Dermatology & Wounds
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Dermatological Findings:
[comment memo="Actinic Keratosis: "][checkbox name="Variable_21" value="Erythematous, hyperkeratotic papules with adherent scaling. "]
[comment memo="Acute urticaria: Resolves within 6 weeks. Hives lasting longer than 6 weeks are called chronic uticaria. Urticarial vasculitis is painful and pruritic. Note: plaques lasting than 24 hours should be biopsied to exclude dx of urticarial vasculitis. "][checkbox name="Variable_38" value="Non-pitting edematous plaques or wheals with intense Pruritus. "]
[comment memo="Angioedema: Cx by increased vascular permeability in subcutaneous tissue of skin and mucosa. Hives, swelling of lips, and swelling of palms are all common characteristic signs. "][checkbox name="Variable_" value="Non-pitting, well-defined area of edema. "]
[comment memo="Cellulitis: "][checkbox name="Variable_" value="Expanding, red, swollen, tender/painful, plaque with indefinite border. "]
[comment memo="Comedone Acne: Whiteheads are closed comedones, and blackheads are open comedones. "][checkbox name="Variable_" value="Open comedones |Closed comedones "]
[comment memo="Chronic urticaria: Greater than 6 weeks. "][checkbox name="Variable_" value="on-pitting edematous plaques or wheals with intense Pruritus. "]
[comment memo="Contact Allergic Dermatitis: May demonstrate oozing, vesicles, or swelling "][checkbox name="Variable_" value="Pruritic patch that is dry and erythematous. "]
[comment memo="BCC vs other: "][checkbox name="Variable_22" value="Pearly pink papule with telangiectasias. "]
[comment memo="Chapped fissured feet: Vesicles are typically absent, and a potassium hydroxide test is negative for fungal elements. "][checkbox name="Variable_" value="Chapped appearance, with scaling, and fissures. "]
[comment memo="Chronic eczematous inflammation: "][checkbox name="Variable_23" value="Confluent erythema with scaling and occasional crust and fissuring. "]
[comment memo="Cystic Acne: Most likely form of acne to cause scars. Cysts are larger, deeper, and last longer than papules and pustules. Most commonly found on face, chest, back, and shoulders. "][checkbox name="Variable_" value="Deep, inflamed cysts. "]
[comment memo="Eczema: History of allergies, irritant contact, winter months, and low humidity are risk factors. "][checkbox name="Variable_24" value="Erythema with excoriations, scaling, and pruritus. "]
[comment memo="Ecchymosis: "][checkbox name="Variable_25" value="Greater than 1 cm erythematous or purple macules. "]
[comment memo="Folliculitis: "][checkbox name="Variable_" value="Dome-shaped pustules with small erythematous halos that arise in the follicle. "]
[comment memo="Hypertrophic scar: "][checkbox name="Variable_26" value="Excess scar tissue growth that does not overgrow the original wound boundaries. "]
[comment memo="Impetigo: "][checkbox name="Variable_" value="=Papules and plaques with thin honey colored crust with surrounding erythema. "]
[comment memo="Irritant Contact Dermatitis: "][checkbox name="Variable_" value="Erythema, xerosis (abnormally dry skin), and scaling. "]
[comment memo="Keloid: "][checkbox name="Variable_27" value="Growth of excess scar tissue that overgrows the original wound boundaries. "]
[comment memo="Keratolysis exfoliativa: Itching is not common. KOH testing is negative. "][checkbox name="Variable_" value="Symmetrical erythema with serpinginous desquamation of palms and soles. "]
[comment memo="Keratosis pilaris: Most commonly found on posterolateral aspects of upper arms but occasionally more widespread on anterior and lateral thighs and buttocks. Most commonly in young children peaking in adolescence. "][checkbox name="Variable_" value="Rough, monomorphic, tiny, follicle-based scaling papules. "]
[comment memo="Lichen sclerosus: "][checkbox name="Variable_" value="White papules with keratotic surface plugs (delling) coalescing into a dull white, atrophic plaques with a fragile wrinkled surface. "]
[comment memo="Lichen planus: Most commonly found on flexor wrists and forearms, ankles, and lumbar regions. Lesions may become thick and dark purple. Purple, papules, polygonal, excoriations, scales, Reticular lines on flexor surfaces. "][checkbox name="Variable_" value="Flat-topped, red to purple, angulated papules with white lines (Wickham striae). "]
[comment memo="Lichen simplex chronicus: "][checkbox name="Variable_28" value=" (history of scratching). "]
[comment memo="Mastocytosis: Urticaria pigmentosa- mast cell proliferation in various organs most commonly seen in young children and usually confined to skin. Involves skin and internal organs in adults. "][checkbox name="Variable_39" value="Usually asymptomatic but scratching of brown to erythematous macules causes itching hives and possible flushing. "]
[comment memo="Milium: "][checkbox name="Variable_29" value="Small superficial cyst containing keratin, 1-2mm in size. "]
[comment memo="Neurofibroma: "][checkbox name="Variable_30" value="Spongy flesh colored nodule. "]
