Exam 1: Dermatology Flashcards
Macule
Lesion is flat and small <1 cm
Ex: Mobiliform drug eruption, tinea versicolor, Benign melanocytic nevi, malignant melanoma
Patch
Lesion is flat and large >1 cm
Ex: seborrheic dermatitis, vitiligo, tinea cruris
Papule
Lesion is raised, small <1 cm, and not fluid filled
Ex: Basal cell carcinoma, skin tags, molluscum contagiosum, guttate psoriasis
Plaque
Lesion is raised, large >1 cm, but not fluid filled
Ex: Plaque psoriasis, atopic dermatitis, herald patch of pityriasis rosea, nummular dermatitis
Vesicle
Lesion is raised, small <1 cm, and filled with fluid
Ex: herpes Simplex virus, herpes zoster or shingles, rhus dermatitis or allergic contact dermatitis from poison ivy
Bulla
Lesion is raised, large >1 cm, and filled with fluid
Ex: Bullous fixed drug eruption, insect bites, and inherited skin fertility disorder
Good descriptions of skin findings include what 8 elements?
NUMBER- Solitary or multiple; estimate of total number
SIZE- Measured in millimeters or centimeters
COLOR- Including erythematous if blanching; if non-blanching, vascular-like cherry angiomas and vascular malformations, petechiae, or Purpera
SHAPE- Circular, oval, annular, nummular, or polygonal
TEXTURE- Smooth, flashy, verrucous or warty, keratotic; greasy if scaly
PRIMARY LESION- flat, a macule or patch; a papule or plaque; or fluid filled, a vesicle or bulla (May also be erosions, ulcers, nodules, ecchymosis, petechiae, and palpable Purpera)
LOCATION- Including measured distance from other landmarks
CONFIGURATION- Grouped, annular, linear
Blanching lesions
Are erythematous and suggest inflammation
Scaly can be ____, ____, or _____.
Include examples
1-Greasy (seborrheic dermatitis or seborrheic keratosis)
2-Dry and fine (tinea pedis)
3-Hard and keratotic (actinic keratosis or SCC)
Alopecia
Hair loss. Can be diffuse, patchy, or total.
The most common cause of diffuse hair thinning:
Male and female pattern baldness
What type of alopecia should be referred to a dermatologist?
Scarring alopecia
Sparse hair is seen in what condition?
Hypothyroidism
Fine, silky hair is seen in what condition?
Hyperthyroidism
What is the ABCDE – EFG rule and what does it stand for?
It is a method to teach clinicians and patients about features suspicious for melanoma. If 2 people or more of these are present, risk for melanoma increases and biopsy should be considered.
ASSYMETRY – of one side of mole compared to the other
BORDER IRREGULARITY – especially if ragged, notched, or blurred
COLOR VARIATIONS – more than 2 colors, especially blue-black, white (loss of pigment d/t regression), or red (inflammatory reaction to abnormal cells)
DIAMETER greater than 6 mm - approximately the size of a pencil eraser
EVOLVING- or changing rapidly in size, symptoms, or morphology
ELEVATED
FIRM to palpation
GROWING progressively over several weeks
Is a homogeneous blue color in a blue nevus concerning for melanoma?
No. Blue or black color within a larger pigmented lesion is concerning for melanoma.
Early melanomas may be ____, and many benign lesions are ______. (Sizes)
Early melanomas may be <6 mm and many benign lesions are >6mm.
What are signs of chronic sun damage?
Numerous solar lentigines on the shoulder and upper back,
Many melanocytic nevi,
Solar elastosis (yellow, thickened skin with bumps, wrinkles, or furrowing),
Cutis rhomboidalis nuchae (leathery thickened skin on the posterior neck), and
Actinic Purpera.
What is the best defense against skin cancers?
Avoid ultraviolet radiation exposure by limiting time in the sun, avoiding midday sun, using sunscreen, and wearing some protective clothing with long sleeves and hats with white brims. Avoid indoor tanning, especially children, and teens, and young adults.
Hair shedding at the roots is common in what two conditions?
Telogen affluvium and alopecia areata
Hair breaks along the shaft suggest what?
Damage from hair care or tinea capitis
What are causes of generalized itching, without apparent rash?
Dry skin, pregnancy, uremia, jaundice, lymphomas and leukemia, drug reactions, and less commonly polycythemia vera and thyroid disease.
