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Pediatric Dermatology E-Book

Pediatric Dermatology E-Book

Lawrence A. Schachner | Ronald C. Hansen

(2011)

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Book Details

Abstract

The latest edition of Pediatric Dermatology, edited by Lawrence A. Schachner, MD and Ronald C. Hansen, MD brings you the detailed guidance you need to effectively diagnose and treat pediatric skin conditions. Review topics from keratinization to stem cell therapy, and gain expert guidance from international contributors. Now in a comprehensive format with 40% all new clinical photos, this resource is ideal for clinical practice.

  • Refer to full-color photographs that accurately capture the appearance of a wide range of skin disorders.
  • Access many new tables and therapeutic algorithms for at-a-glance guidance.
  • Recognize distinguishing factors in skin lesions with 40% new and improved clinical photographs.
  • Find extended coverage of topics like genodermatoses and disorders of keratinization, review excellent information on skin neoplasms in children, new systemic therapies, and viral disorders, and explore new concepts in autoinflammatory disorders and Kawasaki’s disease.
  • Read up on best practices and stay at the forefront of your profession with new perspectives from a host of international contributors like new Associate Editor Antonio Torrello, who co-edits the Pediatric Dermatology journal.

Table of Contents

Section Title Page Action Price
Front cover cover
Pediatric Dermatology i
Copyright page iv
Table of Contents v
Preface xi
List of Contributors xiii
Acknowledgments xix
I Basic Science and Principles of Diagnosis and Treatment 1
1 Structure and function of the skin 1
Skin Development 1
Embryogenesis of the Skin 1
Introduction 1
Properties of the Skin 1
Unique Properties of Prenatal Skin 1
The Periderm 1
Development of Epidermal Appendages 2
Specialized Non-Keratinocyte Cells within the Skin 3
Stages of Human Skin Development 4
Skin Development During the Embryonic Period 4
Skin Development at the Early Fetal Stage 5
Skin Development During the Late Fetal Stage 7
Skin Development in Immature/ Premature Skin 9
Prenatal Testing 10
Summary of Events Occurring During Epidermal Development 10
Structural and Functional Properties of Skin of Infants, Children, and Adults 10
Introduction 10
Overall Skin Structure and Function (Fig. 1.7) 11
Tissues 11
Cells 11
Epidermal Structure and Function (Figs 1.8, 1.9) 13
Tissues 13
Basal Keratinocyte Structure and Function 14
Cells 14
Molecular 15
Spinous Keratinocyte Structure and Function 16
Cells 16
Molecular 16
Granular Cells 17
Cells 17
Molecular 18
Stratum Corneum 19
Cells 19
II Neonatal and Inherited Disorders 299
6 Neonatal skin and skin disorders 299
Fetal and Neonatal Skin Development, Structure and Function 299
Structure and Function 299
Transient Physiologic Changes and Cutaneous Lesions in the Newborn 301
Vernix Caseosa 301
Rubor (Erythema Neonatorum) and Acrocyanosis 302
Cutis Marmorata 303
Harlequin Color Change 304
Physiologic Jaundice 304
Pigmentary Changes 305
Skin Fragility 305
Peeling 305
Lanugo 306
Hair Patterns, Hair Cycle Changes, and Postnatal Alopecia 307
Benign Oral Neonatal Lesions 308
Epstein’s Pearls 308
Bohn’s Nodules 309
Eruption Cysts 309
Dental Lamina Cysts 309
Mucocoeles or Salivary Retention Cysts 309
Congenital Epulis 309
Natal and Neonatal Teeth 310
Sucking Calluses 310
Bednar’s Aphthae 310
Lymphatic Malformations 311
Median Alveolar Notch 311
Benign Self-Limiting Cutaneous Lesions 311
Sucking Blisters, Erosions and Calluses 311
Sebaceous Gland Hyperplasia 311
Milia 311
Maternal and Placental Hormonal Effects: ‘Miniature Puberty’ of the Newborn 312
Birthmarks 313
Vascular Birthmarks 313
Hyperpigmented Birthmarks 314
Hypopigmented Birthmarks 314
Epidermal Nevi 316
Developmental Anomalies 316
Branchial Clefts and Auricular Sinuses 316
Thyroglossal Duct Cysts 318
Bronchogenic Cysts 319
Aplasia Cutis Congenita 319
Amniotic Band Syndrome 321
Congenital Lip Pits (Fistulae Labii Congenita) 322
Cutaneous Signs of Spinal Dysraphism 323
Dermoid Cysts 324
Encephalocele and Meningocele 326