[comment memo="Nummular Eczema: May look like ringworm or eczema. The borders of ringworm and psoriasis are usually sharply defined, but in NE the borders are indistinct. Most commonly on dorsa of hands, lower legs, and upper extremities. Men are more commonly affected. Often a chronic condition that is treatment re-fractory. "][checkbox name="Variable_" value="Round (coin shaped) pruritic erythematous plaques of eczematous inflammation. "]
[comment memo="Papilloma: "][checkbox name="Variable_82" value=" "]
[comment memo="Perioral dermatitis: Almost exclusively occurs in women. "][checkbox name="Variable_" value="Distinct pinpoint papular and pustular eruption of perioral/periocular regions. "]
[comment memo="Petechiae: "][checkbox name="Variable_31" value="1-2 mm erythematous or purple macules that do not blanch with pressure. "]
[comment memo="Pityriasis rosea: Usually spares the face and extremities. "][checkbox name="Variable_" value="Oval, salmon colored 1-10cm plaques with a round collarette scales in the center. "]
[comment memo="Prurigo nodularis: Lesions are thick and eroded by picking and scratching. Hypopigmentation and hyperpigmentation may be present if the scratching is chronic. Look for no excoriations on hard to reach areas. "][checkbox name="Variable_" value="Erythematous, discrete, rounded plaques, with central erosions, and crusts. "]
[comment memo="Purpura: "][checkbox name="Variable_32" value="3-10 mm red or purple macules that do not blanch with pressure. "]
[comment memo="Physical Urticaria: Produced by various physical stimuli most commonly found in young adults. Skin writing and heat bumps are the most common forms. "][checkbox name="Variable_" value="Wheal and red flare minutes after writing with nail on skin. | Swelling occurring hours after application of pressure. |Round popular wheals that occur after exercise or exposure to heat. |Swelling after exposure to cold stimulus. "]
[comment memo="Pityriasis alba: Typically no preceding inflammation evident, and typically found on lateral cheeks, lateral arms, and thighs. "][checkbox name="Variable_33" value="Asymptomatic, hypopigmented, fine scaling patches with indistinct borders. "]
[comment memo="Pseudofolliculits barbae: Pain, pruritus, scarring, hyperpigmentation, and keloid formation are common comorbidies. "][checkbox name="Variable_" value="Perifollicular red papules/pustules occurring in shaved regions of the body. "]
[comment memo="Psoriasis: Psoriasis on hands may be difficult to discern from hand eczema or nummular eczema. Chronic course with exacerbations and remissions may be a sign of psoriasis. Types: Plaque, Guttate (child following group A infection with papules on trunks and extremities not on palms or soles), Pustular, Erythrodermic, Scalp, and Intertriginous (inverse). Pustular and Erythrodermic are not common forms. "][checkbox name="Variable_" value="Pitting nails. |Silvery, dense, scaling plaques. |Papules on trunks and extremities not on palms or soles. |Lesions present on extensor surfaces. |Lesions present on flexor surfaces. |Pinpoint bleeding when scale removed (Auspitz's sign) "]
[comment memo="Pustular acne: Post-inflammatory pigmentation changes and scars are common. Scars are more common with picking and deep lesions."][checkbox name="Variable_" value="Papulopustules. "]
[comment memo="Rosacea (acne rosacea): There may be telangiectasias. Acne may be present with the same lesion and distribution. Chronic rosacea permanently alters the dermis and distorts the structure of the nose (rhinoiphyma). 50% of pts have grittiness and mild conjunctivitis. "][checkbox name="Variable_" value="Papules and pustules on forehead/cheeks/nose with erythema without the presence of comedones. "]
[comment memo="Seborrheic Dermatitis: This is a more extreme form of dandruff. "][checkbox name="Variable_" value="Greasy scales with erythema. "]
[comment memo="Seborrheic Keratosis: "][checkbox name="Variable_35" value="Skin-colored/brown macules or papules with warty or stuck on appearance. "]
[comment memo=""][checkbox name="Variable_36" value="Symmetric brown or pink, macules or papules 3-7mm. "]
[comment memo="Solar lentigos: "][checkbox name="Variable_34" value=" "]
[comment memo="Status Dermatitis: A tight appearance and feel demonstrates a chronic process. "][checkbox name="Variable_" value="Circumferential erythema and scaling of lower legs. "]
[comment memo="Steroid Atrophy: "][checkbox name="Variable_81" value="Hypopigmentation, prominence of underlying veins, thinning of skin, erythematous/purple striae. "]
[comment memo="Venous leg ulcers: Cayenne pepper-like dermatitis and hyperpigmentation may be present around lesion. "][checkbox name="Variable_" value="Ulceration with surrounding atrophy within area of status dermatitis. "]
[comment memo="Wart: "][checkbox name="Variable_37" value="Skin-colored/pink/brown hyperkaryotic papules with punctate hemorrhages. "]
[comment memo="Wheals/Hives: "][checkbox name="Variable_40" value="Transient Less than 24 hours well-circumscribed, superficial edematous papules or plaques that are white to pale red and often appear and disappear over a period of hours."]