Pallor indicates _____
Anemia
Cyanosis can indicate:
Decreased oxygen in the blood or decreased blood flow in response to a cold environment
Jaundice, or yellowing of the skin, results from:
Increased bilirubin
Possible internal causes of diffuse non-scarring hair shedding in young women are:
Iron-deficiency anemia and hyper- or hypothyroidism
Local redness of the skin warns of:
Impending necrosis
Although some deep pressure sores develop without antecedent redness.
Pustule
Small palpable collection of neutrophils or keratin that appears white
Ex: Acne vulgaris, Bacterial folliculitis
Furuncle
Inflamed hair follicle; multiple for ankles together form a carbuncle.
Ex: Abscesses (fluctuant deep infection)
Nodule
Larger and deeper than a papule.
Ex: Dermatofibroma, keloid
Subcutaneous mass/cyst
Whether mobile or fixed, cysts are encapsulated collections of fluid or semisolid.
Ex: Epidermal inclusion cyst, pilar cyst, lipoma
Wheal
Area of localized dermal edema that evanesces (comes and goes) within a period of 1-2 days.
Ex: the essential primary lesion of urticaria, PPD test
Burrow
Small linear or serpiginous pathways in the epidermis created by the scabies mite
Ex: scabies
What is the precursor of squamous cell carcinoma?
Actinic keratosis
Spider angioma
COLOR/SIZE: fiery red; from very small to 2 cm
SHAPE: Central body, sometimes raised, surrounded by erythema and radiating legs
PULSATILITY and EFFECT OF PRESSURE: Often seen in center of the spider when pressure with a glass slide is applied; pressure on the body causes blanching of the spider
DISTRIBUTION: Face, neck, arms, and upper trunk; almost never below the waist
SIGNIFICANCE: Single spider angiomas are normal and are common on the face and chest; also seen in pregnancy and liver disease
Cherry angioma
COLOR/SIZE: Bright or ruby red; may become purpleish with age; 1 to 3 mm
SHAPE: Round, flat, or sometimes raised; maybe surrounded by a pale halo
PULSATILITY and EFFECT OF PRESSURE: Absent; may show partial blanching, especially if pressure applied with edge of a pinpoint
DISTRIBUTION: Trunk; also extremities
SIGNIFICANCE: None; increases in size and number with aging
Spider vein
COLOR/SIZE: Bluish; size variable, from very small to several inches
SHAPE: Variable; may resemble a spider or be linear, irregular, cascading
PULSATILITY and EFFECT OF PRESSURE: Absent; pressure over the center does not cause blanching, but diffuse pressure blanches the veins
DISTRIBUTION: Most often on the legs, near veins; also on the anterior chest
SIGNIFICANCE: Often accompanies increased pressure in the superficial veins, as in varicose veins
Petechiae/Purpera
COLOR/SIZE: Deep red or reddish purple, fading away over time; petechiae, 1 to 3 mm; Purpera are larger
SHAPE: Rounded, sometimes irregular; flat
PULSATILITY and EFFECT OF PRESSURE: Absent; no affect from pressure
DISTRIBUTION: Variable
SIGNIFICANCE: Blood outside the vessels; may suggest a bleeding disorder, or if petechiae, emboli to skin; palpable Purpera in vasculitis
Ecchymosis
COLOR/SIZE: Purple or purpleish blue, fading to green, yellow, and brown with time; ariable size, larger than petechiae, >3 mm
SHAPE: Rounded, oval, or irregular; may have a central subcutaneous flat nodule (a hematoma)
PULSATILITY and EFFECT OF PRESSURE: Absent; no effect from pressure
DISTRIBUTION: Variable
SIGNIFICANCE: Blood outside the vessels; often secondary to bruising or trauma; also seen and bleeding disorders
Solar lentigo
Light brown and uniform in color but may be asymmetric.
Bilaterally symmetric brown macules located on sun-exposed to skin, including the face, shoulders, and arms and hands
Solar elastosis
Yellowish white macules or papules in sun exposed skin, especially on the forehead
Actinic Purpera
Ecchymosis limited to the dorsal forearms and hands but not extending above the “shirt sleeve” line on the upper arm.
Purple patches or macules that fade over time. These spots and patches come from blood that has leaked through poorly supported capillaries and spread within the dermis.
