Acne keloidalis, or acne keloidalis nuchae (AKN), refers to the keloid-like lesions occurring on the occiput or nape, primarily in young African-American men, with only a few women having the condition. Development occurs in a window between puberty and 50 years of age. The term acne keloidalis is a misnomer: • Keloidal collagen is u
Actinic damage, also called sun damage, represents skin changes due to excessive sun exposure. Ultraviolet light A (UVA) interferes with DNA repair through the release of reactive oxygen, resulting in oxidation of both protein and lipids, whereas ultraviolet light B (UVB) causes DNA mutations. Signs of sun damage include: • Atrophy &
Actinic keratosis (AK) becomes more prevalent with advanced age. Over one million new cases are reported annually. This lesion is the principal precursor of squamous-cell carcinoma (SCC) of the skin (6-10%), and 60% of all SCC develop from AK. Some authors consider it as a type of carcinoma in situ. AK occurs more frequently in Caucasians with long exposure
The word aphthae is usually used for any painful ulcer of the mucosa, especially the oral mucosa. True aphthae, however, are considered, when one or more areas are ulcerated in the mouth. They have a recurrent pattern and rapid onset. They are painful, well demarcated, necrotic at first, and not preceded by vesicles or bullae. The best term to define this
Atopic dermatitis (AD), sometimes called eczema, is a chronic dermatitis, beginning as early as the first months of life and usually found first on the face and on the extensor sides of the arms and legs are. It is the most prevalent childhood skin disorder, with more than 10% of children afflicted in developed countries. AD is associated with hay fever and asthma
Basal cell carcinoma (BCC) is the most common type of skin cancer in man. It is a malignancy that develops from cells in the basal layer of the epidermis. The incidence of BCC has risen rapidly in recent years due to the influence of excessive sun exposure in a generation that is now approaching its golden age. An estimated 1 million new cases are diagnosed
Cellulite is an anatomical alteration to the cutaneous surface that confers a mattress, cottage cheese, and orange skin appearance to the affected areas. It may vary from patient to patient, regarding its severity and intensity. Cellulite mainly occurs in women, affecting the thighs and buttocks, due to the particular anatomy of the women’s body with the sub
• Cheilitis is the name given to the inflammatory processes of the lips provoked by various factors. Those with specific histology and eventual labial location, as lichen planus, lupus erythematosus, pemphigus and syphilis, are excluded from the group of cheilitis. The main classically described cheilitis in medical literature for its clinical im
• Dermatosis papulosis nigra (DPN) is a common affliction on the face and neck of skin of color patients, with an incidence of upwards of 70%, being more common in women. When DPN was first described in 1925, it was thought that it was a genetic problem of West Africans; however, it has occasionally been diagnosed in white patients. While the etiology is uncle
“Any rash can be due to any drug.” It is an inescapable truth that more and more people — primarily the older population — are taking increasingly more over-the-counter and prescription medications. New drugs for all types of disorders - high blood pressure, stomach ulcers, diabetes, high cholesterol, etc. — are appearing in t
The term dyshidrosis describes a situation of disturbed sweating in contrast to normal sweating (normohidrosis). It is also known as: • Chronic vesiculobullous hand dermatitis • Dyshidrotic hand dermatitis • Dyshidrotic hand eczema • Pomphylox Dyshidrosis represents the combination of v
Folliculitis represents inflammation of the hair follicles in areas of the body where these appendages are more prominent than the sebaceous glands. Hair follicles predominate over the sebaceous glands on the scalp, trunk, arms, and legs, as opposed to the face where the sebaceous glands are larger and more numerous, where acne develops rather than folliculitis.&n
Hair loss may be called baldness, thinning hair, or the preferred Alopecia, from the Greek. Contrary to popular belief, washing the hair daily, wearing a hat, and standing under the shower nozzle do not cause hair loss. Hair is dead tissue, and no amount of “hair food” will change the growth cycle. Hair remains on the scalp for five to se
Herpes simplex infection is the result of the herpes simplex virus (HSV) invading the dorsal root ganglia. The virus is often reactivated, leading it to spread down neuronal axons in spinal or trigeminal nerves and either to be shed asymptomatically in saliva (HSV-1) or genital secretions (HSV-2), or to cause disease of the skin, mucosa (erythema multiforme) and o
Herpes zoster (HZ), also called shingles, is the result of re-activation of the varicella-zoster virus (HSV) for unknown reasons. HSV, which has remained in the nerve endings from the time of childhood chickenpox, emerges many years later. Clinically, there are clusters of vesicles on a red base that evolve into crusted areas. The infecti
Hirsutism, defined as excessive male-pattern hair growth, affects between 5 and 10 per cent of women of reproductive age. A separate term, virilization, refers to the state in which androgen levels are sufficiently high to cause not only hirsutism, but also additional signs and symptoms such as deepening of the voice, breast atrophy, increased muscle bulk, and cli
Primary focal hyperhidrosis is defined as excess sweating in selected areas that is not associated with an underlying disease process. The most common locations are the axillae, palms, soles, and face. This condition affects otherwise healthy individuals and significantly impairs their activities of daily living. It is important to distinguish this t
A keloid is a raised, firm, progressively enlarging type of “scar”, projecting above the skin surface, and is a benign lesion. The diagnosis is based upon clinical appearance. It develops where the skin has been previously injured and usually appears as a shiny, dome shaped, pink to reddish nodule. There is no way to predict when a keloid w
A keratinous cyst is the most common kind of epidermal cyst and is filled with keratin originating from the epidermis, most often from a hair follicle. Once called a sebaceous cyst, it arises spontaneously and is prone to rupture. It is most commonly found on the trunk, nape, and behind the ears. When a cyst appears on the scalp, it is most commonly a
