Are You Confident of the Diagnosis? Characteristic findings on physical examination Dermatosis papulosa nigra is found in black people. It is assumed that dermatosis papulosa nigra in fact is a variant of seborrheic keratosis in darkly pigmented people. The lesions occur usually as multiple black papules with a diameter of 1 to 5mm. They are…
Are You Confident of the Diagnosis? The clinician should be alert for dermatomyositis in the following clinical scenarios: –in any photosensitive eruption (Figure 1) Figure 1. Dermatomyositis may present as a photodermatitis, as manifested by the facial involvement and “V” of the neck onto the chest. –photosensitive eruption in the setting of muscle weakness or…
Are You Confident of the Diagnosis? What you should be alert for in the history Most often patients have an antecedent history of asthma and/or severe allergic rhinitis with elevated eosinophil counts. Skin lesions may present as palpable purpura, papules on the extensor extremities, persistent urticarial lesions, livedo, nodules or ulceration (Figure 1). Skin lesions…
Are You Confident of the Diagnosis? A diagnosis of basal cell nevus syndrome (BCNS) is based on the presence of at least two major criteria or at least one major and two minor criteria. Major criteria: basal cell carcinoma (BCC; multiple and/or early onset, ie, before 20 years of age) odontogenic keratocysts of the jaw…
Are You Confident of the Diagnosis? Hypohidrotic ectodermal dysplasia (HED) is the most correct term for this inherited condition. Other synonyms include anhidrotic ectodermal dysplasia, but this is a misnomer, as affected individuals are typically able to sweat to some degree. What to be alert for in the history Sweating is greatly diminished. An infantile…
Are You Confident of the Diagnosis? The procedure for angioedema is closely related to that for urticaria (see chapter on Chronic Spontaneous Urticaria.) What to be alert for in the history Of all the diagnostic procedures, the most important is to obtain a thorough history, including all possible eliciting factors and significant aspects of the…
Are You Confident of the Diagnosis? Seborrheic keratosis (SK) is a very frequent benign epithelial skin tumor. It usually is asymptomatic, but occasionally itching, bleeding, pain, redness and crusting is observed after trauma or irritation. In most cases patients will ask for removal of SK due to aesthetic reasons. Characteristic findings on physical examination SK…
Are You Confident of the Diagnosis? What you should be alert for in the history Lymphomatoid papulosis (LyP) is characterized by a chronic relapsing course with grouped or disseminated papulonodular lesions involving the trunk and/or extremities. The duration of the disease may vary from less than 1 year to several decades. The eruption is generally…