[checkbox name="Variable_" value="Differential for hypopigmented macules: Pityriasis alba, Tinea verisicolor, Post inflammatory hypopigmentation, vitiligo, and rarely hypopigmented cutaneous T-cell lymphoma. "]
[comment memo=""][checkbox name="Variable_" value=" "]
Dermatological Findings:
Actinic Keratosis:
Acute urticaria: Resolves within 6 weeks. Hives lasting longer than 6 weeks are called chronic uticaria. Urticarial vasculitis is painful and pruritic. Note: plaques lasting than 24 hours should be biopsied to exclude dx of urticarial vasculitis.
Angioedema: Cx by increased vascular permeability in subcutaneous tissue of skin and mucosa. Hives, swelling of lips, and swelling of palms are all common characteristic signs.
Cellulitis:
Comedone Acne: Whiteheads are closed comedones, and blackheads are open comedones.
Chronic urticaria: Greater than 6 weeks.
Contact Allergic Dermatitis: May demonstrate oozing, vesicles, or swelling
BCC vs other:
Chapped fissured feet: Vesicles are typically absent, and a potassium hydroxide test is negative for fungal elements.
Chronic eczematous inflammation:
Cystic Acne: Most likely form of acne to cause scars. Cysts are larger, deeper, and last longer than papules and pustules. Most commonly found on face, chest, back, and shoulders.
Eczema: History of allergies, irritant contact, winter months, and low humidity are risk factors.
Ecchymosis:
Folliculitis:
Hypertrophic scar:
Impetigo:
Irritant Contact Dermatitis:
Keloid:
Keratolysis exfoliativa: Itching is not common. KOH testing is negative.
Keratosis pilaris: Most commonly found on posterolateral aspects of upper arms but occasionally more widespread on anterior and lateral thighs and buttocks. Most commonly in young children peaking in adolescence.
Lichen sclerosus:
Lichen planus: Most commonly found on flexor wrists and forearms, ankles, and lumbar regions. Lesions may become thick and dark purple. Purple, papules, polygonal, excoriations, scales, Reticular lines on flexor surfaces.
Lichen simplex chronicus:
Mastocytosis: Urticaria pigmentosa- mast cell proliferation in various organs most commonly seen in young children and usually confined to skin. Involves skin and internal organs in adults.
Milium:
Neurofibroma:
Nummular Eczema: May look like ringworm or eczema. The borders of ringworm and psoriasis are usually sharply defined, but in NE the borders are indistinct. Most commonly on dorsa of hands, lower legs, and upper extremities. Men are more commonly affected. Often a chronic condition that is treatment re-fractory.
Papilloma:
Perioral dermatitis: Almost exclusively occurs in women.
Petechiae:
Pityriasis rosea: Usually spares the face and extremities.
Prurigo nodularis: Lesions are thick and eroded by picking and scratching. Hypopigmentation and hyperpigmentation may be present if the scratching is chronic. Look for no excoriations on hard to reach areas.
Purpura:
Physical Urticaria: Produced by various physical stimuli most commonly found in young adults. Skin writing and heat bumps are the most common forms.
Pityriasis alba: Typically no preceding inflammation evident, and typically found on lateral cheeks, lateral arms, and thighs.
Pseudofolliculits barbae: Pain, pruritus, scarring, hyperpigmentation, and keloid formation are common comorbidies.
Psoriasis: Psoriasis on hands may be difficult to discern from hand eczema or nummular eczema. Chronic course with exacerbations and remissions may be a sign of psoriasis. Types: Plaque, Guttate (child following group A infection with papules on trunks and extremities not on palms or soles), Pustular, Erythrodermic, Scalp, and Intertriginous (inverse). Pustular and Erythrodermic are not common forms.
Pustular acne: Post-inflammatory pigmentation changes and scars are common. Scars are more common with picking and deep lesions.
Rosacea (acne rosacea): There may be telangiectasias. Acne may be present with the same lesion and distribution. Chronic rosacea permanently alters the dermis and distorts the structure of the nose (rhinoiphyma). 50% of pts have grittiness and mild conjunctivitis.
Seborrheic Dermatitis: This is a more extreme form of dandruff.
Seborrheic Keratosis:

Solar lentigos:
Status Dermatitis: A tight appearance and feel demonstrates a chronic process.
Steroid Atrophy:
Venous leg ulcers: Cayenne pepper-like dermatitis and hyperpigmentation may be present around lesion.
Wart:
Wheals/Hives:

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