Atlas of Dermatology in Internal Medicine (eBook)

NéstorP. Sánchez, MDProfessor of Pathology and Dermatology and chairmanDepartment of DermatologyUniversity of Puerto RicoMedical Sciences CampusSchool of MedicineSan Juan, Puerto Rico

Atlas of Dermatologyin Internal Medicine 3
Preface 7
Acknowledgments 9
Contents 11
Contributors 13
Cutaneous Manifestations of Connective Tissue Diseases 15
Introduction 15
Systemic Lupus Erythematosus 15
Acute Cutaneous Lupus Erythematosus 15
Subacute Cutaneous Lupus Erythematosus 15
Chronic Cutaneous Lupus Erythematosus 16
Bullous Systemic Lupus Erythematosus 17
Classification and Treatment 17
Dermatomyositis 18
Classification and Treatment 20
Scleroderma 20
Systemic Sclerosis 20
Morphea or Localized Scleroderma 22
Classification and Treatment 23
Rheumatoid Arthritis 24
Introduction 24
Classic Rheumatoid Nodules 24
Accelerated Rheumatoid Nodulosis 25
Rheumatoid Nodulosis 26
Rheumatoid Vasculitis 26
Pyoderma Gangrenosum 27
Interstitial Granulomatous Dermatitis with Arthritis 28
Palisaded Neutrophilic Granulomatous Dermatitis 28
Conclusion 29
References 29
Cutaneous Manifestations of Pulmonary Disease 31
Sarcoidosis 31
Specific Sarcoidosis 32
Lupus Pernio (Besnier–Boeck–Schaumann Disease) 32
Papules, Macules, Nodules, and Plaques 32
Subcutaneous Nodules (Darier–Roussy) 33
Scar Sarcoidosis 33
Alopecia 35
Ichthyosiform Sarcoidosis 35
Hypopigmentation 35
Nonspecific Sarcoidosis 35
Erythema Nodosum 35
Other 35
Nail, Mucosal, and Childhood Sarcoidosis 35
Treatment 36
Tuberculosis 36
True Cutaneous Tuberculosis 37
Endogenously Acquired Disease 37
Lupus Vulgaris 37
Scrofuloderma 38
Acute Miliary Tuberculosis 38
Orificial Tuberculosis 39
Exogenously Acquired Disease 39
Tuberculous Chancre 39
Tuberculosis Verrucosa Cutis 39
Tuberculids 39
Lichen Scrofulosorum 40
Erythema Induratum of Bazin 40
Papulonecrotic Tuberculid 40
Nodular Tuberculid 40
Treatment 40
Birt–Hogg–Dubé Syndrome 40
Fibrofolliculoma 41
Trichodiscomas 41
Acrochordons 41
Cystic Fibrosis 41
References 42
Cutaneous Manifestations of Renal Disease 45
Introduction 45
General Changes 45
Uremic Pruritus 45
Calcinosis Cutis 46
Calciphylaxis 47
Nephrogenic Systemic Fibrosis 48
Bullous Disease of Hemodialysis 49
Porphyria Cutanea Tarda 49
Pseudoporphyria 49
Conclusion 50
References 50
Cutaneous Manifestations of Gastrointestinal Diseases 55
Inflammatory Bowel Disease 55
Erythema Nodosum 55
Pyoderma Gangrenosum 57
Sweet’s Syndrome 58
Nutritional and Metabolic Disorders 59
Dermatitis Herpetiformis 59
Lichen Planus 60
Gastrointestinal Hemorrhage 61
Kaposi’s Sarcoma 61
Gastrointestinal Neoplasias 61
Gardner’s Syndrome 61
Müir–Torre Syndrome 62
Peutz–Jeghers Syndrome 63
Bazex’s Syndrome 63
Necrolytic Migratory Erythema 63
Conclusions 64
References 64
Cutaneous Manifestations of Common Endocrine Disease 66
Thyroid Disease 66
Hyperthyroidism 66
Hypothyroidism 67
Diabetes Mellitus 68
Acanthosis Nigricans 68
Necrobiosis Lipoidica Diabeticorum 68
Miscellaneous Conditions 69
Adrenal Disorders 69
Conclusion 71
References 71
Cutaneous Manifestations of Internal Malignancy and Paraneoplastic Syndromes 72
Cutaneous Metastasis of Internal Malignancies 72
Sister (Mary) Joseph’s Nodule 74
Cutaneous Manifestations of Internal Malignancies: Symptoms, Signs, and Other Distinct Disease Entities 75
Paget’s Disease of the Breast and Extramammary Paget’s Disease 75
Paraneoplastic Syndromes: A Brief Overview 77
Acanthosis Nigricans 77
The Sign of Leser–Trélat 78
Tripe Palms (Pachydermatoglyphy) 78
Acrokeratosis Paraneoplastica (Bazex’s Syndrome) 79
Necrolytic Migratory Erythema 79
Erythema Gyratum Repens 81
Acute Febrile Neutrophilic Dermatosis (Sweet’s Syndrome) 81
Acquired Ichthyosis 84
Paraneoplastic Pemphigus 84
Conclusion 85
References 85
Cutaneous Manifestations of Infectious Diseases 90
Bacteria, Spirochetes, and Mycobacteria (Table  1) 90
Bacteria 90
Impetigo 90
Folliculitis 90
Introduction 90
Incidence and Prevalence 90
Etiology 90
Clinical Features 90
Diagnosis 91
Pathology 91
Differential Diagnosis 91
Complications 91
Treatment 92
Furuncles and Carbuncles 93
Introduction 93
Clinical Features 93
Etiology 93
Diagnosis 93
Pathology 94
Differential Diagnosis 94
Complications 94
Treatment 94
Cellulitis 94
Introduction 94
Incidence and Prevalence 94
Etiology 94
Clinical Features 96
Diagnosis 96
Pathology 96
Differential Diagnosis 96
Complications 96
Treatment 96
