Contents

Part I Introduction

The

Starter Kit ............................................................................................... 3

1.1

General Advice on Studying ................................................................... 4

1.1.1
1.1.2
1.2

How to Study ............................................................................ 4

Logic of This Book ................................................................... 4

Describing Skin Conditions .................................................................... 6

1.2.1

Primary Lesions (Defining

Lay Terms) .............................................................................. 10

1.2.2
1.2.3

Secondary Lesions 13
Other Non-specific Terms (Try to Limit
Use, but Impossible to Avoid) ................................................ 14

1.3

Describing Dermatopathology Findings .....................................

1.3.1
1.3.2
1.3.3

14

Dermpathology Terminology ................................................. 14

A Few Quick Tips ................................................................... 16
Approaching Histopathologic
Description .............................................................................. 16

1.3.4
1.4

Immunofluorescence Findings ................................................ 17

Morphologic Reaction Patterns ............................................................ 18

Part II Medical Dermatology Outlines

Papulosquamous Diseases................................................................................. 23

2.1

Psoriasiform .......................................................................................... 24

2.1.1
2.1.2
2.1.3
2.1.4
2.1.5

Psoriasis .................................................................................. 24
Seborrheic Dermatitis ............................................................. 27
Parapsoriasis ........................................................................... 28
Mycosis fungoides (MF)......................................................... 29
Reactive arthritis (Formerly Reiters
syndrome) ............................................................................... 29
IX

Contents

2.1.6
2.1.7

Pityriasis rubra pilaris (PRP) .................................................. 29

Palmoplantar keratoderma (PPK) ..................................

Pityriasiform
Pityriasis Rosea (PR)
Secondary Syphilis
Tinea/Dermatophytoses
Pityriasis (Tinea) Versicolor
Pityriasis Rotunda
Lichenoid
Lichen Planus (LP)
Lichenoid Drug Reaction
Lichen Nitidus
Lichen Striatus
Graft vs. Host Disease (GVHD)
Keratosis Lichenoides Chronica
Erythroderma/Exfoliative Dermatitis
Other (Not Traditionally Thought of as Papulosquamous,
but maybe Pink, Raised, and Scaly)

Eczematous Diseases

3.1

The Three Stages of Eczema

3.1.1
3.1.2
3.1.3
3.2

Acute
Subacute
Chronic

Types of Eczema

3.2.1
3.2.2
3.2.3
3.2.4
3.2.5

Contact Dermatitis
Atopic Dermatitis
Nummular Dermatitis
Dyshidrotic Eczema/Pompholyx
Id Reaction (Autosensitization or
Autoeczematization Dermatitis)

3.2.6
3.2.7
3.2.8
3.2.9

Infectious Eczematoid
Drug Dermatitis
Stasis Dermatitis
Cutaneous T-Cell Lymphoma (CTCL)/
Mycosis Fungoides (MF)

3.2.10

Asteatotic Dermatitis
(Eczema Craquele)

30

Contents

3.2.11

XI

Lichen Simplex Chronicus

(LSC)/Prurigo Nodularis

3.2.12

Exfoliative Dermatitis
(Erythroderma)

3.2.13
3.2.14

Seborrheic Dermatitis
Other Eczemas

4 .................................................................................................
Vesiciilohullous Diseases

4.1
4.2
4.3
4.4

Subcorneal Blisters/Superficial
Intraepidermal Blisters
Suprabasilar Blisters
Subepidermal Blisters

4.4.1
4.4.2
4.4.3
4.4.4
4.5

Neutrophilic
Lymphocytic
Eosinophilic and Mixed
Non-inflammatory/Cell-Poor

Other

5 .................................................................................................
Vascular Diseases

5.1

Toxic Erythema

5.1.1

Viral Exanthems
(Children > > Adults)

5.1.2

Drug Eruptions
(Adults > > Children)

5.1.3
5.1.4
5.2

Scarlatiniform Eruptions
Other Reactive Toxic Erythema

Figrate Erythemas
(Annular or Gyrate Erythemas)

5.3
5.4
5.5

Urticaria
Erythema Multiforme (EM)
Purpura

5.5.1
5.5.2
5.5.3

Palpable Purpura/Vasculitis
Macular Purpura
Vasculopathy

5.6
5.7
5.8

Regional Erythema
Vascular Tumors
Other

xii Contents

6 .................................................................................................
Dermal Diseases........................................................................................................................... 107

6.1

Inflammatory

6.1.1
6.1.2
6.1.3
6.1.4
6.1.5
6.1.6
6.1.7
6.2
6.3

Lymphocytic
Granulomatous/Histiocytic
Neutrophilic
Eosinophilic
Mastocytic
Plasmacytic
Mixed Cell Infiltrate

Neoplastic
Depositional

6.3.1
6.3.2
6.3.3
6.3.4
6.3.5
6.3.6
6.3.7

Amyloid
Calcium
Urate
Mucin
Lipid
Pigment Deposition
Hyaline-Like Material
Deposition

6.3.8 Implantable Depositions

6.3.9 Porphyrias
6.3.10 Storage Disorders
6.4

Subcutaneous/Panniculitis

6.4.1
6.4.2
6.4.3

Mostly Septal Panniculitis

Mostly Lobular Panniculitis
Other

7 .................................................................................................
Neoplastic Diseases ............................................................................................... 151

7.1
7.2
7.3
7.4

Keratinocyte Neoplasms
Melanocytic Neoplasms
Adnexal Tumors
Other Epidermal
Neoplasms/Hyperplasias