Poikiloderma
Red patches in sun damaged areas, especially the V of the neck, and lateral neck (usually sparing the shadow inferior to the chin) with fine telangiectasias, and both hyper- and hypopigmentation
Wrinkles
Increased sun damage and tanning leads to deeper wrinkles at an earlier age
Cutis rhomboidalis nuchae
Deep wrinkles on the posterior neck that “criss-cross”
Acral melanoma
Rapid change or evolution helps detect acral melanoma.
Consider biopsies if >7 mm, rapidly growing, or concerning features on dermoscopy
Acral nevus
Likely benign if <7 mm and has a reassurance pattern on dermoscopy, such as the parallel furrow or Lattice patterns
Blue nevus
Blue nevi have a homogeneous blue-gray appearance, clinically and dermoscopy
Seborrheic keratosis
Often have a verrucous texture.
Appear like a “Stuck-on” or flattened ball of wax.
May be darkly pigmented
May crumble or bleed if picked.
Specific features on dermoscopy such as milia-like cysts or comedome-like openings are reassuring if present.
May be erythematous if inflamed.
Mimics SCC
Actinic keratosis
Often easier to feel then to see.
Superficial keratotic populous “come and go” on some damaged skin
Cutaneous horn/ keratotic scale
The protypic keratotic scale of actinic keratoses and SCC is formed by keratin and can result in a cutaneous horn.
Cutaneous horns should generally be biopsied to rule out SCC.
Warts
Usually skin-colored to pink, texture more verrucous then keratotic.
May be filiform.
Often have a hemorrhagic punk day that can be seen with a magnifying glass or dermascope
Mimics cutaneous horn/ keratotic scale
Telogen Effluvium
Overall, the patient’s scalp and hair distribution appear normal, but a positive hair pull test reveals most hairs have telogen bulbs.
Anagen Effluvium
There is diffuse hair loss from the roots. The hair pull test shows few if any hairs with telogen bulbs.
Alopecia Areata
Focal hair loss.
There is sudden onset of cleary demarcated, usually localized, round or oval patches of hair loss leaving smooth skin without hairs, in children and young adults. There is no visible scaling or erythema.
Tinea Capitis
“Ringworm”
Scaling, crusting, and hair loss are seen in the scalp, along with a painful plaque (kerion) and occipital lymph node (arrow).
Mostly seen in children.
There may be black dots of broken hairs and comma or corkscrew hairs on dermoscopy.
Usually caused by Trichophyton tonsurans from humans, and less commonly Microsporum canis from cats or dogs.
Boggy plaques are called kerion.
Scarring alopecia
Scarring on the scalp is characterized by shiny skin, complete loss of hair follicles, and often, discoloration.
Presence of any scarring should prompt referral to a dermatologist for a possible scalp biopsy if the patient desires treatment.
Ex: Central centrifugal scarring alopecia and discoid lupus erythematous, among others
Paronychia
A superficial infection of the proximal and lateral nail folds adjacent to the nail plate. The nail folds are often red, swollen, and tender. Represents the most common infection of the hand, usually from Staphylococcus aureus for streptococcus species, and may spread until it completely surrounds the nail plate. Creates a felon if it extends into the pulp space of the finger. Arises from local trauma due to nail biting, manicuring, or frequent hand immersion in water. Chronic infections may be related to candida.
Clubbing of the fingers
Clinically, a bulbous swelling of the soft tissue at the nail base, with loss of the normal angle between the nail and the proximal nail fold. The angle increases to 180° or more, and the nailbed feels spongy or floating. The mechanism is still unknown but involves vasodilation with increased blood flow to the distal portion of the digits and changes in connected tissue, possibly from hypoxia, changes in innervation, genetics, or a platelet-derived growth factor from fragments of platelet clumps. Seen in congenital heart disease, interstitial lung disease and lung cancer, inflammatory bowel disease, and malignancies.
Habit tic deformity
There is depression of the central nail with a “Christmas tree” appearance from small horizontal depressions, resulting from repetitive trauma from rubbing the index finger over the thumb or vice versa. Pressure on the nail matrix causes the nail to grow out abnormally. Avoidance of the behavior leads to normal nail growth.
Melanonychia
Caused by increased pigmentation in the nail matrix, leading to a streak as the nail grows out this may be a normal ethnic variation if found in multiple nails. Ethan uniform streak may be caused by a nervous, but a white streak, especially if growing or a regular, could represent a subungual melanoma.