Keratosis pilaris (KP)is a common skin condition, caused when dead skin cells accumulate around the opening of a hair follicle, forming a tiny pointed plug. This results in skin that is rough to the touch, appearing noticeably bumpy and having a texture similar to coarse sandpaper. KP usually occurs on the cheeks and the backs of the upper arms but can
Melanoma is the most serious cancer of the skin and its incidence is increasing, possibly due to the reduction of the ozone layer, allowing more sun exposure. Melanoma is a curable malignancy, when discovered early enough. Unfortunately, many patients still die from this skin cancer - even young people, because they do not heed the warning signs. Some
Melasma is an acquired condition, also known as chloasma or the “mask of pregnancy,” because it usually occurs during the second or third trimester of pregnancy. Melasma is a type of hyperpigmentation and is caused by an increase in melanin, the substance responsible for color (pigment). The disease is more common in women due to taking oral cont
A milial cyst (milium s, milia p) is a small keratin-filled cyst, often found on the face. It represents hardened keratin that distinguishes a whitehead from an epidermal inclusions cyst. The milium is associated with a vellus hair follicle or eccrine sweat duct. This lesion is quite common in women who apply moisturizers and are also found in one out of 12
Molluscum contagiosum (MC) is a common viral disease, caused by a poxvirus distinct from other poxviruses (large 200 by 300 nm DNA virus), which infects the skin and mucous membranes in both children and adults. The characteristic lesion is a discrete pearly dome shaped papule, which look like M&M candies pasted on the skin. They often appear in clusters
The nail unit is not only a very important but also a much overlooked and neglected anatomical structure. It is composed of the nail matrix (growth center of the nail), the nail plate (cosmetic component upon which enamel is placed), the nail bed (skin-like portion beneath the nail plate and the most common site for fungal infections), and the proximal and lateral
Neurodermatitis is a term that is frequently used by dermatologists and patient alike. It involves itching, redness, and lichenification of various parts of the body. The concept for this type of eczema is vague, but some details of the disease, better termed lichen simplex chronicus, include: 1. There are no primary lesions, with scratching, ind
Poikiloderma of Civatte (PC) is a common skin condition, affecting fair skinned, middle-aged, or older people. It is more often diagnosed in menopausal women, but, occasionally, also in men. PC is characterized by a combination of linear telangiectasia, mottled hyperpigmentation, and superficial atrophy in a reticular pattern. The etiology is unclear, but a predi
Psoriasis is a chronic inflammatory disease affecting the skin and not-infrequently the joints. This inherited condition causes considerable distress and affects 1-3% of the United States and European populations, with approximately 25% of patients having moderate to severe disease. Some 40% of psoriatic patients also have psoriatic arthritis. Patients
Rosacea is a common skin condition which is sometimes called “The Curse of the Celts,” due to its tendency to affect mostly fair skinned people. Patients who develop rosacea often have an unpleasant redness of the face. This can be associated with flushing, and in its typical form, there is an outbreak of red spots, both bumps and pustules
Scabies, also known as the seven year itch, is a dermatologic condition caused by infestation of the mite Sarcopetes scabiei var hominis. The female mite is located in the upper layers of the epidermis, just below the surface. Intense pruritus, usually worse in the evening, is the main symptom. Burrows, a characteristic skin lesion associated with sca
Sebaceous gland hyperplasia represents a 1 to 4 mm flesh-colored elevated lesion, often with a central dell, that occurs on the face. Sometimes mistaken for a wart or an acne papule, this is entirely benign lesion due to obstruction of the pilo-sebaceous gland orifice. Treatment is readily accomplished with light electrodesiccation, cryosurgery, or repeated
Seborrheic dermatitis (SD) represents redness, scaling, and even crusting that is found in many areas: • Scalp • Glabella (between the eyebrows) • Paranasal area • Post-auricular area (behind the ears) • Sternum • Axillae • Inframmary areas (unde
Seborrheic keratoses (SKs) are one of the most common skin growths occurring on older adults. These brownish to pale lesions, sometimes even black, are flat or slightly elevated papules or plaques ranging from a few millimeters to over 2.5 cm in diameter. They can present as solitary or - more commonly - clustered lesions, on the face, neck, chest, back and
Squamous cell carcinoma (SCC) is the second most common type of skin cancer in man. It is a malignancy that develops from cells in the upper layer of the epidermis. An estimated 250,000 new cases are diagnosed in the United States, annually. Although SCCs are more common in fair-skinned individuals, more than two thirds of the skin cancers that dark-skinned individuals
Tinea versicolor (TV), also called pityriasis versicolor, is a superficial fungal infection, caused by the yeast Malassezia furfur or possibly M. globose. The organism seems to represent the mycelial phase of Pityrosporum ovale and P. orbiculare that are part of the normal skin flora. This may explain why TV can be treated but not cured, thus returning at irregular inte
Common warts are ubiquitous scaly, rough, papules or nodules, which may be found on all skin surfaces, especially the hands, feet, and face. They are called verrucae vulgaris (VV) and occur from childhood onwards. Several specific names may be used: plantar warts – lesions on the plantar surface of the feet; flat warts – minimally elevated
Vitiligo is an acquired progressive autoimmune skin disorder characterized by white depigmented patches due to selective destruction of epidermal melanocytes. It is relatively common affecting approximately 1% of the population, equally prevalent between both sexes, and found in all races. Vitiligo may appear at any time, although the onset is most commonly