7.5
7.6
7.7
7.8

Vascular Tumors
Spindle Cell Tumors
Fatty Tumors
Cysts

Contents xiii

7.9
7.10
7.11
7.12
7.13

Lymphatic Malformations
Lymphomas
Other Malignant (Including Metastatic)
Other Benign
Syndromes with Multiple Tumors
or Multiple Types of Tumors

7.14
7.15

Paraneoplastic Syndromes
Skin Diseases Associated with Monoclonal
Gammopathy

8 .................................................................................................
Acneiform Diseases ............................................................................................... 227

8.1
8.2
8.3

Acne
Rosacea
Folliculitis

8.3.1
8.3.2
8.3.3
8.4

Superficial Folliculitis
Deep Folliculitis
Pseudofolliculitis

Follicular Cysts

9 .................................................................................................
Alopecia................................................................................................................ 237

9.1

Scarring Alopecia

9.1.1
9.1.2

Inflammatory Scarring Alopecia

Non-Inflammatory Scarring
Alopecia

9.2

Non-Scarring Alopecia

9.2.1

Non-Inflammatory Non-Scarring
Alopecia

9.2.2

Inflammatory Non-Scarring
Alopecia

9.3

Genodermatoses Associated
with Alopecia

9.4

Hair Shaft Abnormalities

9.4.1

Structural Abnormalities
with Increased Hair Fragility

9.4.2

Structural Abnormalities
Without Hair Fragility

9.5

Excess Hair Growth

xiv Contents

10 .................................................................................................
Connective Tissue Diseases....................................................................................... 249

10.1
10.2
10.3

Lupus Erythematosus (LE)

Dermatomyositis
Sclerotic Disease

10.3.1

Scleroderma/Systemic
Sclerosis

10.3.2

Lichen Sclerosus
(et atrophicus)

10.3.3

Other Sclerodermoid
Conditions

10.4
10.5
10.6

Rheumatoid Arthritis
Sjogrens Syndrome
Other Autoimmune Connective
Tissue Diseases

10.7

Non-Autoimmune Connective
Tissue Diseases

10.7.1

Inherited Non-Autoimmune
Connective Tissue Diseases

10.7.2

Acquired Non-Autoimmune
Connective Tissue Diseases

11 .................................................................................................
Infectious Diseases ................................................................................................... 265

11.1

Bacterial

11.1.1
11.1.2
11.2
11.3

Fungal
Subcutaneous Fungal
Deep/Systemic Fungal Infection
Typical Mycobacteria
Atypical Mycobacteria

Viral

11.5.1
11.5.2
11.6

Superficial Fungal

Mycobacteria

11.4.1
11.4.2
11.5

Gram Negative Bacteria

Treponemes and Spirochetes

11.3.1
11.3.2
11.3.3
11.4

Gram Positive Bacteria

DNA Viruses
RNA Viruses

Sexually Transmitted

Infections (STIs)

11.7

Congenital Infections: TORCHeS

Contents

11.8

Parasites

11.8.1
11.8.2
11.9

Protozoa
Helminths (Worms)

Infestations

11.9.1
11.9.2
11.10

xv

Arthropods (Insects)
Arachnids

Other Bites and Stings

12 ................................................................................................
Pigmentary Disorders .............................................................................................. 325

12.1

Hyperpigmented Conditions

12.1.1
12.1.2

Localized Hyperpigmentation
Generalized
Hyperpigmentation

12.2

Hypopigmented Conditions

12.2.1
12.2.2

Localized Hypopigmentation
Segmental/Nevoid
Hypopigmentation

12.2.3
12.2.4

Generalized Hypopigmentation
Leukodermas
(Depigmentation)

12.3
12.4

Reticulated Pigmentation
Mixed Hyper and Hypopigmentation

13 ................................................................................................
Keratotic Diseases .................................................................................................... 337

13.1

Ichthyoses

13.1.1

Retention of Keratin (Retention

Hyperkeratosis)

13.1.2

Hyperproliferation
of Keratin (Proliferative Hyperkeratosis)

13.1.3

Genodermatoses With
Ichthyosis
or Erythrokeratodermia

13.2

Palmoplantar Keratoderma (PPK)

13.2.1

Inherited Palmoplantar
Keratodermas

13.2.2

Acquired Palmoplantar
Keratoderma

13.3

Papillomatous Epidermal Eruptions

XVI

Contents

13.4

Hyperkeratotic/Verrucous
Lesions and Eruptions

13.5
13.6
13.7
14

Prurigo and Lichen Simplex

Perforating Disease
Porokeratosis

Nutritional Diseases ........................................................................................ 357

14.1

General Nutrition Deficiency/

Protein-Energy Malnutrition

14.2
14.3
14.4
14.5
14.6
14.7

Vitamin Deficiencies
Hypervitaminosis/Vitamin Excess
Mineral Deficiencies
Mineral Excess
Other Deficiencies/Excesses
Other Diseases Associated
with Malnutrition

Part III Lists and Mnemonics

15

Lists, Common Differential Diagnoses,

and Mnemonics ............................................................................................... 369

15.1

Differentials ................................................................................... 370

15.1.1
15.1.2
15.1.3

Triads and Near Triads ................................................. 370

Important Clinical Differentials ...

373

Differentials by Distribution/
Anatomic Location ...................................................... 377

15.1.4

Differentials by Morphology and

Configuration ............................................................... 382

15.1.5
15.1.6

Other Clinical Differentials ..................................

384

Other Disease Category

Differentials ................................................................. 385

15.2

Associations and Work-Ups .......................................................... 389

15.2.1
15.2.2
15.3

Disease-Specific Associations .............................

389

Work-Ups ..................................................................... 391

Acronyms....................................................................................... 394

15.3.1
15.3.2

List of Acronyms ......................................................... 394

Diseases Known Primarily
by Acronyms ................................................................ 397