Onycholysis
A painless separation of the white and opaque nail plate from the Pinker translucent nail bed. Fingernails that extend past the fingertips are more likely to result in the traumatic sharing forces that produce onycholysis. Starts distally and progresses proximally, enlarging the free edge of the nail. Local causes include trauma from excess manicuring, psoriasis, fungal infection, and allergic reaction‘s to nail cosmetics. Systemic causes include diabetes, anemia, photosensitive drug reactions, hyperthyroidism, peripheral ischemia, bronchiectasis, and syphilis.
Onychomycosis
The most common cause of nail thickening and subungual debris, most often from the dermophyte Trichophyton rubrum, but also from other dermatophytes and some molds such as Alternaria and Fusarium species.
Affects one and five over age 60.
The best prevention is to treat and prevent tinea pedis.
Only half of all nail dystrophies are caused by onychomycosis, so a positive fungal culture, potassium hydroxide exam, or pathologic evaluation of nail clippings is recommended before treating with oral antifungals.
Terry nails
Nail plate turns white with a ground glass appearance, a distal band of reddish brown, and obliteration of the lunula. Commonly affects all fingers, although may appear and only one finger.
Seen in liver disease, usually cirrhosis, heart failure, and diabetes. May arise from decreased vascularity and increased connective tissue and nail bed.
Transverse linear depressions
Usually bilateral, resulting from temporary disruption of proximal nail growth from systemic illness. Timing of the illness may be estimated by measuring the distance from the line to the nail bed. (Nails grow approximately 1 mm every 6 to 10 days)
Seen in severe illness, trauma, and cold exposure if Raynaud’s disease is present.
Pitting (in nail)
Punctuate depressions of the nail plate caused by defective layering of the superficial nail plate by the proximal nail matrix. Usually associated with psoriasis but also seen in Reiter syndrome, sarcoidosis, alopecia Areata, and localized a topic or chemical dermatitis.
Pressure (decubitus) ulcer
What is and what are risk factors?
Arise from obliteration of arteriolar and capillary blood flow to the skin or from sheer forces during movement across sheets or when lifted upright incorrectly.
Usually develop over bony prominences subject to unrelieved pressure, resulting in ischemic damage to underlying tissue.
Decreased mobility, especially if accompanied by increased pressure or movement causing friction or shear stress.
Decreased sensation, from brain or spinal cord lesions or peripheral nerve disease.
Decreased blood flow from hypotension or micro vascular disease such as diabetes or atherosclerosis.
Because or urinary incontinence.
Presence of fracture.
Poor nutritional status or low albumin.
Stage I pressure ulcer
Presence of a red and area that fails to blanch with pressure, any changes in temperature (warmth or coolness), consistency (firm or boggy), sensation (pain or itching), or color (red, blue, or purple on darker skin; red on lighter skin).
Stage II pressure ulcer
The skin forms a blister or sore. Partial thickness skin loss or ulceration involving the epidermis, dermis, or both.
Stage III pressure ulcer
A cleaner appears in the skin, with full thickness skin loss and damage to or necrosis of subcutaneous tissue that may extend to, but not through, underlying muscle.
Stage IV pressure ulcer
The pressure ulcer deepens. There is a full thickness skin loss, with destruction, tissue necrosis, or damage to underline muscle, bone, and sometimes tendons and joints.
Apgar score
What is it and components?
It’s five components classify the newborns neurologic recovery from the stress of birth and immediate adaptation to extrauterine life.
Scored at 1 and 5 minutes after birth.
3 point scale 0,1,2 in each category, total 0-10
Heart rate Respiratory effort Muscle tone Reflex irritability Color
Newborns with polycythemia
Have a ruddy complexion. This is a reddish purple color.
Cutis marmorata
A lattice like, bluish mottled appearance, particularly on the trunk, arms, and legs.
This is in response to cold and may last for months in normal infants.
Is prominent in premature infants and an infant with congenital hypothyroidism and down syndrome.
Acrocyanosis
A blueish discoloration to the palms and soles when exposed to cold.
Is very common in newborns for the first few days and may recur throughout early infancy.
If acrocyanosis does not disappear within 8 hours or with warming, cyanotic congenital heart disease should be considered.
Central cyanosis
In a baby or a child of any age should raise suspicion of congenital heart disease.
The best area to look for central cyanosis is the tongue and oral mucosa, not the nail beds, lips, or the extremities.
Cafe-au-lait spots
Benign newborn birthmark
Pigmented light brown lesions (<1-2 cm at birth) usually have borders and are uniform.
They are noted in more than 10% of black infants.
