2 derm pattern recognition 1

CASE STUDIES IN DERMATOLOGIC PATTERN

RECOGNITIONPart 1

PATTERN RECOGNITION IS THE CAPACITY TO DESCRIBE A RASH OR LESION USING A VARIETY OF PHYSICAL CHACTERISTICS IN ORDER

TO LIMIT THE DIFFERENTIAL DIAGNOSIS

PHYSICAL CHARACTERISTICS OF ALL

RASHES AND LESIONS

• 1.BASIC MORPHOLOGY

• 2.SIZE

• 3.SHAPE

• 4.COLOR

• 5.PATTERN

• 6.DISTRIBUTION

EXAMLPES OF BASIC MORPHOLOGY

• 1.MACULE AND PATCH

• 2.PAPULE AND NODULE

• 3.PUSTULE

• 4.WHEAL

• 5.VESICLE AND BULLA

• 6.PLAQUE

MACULES AND PATCHES

MACULES ARE FLAT AND THEREFORE NOT RECOGNIZED

BY TOUCH BUT RATHER A CHANGE IN COLOR FROM YHE SURROUNDING SKIN. PATCHES

ARE LARGER MACULES

MONGOLIAN SPOTS

PAPULES AND NODULES

PAPULES ARE ELEVATED SOLID LESIONS UP TO.5 CM IN

DIAMETER. NODULES ARE LARGER THAN PAPULES

NEUROFIBROMA

PUSTULES

PUSTULES ARE EPIDERMAL OR UPPER DERMAL COLLECTIONS

OF PUS. ABSCESSES ARE DEEPER PUSTULES

BULLOUS IMPETGO

ABSCESSES

WHEALS

WHEALS ARE ROUNDED PALE RED PAPULES OR PLAQUES

CAUSED BY THE EXTRAVASATION OF FLUID

URTICARIA

VESICLES AND BULLAE

VESICLES ARE LESIONS FORMED BY FLUID CREATING A

CLEAVAGE PLANE BENEATH THE STRATUM CORNEUM.

BULLAE ARE LARGER VESICLES

IMPETIGO

PLAQUES

PLAQUES ARE RAISED LESIONS WITH A FLAT TOP. THE RISE IN

ELEVATION IS MUCH LESS THAN YHR WIDTH OF THE

LESION

PSORIASIS

EXAMLPLES OF LESION SHAPE

• 1.ANNULAR.. Like a ring• 2.NUMMULAR… like a coin• 3.LINEAR• 4.OVAL• 5.TARGET• 6.SERPIGENOUS• 7.RETICULATE .. Forming a network• 8.STELLATE …star like

ANNULAR

ANNULAR LESIONS ARE CIRCULAR AND HAVE A

CENTER WITH AN APPEARANCE DIFFERENT FROM THEIR

EDGE OR BORDER

KERATOACANTHOMA

NUMMULAR

NUMMULAR LESIONS TAKE ON THE APPEARANCE OF A FILLED

CIRCLE OR COIN

NUMMULAR ECZEMA

LINEAR

LINEAR LESIONS ARE LONG RELATIVE TO THEIR WIDTH AND GENERALLY STRAIGHT

KELOID

OVAL

THE WORD IS SELF EXPLANATORY

FIXED DRUG ERUPTION

TARGET

TARGET LESIONS ARE MADE UP OF CONCENTRIC CIRCLES OF WHITE AND RED FORMING A

BULLSEYE APPEARANCE

ERYTHEMA MULTIFORME

SERPIGENOUS

LESIONS THAT ARE LONG AND WAVEY WITH A SNAKE-LIKE

APPEARANCE

LARVA MIGRANS

RETICULATE

LESIONS WITH AN INTERCONNECTED OR LACE-

LIKE APPEARANCE

STRETCH MARKS

STELLATE

LESIONS WITH A STAR-LIKE APPEARANCE USUALLY FROM

A RADIAL SPREAD FROM A CENTRAL FOCUS

SUPERFICIAL VARICOSITIES

EXAMPLES OF LESION PATTERN

• 1.GROUPED

• 2.DISSEMINATED

• 3.DERMATOMAL

• 4.SYMMETRIC

• 5.PHOTOSENSITIVE

• 6. CONFLUENT

• 7.INTERTRIGENOUS

GROUPED

MULTIPLE SIMILAR LESIONS ORGANIZED IN CLOSE

PROXIMITY

GENITAL WARTS

DISSEMINATED

LESIONS WHICH ARE SCATTERED RANDOMLY OVER

ALL OR MOST OF THE BODY

GENERALIZED DRUG

REACTION

DERMATOMAL

LESIONS THAT FOLLOW THE PATH OF A PERIPHERAL

SENSORY NERVE

HERPES ZOSTER

SYMMETRIC

LESIONS THAT ARE MIRROR IMAGES OF EACHOTHER FROM ONE SIDE OF THE BODY TO THE

OTHER

ONYCHOMYCOSIS

PHOTOSENSITIVE

LESIONS LIMITED TO THE SUN EXPOSED PARTS OF THE BODY

PHOTOSENSITIVE DRUG ERUPTION

CONFLUENT

THE PROCESS OF SMALLER LESIONS COMING TOGETHER UNTIL THEY FORM A LARGE

LESION BY MERGING

TINEA CORPORIS

INTERTRIGENOUS

LESIONS THAT ARE LOCATED BETWEEN SKIN FOLDS SUCH AS

THE AXILLA, GROIN OR BETWEEN FINGERS OR TOES

LESION SIZE

• USUALLY DESCRIBED IN MILLIMETERS OR CENTIMETERS

EXAMPLES OF LESION OR RASH COLOR

• 1.HYOPIGMENTED• 2.HYPERPIGMENTED• 3.WHITE• 4.BLACK• 5.BLUE• 6.YELLOW• 7.VIOLACEOUS• 8.VARIEGATED

EXAMPLES OF LESION DISTRIBUTION

• 1.HEAD• 2.ORAL• 3.AXILLARY• 4.TRUNCAL• 5.ANOGENITAL• 6.INGUINAL• 7.DEPENDENT• 8.PEDAL