Methicillin-Resistant S. aureus 97
Introduction 97
Incidence and Prevalence 97
Etiology 97
Clinical Features 97
Diagnosis 97
Treatment 97
Erysipelas 98
Introduction 98
Etiology 98
Pathology 98
Differential Diagnosis 98
Complications 98
Treatment 98
Ecthyma 98
Introduction 98
Incidence and Prevalence 99
Etiology 99
Clinical Features 99
Diagnosis 99
Pathology 99
Differential Diagnosis 99
Complications 99
Treatment 99
Ecthyma Gangrenosum 99
Introduction 99
Incidence and Prevalence 99
Etiology 99
Clinical Features 99
Diagnosis 99
Pathology 100
Differential Diagnosis 100
Complications 100
Treatment 100
Staphylococcal Scalded Skin Syndrome 100
Introduction 100
Incidence and Prevalence 100
Etiology 100
Clinical Features 100
Diagnosis 100
Pathology 101
Differential Diagnosis 101
Complications 101
Treatment 101
Toxic Shock Syndrome 102
Introduction 102
Incidence and Prevalence 102
Etiology 102
Clinical Features 102
Diagnosis 102
Pathology 103
Differential Diagnosis 103
Complications 103
Treatment 103
Blistering Distal Dactylitis 104
Introduction 104
Incidence and Prevalence 104
Etiology 104
Clinical Features 104
Diagnosis 104
Differential Diagnosis 104
Treatment 104
Necrotizing Soft Tissue Infections 104
Introduction 104
Etiology 105
Clinical Features 105
Diagnosis 106
Pathology 106
Differential Diagnosis 106
Complications 106
Treatment 106
Rhinoscleroma 107
Introduction 107
Incidence and Prevalence 107
Etiology 107
Clinical Features 107
Diagnosis 107
Pathology 107
Differential Diagnosis 107
Complications 107
Treatment 107
Spirochetes 107
Leptospirosis 107
Introduction 107
Incidence and Prevalence 107
Etiology 108
Clinical Features 108
Diagnosis 108
Pathology 108
Differential Diagnosis 108
Complications 108
Treatment 108
Lyme Disease 109
Introduction 109
Incidence and Prevalence 109
Etiology 109
Clinical Features 109
Diagnosis 110
Pathology 110
Differential Diagnosis 110
Complications 110
Treatment 110
Mycobacteria 111
Hansen’s Disease 111
Introduction 111
Incidence and Prevalence 111
Etiology 111
Clinical Features 111
Diagnosis 111
Differential Diagnosis 113
Complications 113
Treatment 114
Atypical Mycobacteriosis 114
Introduction 114
Incidence and Prevalence 115
Etiology 115
Clinical Features 116
Diagnosis 116
Treatment 116
Fungal Infections 116
Superficial Mycoses 116
Inflammatory Superficial Mycoses 117
Dermatophytoses 117
Introduction 117
Incidence and Prevalence 117
Etiology 119
Diagnosis 119
Pathology 119
Complications 119
Treatment 119
Mucocutaneous Candidiasis 119
Introduction 119
Etiology 119
Clinical Features 119
Diagnosis 119
Treatment 119
Non-inflammatory Superficial Mycoses 121
Pityriasis Versicolor 121
Introduction 121
Incidence and Prevalence 121
Etiology 121
Clinical Features 122
Diagnosis 122
Pathology 122
Differential Diagnosis 122
Treatment 122
Subcutaneous Mycoses 123
Sporotrichosis 123
Introduction 123
Incidence and Prevalence 123
Etiology 123
Clinical Features 123
Diagnosis 124
Pathology 124
Differential Diagnosis 124
Treatment 124
Systemic Mycoses 125
Diagnosis 125
Treatment Histoplasmosis 125
Treatment Coccidioidomycosis 125
Treatment Blastomycosis 125
Treatment Paracoccidioidomycosis 125
Viral Infections 125
Varicella-Zoster Virus 125
Introduction 125
Incidence and Prevalence 125
Etiology 125
Clinical Features: Varicella 127
Clinical Features: Herpes Zoster 127
Diagnosis 128
Differential Diagnosis 128
Complications 128
Treatment 129
References 129
Cutaneous Manifestations of HIV Disease 133
Exanthem of Primary HIV Infection (Acute Retroviral Syndrome) 133
Bacillary Angiomatosis 133
Varicella-Zoster Virus 134
Seborrheic Dermatitis 135
Oral Hairy Leukoplakia 136
Mucocutaneous Candidiasis 136
Oral Thrush 136
Intertriginous Infections 137
Onychomycosis (Tinea Unguium) 137
Kaposi’s Sarcoma 137
Molluscum Contagiosum 138
Summary 139
References 139
Cutaneous Disorders in the Intensive Care Unit 140
Introduction 140
Pathogen-Related Skin Disorders 141
Dermatomycoses: Mucocutaneous Candidiasis 141
Pyoderma: Impetigo 142
Peripheral Vascular Disease-Related Skin Disorders 143
Meningococcal Septicemia 143
Ecthyma Gangrenosum 144
Drug Reaction-Related Skin Disorders 145
Hypersensitivity Syndrome or Drug Reaction with Eosinophilia and Systemic Symptoms 146
Steven–Johnson Syndrome and Toxic Epidermal Necrolysis 148
Hypersensitivity Vasculitis or Leukocytoclastic Vasculitis 150
Conclusion 152
References 152
Index 154