Isolated lesions have no significance, but multiple lesions (>5) with sharp borders may suggest neurofibromatosis.
Skin desquamation
Is normal in full-term newborns but may rarely be a sign of placental circulatory insufficiency or congenital ichthiosis
What are four common (clinically insignificant) dermatologic conditions in newborns?
Miliaria rubra,
Erythema toxicum,
Pustular melanosis
Milia
Both erythema toxicum and pustular melanosis may appear similar to what?
Pathologic vesiculopustular rash of herpes Simplex or staphylococcus aureus skin infection
Midline hair Tufts over the lumbosacral spine region possibly suggest what?
Spinal cord defect (spina bifida)
Jaundice within the first 24 hours of birth may be from what?
Hemolytic disease of the newborn
Late appearing jaundice or jaundice that persist beyond 2 to 3 weeks should raise suspicions of what 2 conditions?
Biliary obstruction or liver disease
A common source of jaundice during the first couple of weeks is what? And when does it resolve?
Breast-feeding jaundice.
Resolves around 10 to 14 days of life.
Newborn jaundice appears to progress in what fashion?
From head to toe, with more intense jaundice on the upper body and less intense yellow color in the lower extremities.
Port wine stain
What is it and what might it be a sign of?
A unilateral yeah dark, purpleish lesion, over the distribution of the ophthalmic branch of the trigeminal nerve.
May be a sign of Sturge-Weber syndrome
Sturge-Weber syndrome
Is associated with seizures, hemiparesis, glaucoma, and mental retardation.
Turner syndrome (in infant)
Significant edema of the hands and feet of a newborn girl. Other features such as a webbed neck would reinforce this diagnosis.
Infant dehydration causes
Is a common problem in infants. Usual causes are insufficient intake or excess loss of fluids from diarrhea.
Physiologic jaundice
Occurs during days 2 to 5 of life and progresses from head to toe as it peaks.
Miliaria rubra
Common benign newborn rash.
Scattered vesicles on an erythematous base, usually on the face in trunk, result from obstruction of the sweat gland ducts; this condition disappears spontaneously within weeks.
Erythema toxicum
Common benign newborn rash.
Usually appearing on days 2 to 3 of life.
This rash consists of erythematous macules with central pinpoint vesicles scattered diffusely over the entire body. Yellow or white pustules surrounded by a red base.
They appear similar to flea bites.
These lesions are of unknown ideology but disappear within one week of birth.
Pustular melanosis
Common benign newborn rash.
Seen more commonly in black infants, the rash presents at birth as small vesiculopustules over a brown macular base; these can last for several months.
Milia
Common benign newborn rash.
Pinhead sized smooth white raised areas without surrounding erythema on the nose, chin, and forehead result from retention of sebum in the openings of the sebaceous glands. Although occasionally present at birth, milia usually appear within the first few weeks and disappears over several weeks.
Eyelid patch
Benign newborn birthmark
This birthmark fades, usually within the first year of life.
Salmon patch
Benign newborn birthmark
Also called the “stork bite” or “angel kiss”.
This splotchy pink mark fades with age.
Slate blue patches
Benign newborn birthmark
These are more common among dark skinned babies. It is important to note them so they are not mistaken for bruises.
Adolescent acne
Acne in adolescence involves open comedones (blackheads) and closed comedones (whiteheads), and inflamed pustules.
A common skin condition, tends to resolve eventually, but often visit benefits from proper treatment.
It tends to begin during middle to late puberty.
Moles or benign nevi may appear during what stage of life?
Adolescence.
They are characteristics differentiate them from atypical nevi.
Neonatal acne
Red pustules and papules are more prominent over the cheeks and nose of some normal newborns.
Seborrhea
The salmon red, scaly eruption often involves the face, neck, axilla, diaper area, and behind the ears.
Atopic dermatitis (eczema)
Erythema, scaling, dry skin, and intense itching characterize this condition.
Neurofibromatosis
Characteristic features include more than five café au lait spots and axillary freckling. Later findings include neurofibromas and Lisch nodules.
Candidal diaper dermatitis
This bright red rash involves the intertriginous folds, with small “satellite lesions” along the edges.
Contact diaper dermatitis
This irritant rash is secondary to diarrhea or irritation and is noted along contact areas (touching the diaper)
Impetigo
This infection is due to bacteria and can appear bullous or crusty and yellowed with some pus.
