eruption 333
18.2 Direct Effect of Sunlight on the Skin 335
18.3 Photosensitive Skin Reactions 341
18.4 Skin Diseases Affected by Sunlight 341
18.5 Congenital Disorders Leading to Increased Photosensitivity 342
18.6 Injuries Due to Cold 347
Diseases of the Sebaceous, Sweat, and Apocrine Glands 351
19.1 Acne Vulgaris 351
19.2 Rosacea 359
19.3 Perioral Dermatitis 361
19.4 Hyperhidrosis of the Hands, Feet, and Axilla 362
19.5 Miliaria (Prickly Heat) 364
19.6 Congenital Disorders of the Sweat Glands 365
19.7 Intertrigo 367
19.8 Hidradenitis Suppurativa (HS) 368
19.9 Bromhidrosis (Fetid Sweat) 369
19.10 Tumors of the Sweat Glands 369
Hair Disorders 372
20.1 Excessive Hair 373
20.2 Loss of Hair (Alopecia) 377
20.3 Disorders of Color and Texture 386
20.4 Tumor of the Hair Follicles 387
20.5 Miscellaneous Disorders 389
Nail Disorders 394
21.1 Paronychial Disorders 394
21.2 Common Nail Dystrophies 399
21.3 Discoloration 402
21.4 Tumors Adjacent to and Under the Nails 403
21.5 Differential Diagnosis of Common Nail Disorders 405
Diseases of the Subcutaneous Tissue 407
22.1 Panniculitis 407
22.2 Fat Dystrophies 409
22.3 Dercums Disease (Adiposis Dolorosa) 409
22.4 Sclerema Neonatorum 410
22.5 Subcutaneous Fat Necrosis of the Newborn 410
22.6 Cellulite 411
Tumors of the Skin 412
23.1 Benign Tumors 412
23.2 Premalignant Tumors 421
23.3 Malignant Tumors 424
Naevi and Hereditary Disorders of the Skin 441
24.1 Naevi 441
24.2 Neurofibromatosis 452
24.3 Adenoma Sebaceum ( Tuberous Sclerosis) 454
Skin and Malnutrition 456
25.1 Vitamin and Mineral Deficiency and Their Effects on the Skin 458
Skin and Systemic Disease 460
26.1 Diabetes Mellitus 460
26.2 Liver Disease 462
26.3 Kidney Disease 465
26.4 Rheumatoid Arthritis 466
26.5 Hyperthyroidism 468
26.6 Hypothyroidism 468
26.7 Cushing’s Syndrome 469
26.8 Addison’s Disease 469
26.9 Acromegaly 470
26.10 Hyperlipidemias 470
26.11 Phenylketonuria 472
26.12 Sarcoidosis 473
26.13 Skin and Immunodeficiency 475
26.14 Skin and Internal Malignancy 476
Skin and the Psyche 479
27.1 The Effect of Skin Disease on the Psyche 479
27.2 The Effect of the Psyche on the Skin 480
Erythroderma 484
28.1 Diagnosis 486
28.2 Treatment 486
Ages of Man and Their Dermatoses 487
29.1 Neonates and Infants 487
29.2 Skin and Pregnancy 490
29.3 Dermatoses of Pregnancy 490
29.4 Skin and the Menopause 492
29.5 Cutaneous Disease at the Menopause 492
29.6 Aging Skin 493
29.7 Dermatoses of Old Age 494
29.8 Looking Younger 494
Diseases of the Oral Cavity 496
30.1 Apthous Ulcer 496
30.2 Oral Candidiasis (Trush) 498
30.3 Leukoplakia 499
30.4 White Hairy Leukoplakia 500
30.5 Submucous Fibrosis 501
30.6 Lichen Planus 502
30.7 Betel Leaf Stomatitis 503
30.8 Lesions on the Tongue 504
30.9 Lesions on the Lips 504
Diseases of the External Genitalia 508
31.1 Vulval Intraepithelial Dysplasia (VIN) 508
31.2 Paget’s Disease 509
31.3 Lichen Sclerosus (LS) 509
31.4 Erythroplasia of Queyrat 510
Miscellaneous Disorders 512
32.1 Amyloidosis 512
32.2 Mucinosis 514
32.3 Langerhans Cell Histiocytosis 515
32.4 Benign Lymphocytic Cutaneous Infiltrations 516
32.5 Kyrle’s Disease 517
32.6 Granuloma Annulare 517
32.7 Reiter’s Disease 518
32.8 Poikiloderma 519
32.9 Cutis Verticis Gyrata 520
Drug Reactions 521
33.1 Classification of Drug Reactions 521
33.2 Approach to a Patient with a Suspected Drug Reaction 522
Management of Skin Diseases 526
34.1 Principles of Topical Therapy 526
34.2 Drugs Commonly Used in the Management of Skin Disorders 528
34.3 Immunobiologicals 541
34.4 Topical Immunomodulators 544
34.5 Physical Modalities Used in the Management of Skin Disorders 546
Compression Bandaging for Venous Ulcers 553
A1.1 Four-Layer Compression Bandage 554
A1.2 Two-Layer Compression Bandage 554
Patch Testing and Prick Testing 556
A2.1 Patch Testing 556
A2.2 PhotoPatch Testing 559
A2.3 Prick Testing 559
Removal of the Nail by Urea 561
A3.1 Method 561
Photochemotherapy 562
A4.1 Ultraviolet Radiation 562
A4.2 Photochemotherapy 563
Laser Therapy 567
Cryotherapy 570
A6.1 Macroscopic Changes After Cryosurgery 571
A6.2 Contraindications to Cryosurgery 572
A6.3 Side Effect of Cryosurgery 572
Management and Care of Wounds 573
A7.1 Type of Wound and Dressings to Use 574
Bibliography 576
Index 578