Verruca vulgaris
Dry, rough warts on hands
Verica plana
Small, flat warts
Plantar warts
Tender warts on feet
Molluscum contagiosum
Dome shaped, fleshy lesions
Bites (childhood)
Intensely pruritic, red, distinct papules characterize these lesions
Urticaria
(Hives)
This pruritic, allergic sensitivity reaction changes shape quickly.
Scabies
Intensely itchy papules and vesicles, sometimes burrows, most often on extremities
Tinea corporis
This annular lesion has central clearing and papules along the border.
Pityriasis Rosea
Oval lesions on trunk, in older children, often in a Christmas tree pattern, sometimes a herald patch (a large patch that appears first).
Older adult skin
The skin wrinkles, becomes lax, and loses turgor. The dermis is less vascular, causing lighter skin to look paler and more opaque. Skin on the backs of the hands and forearms appears thin, fragile, loose, and transparent. Actinic keratosis.
Older adult nails
Nails lose luster with age and may yellow and thicken, especially on the toes
Older adult Hair
Hair undergoes a series of changes. Scalp hair loses its pigment, changing hair color to gray. Hair loss on the scalp is genetically determined. As early as 20 years, a man’s hairline may start to reseed at the temples and then at the vertex. In women hair loss follows a similar but less severe pattern. In both sexes the number of scalp hairs decreases in a generalized pattern and the diameter of each hair gets smaller. There is also normal hair loss everywhere on the body – the trunk, pubic areas, axillae, and limbs. Women over 55 years may develop course facial hairs on the chin and upper lip.
Basal cell carcinoma
A translucent nodule that spreads and leaves a depressed center with a firm elevated border.
Squamous cell carcinoma
A firm reddish–appearing lesion often emerging in a sun exposed area.
Melanoma
A dark raised asymmetric lesion with irregular borders
Herpes zoster
Vesicular lesions occurring in a dermatomal distribution from reactivation of latent varicella zoster virus in the dorsal root ganglia.
Risk increases with age and impaired cell-mediated immunity.
Lichenified
Thickened from rubbing
How do you assess for cyanosis in the newborn?
In the mouth
How do you assess for skin turgor in the newborn/infant?
Roll a fold of loosely adherent skin on the abdominal wall between your thumb and forefinger to determine its consistency.
Skin findings in chronic renal disease
Pallor, xerosis, uremic frost, pruritus, half-and-half nails, calciphylaxis
Skin findings in Crohn’s disease
Erythema nodosum, pyoderma gangrenosum, enterocutaneous fistulas, aphthous ulcers
Skin findings in Cushing’s disease
Striae, atrophy, Purpera, Ecchymosis, telangiectasia, acne, moon faces, buffalo hump, hypertrichosis
Skin findings in diabetes
Pruritus, diabetic dermopathy, acanthosis nigricans, candidiasis, neuropathic ulcers, necrobiosis lipoidica, eruptive xanthomas
Skin findings in dyslipidemia
Xanthomas (tendon, eruptive, tuberous), xanthylasma (may also occur in healthy people)
Skin findings in hypothyroidism
Rough, dry, and pale skin; course and brittle hair; myxedema; alopecia (lateral 1/3 of eyebrows to diffuse); skin cool to touch; thin and brittle nails
Skin findings for hyperthyroidism
Warm, moist, soft, and velvety skin; then and fine hair; alopecia; vitiligo; pretibial myxedema (in graves); hyperpigmentation (local or generalized)
Skin findings in Kawasaki disease
Mucosal erythema (lips, tongue, and pharynx), strawberry tongue, cherry red lips, polymorphous rash (primarily on trunk), erythema of palms and soles with later desquamation of fingertips
Skin findings in liver disease
Jaundice, spider angioma’s and other telangiectasis, Palmar erythema, Terry nails, pruritus, purpura, caput medisae
Skin findings in leukemia/lymphoma
Pallor, exfoliative erythroderma, nodules, petechiae, ecchymosis, pruritus, vasculitis, pyoderma gangrenosum, bullous diseases
Skin findings in meningococcemia
Angular or delayed purpuric patches and plaques with gun metal gray center. Progresses to Ekhymosis, bullae, necrosis
Skin findings in neurofibromatosis
Neurofibromas, 5+ café au lait spots with sharp borders, freckling in axillae (Crowe sign), plexiform neurofibroma
Skin findings in systemic lupus erythematosus
Mallory erythema (across nose and cheeks), relative sparing of nasolabial folds, periungual erythema, interphalangeal erythema