Rudimentary Meningocele and Heterotopic Brain Tissue 326
Nasal Glioma 327
Umbilical Polyp 327
Umbilical Granuloma 328
Congenital Pedal Papules in the Newborn 328
Vesiculopustular, Bullous and Erosive Diseases of the Newborn 328
Neonatal Disorders Presenting with Vesiculopustular Lesions 329
Erythema Toxicum Neonatorum (Toxic Erythema of the Newborn) 329
Transient Neonatal Pustular Melanosis (Transient Neonatal Pustular Dermatosis) 333
Miliaria 334
Eosinophilic Pustular Folliculitis of Infancy 335
Acropustulosis of Infancy 336
Neonatal Acne 337
Neonatal Cephalic Pustulosis 337
Vesiculopustular Eruption in Down Syndrome with Transient Myeloproliferative Disorders 337
Congenital Langerhans Cell Histiocytosis 338
Incontinentia Pigmenti 338
Neonatal Disorders Presenting with Bullae and/or Erosions 339
Congenital Erosive and Vesicular Dermatosis 339
Neonatal Herpes Gestationis 340
Diffuse Cutaneous Mastocytosis (Bullous Mastocytosis) 341
Zinc Deficiency in the Newborn 341
Epidermolysis Bullosa 341
Transient Porphyrinemia in Hemolytic Disease of the Newborn 342
Bullous Congenital Ichthyosiform Erythroderma 342
Infectious Diseases of the Newborn 342
Neonatal Scabies 342
Impetigo Neonatorum (Bullous Impetigo) and Staphylococcal Scalded Skin Syndrome 343
Congenital and Neonatal Candidiasis 343
Congenital Candidiasis 344
Systemic Candidiasis 345
Localized Neonatal Candidiasis 345
Invasive Fungal Dermatitis 346
Diagnosis and Investigation 346
Differential Diagnosis 346
Management 346
Congenital Toxoplasmosis 347
Rubella 348
Cytomegalovirus Disease 349
Neonatal Herpes Simplex Virus Infection 351
Congenital and Neonatal Varicella 354
Fetal Varicella Syndrome 354
Neonatal Varicella 355
Congenital Syphilis in the Neonate 356
Clinical Manifestations 356
Differential Diagnosis 357
Diagnosis and Investigations 357
Management 358
Neonatal Hiv Disease 358
Prenatal Injury, Birth Trauma and Injury in the Neonatal Period 359
Prenatal Injury 359
Chorionic Villus Sampling 359
Fetal Skin Biopsy 360
Amniocentesis 360
Fetal Heart Monitoring 360
Fetal Scalp Blood Sampling 361
Injuries During Delivery 361
Erythema 361
Skin and Soft Tissue Injury 361
Caput Succedaneum and Edema 362
Cephalhematoma 362
Petechiae, Purpura and Subconjunctival Hemorrhage 363
Intrapartum Lacerations 363
Postnatal Injury 363
Endotracheal Intubation 363
Pneumothorax Treatment 364
Large Vessel Catheterization 364
Arterial Catheters 364
Central Venous Catheters 365
Transcutaneous Oxygen and Carbon Dioxide Monitoring 365
Transillumination 365
Anetoderma of Prematurity 365
Chemical Injury 366
Phototherapy 366
Pressure Ulcerations 366
Extravasation Injuries 367
Calcinosis Cutis 367
Adverse Drug Reactions 368
Nosocomial Infection 368
Subcutaneous Fat Necrosis 368
Sclerema Neonatorum 370
Prenatal Diagnosis 370
Skin Care of Newborn Infants 372
7 Genodermatoses 374
Ectodermal Dysplasia Syndromes 374
Introduction 374
Classification Schema 374
Historical Note and Overview 375
Hypohidrotic Ectodermal Dysplasia 376
Introduction 376
Epidemiology 376
Pathophysiology 376
Clinical Manifestations 376
Therapeutics and Prognosis 378
Hypohidrotic Ectodermal Dysplasia with Immune Deficiency 379
III Diseases of Mucous Membranes and Appendageal Structures 644
9 Mucous membrane disorders 644
Introduction 644
Disorders of the Ocular Mucous Membranes 644
Anatomy (See Fig. 9.1.) 644
Blepharitis 644
Pediculosis of the Eyelashes (Phthiriasis Palpebrarum) 645
Conjunctivitis 645
Conjunctivitis in the infant 645
Chemical conjunctivitis 645
Bacterial conjunctivitis 645
Gonococcal conjunctivitis 646
Chlamydial conjunctivitis 646
Conjunctivitis in the child 646
Viral conjunctivitis 646
Bacterial conjunctivitis 646
Foreign body 646
Allergic conjunctivitis 647
Vernal conjunctivitis 647
Ocular Herpes Simplex Infection 647
Ocular Varicella-Zoster Virus Infection 647
Disorders of the Genital Mucous Membranes 648
Anatomy 648
Pruritus Vulvae 648
Pinworm Infestation (Enterobius Vermicularis) 649
Lichen Sclerosus 649
Genital Herpes Simplex 650
Non-Sexually Related Acute Genital Ulcers in Pubertal Girls 650
Disorders of the Oral Mucous Membranes 651
Mucous Membrane Anatomy 651
Dental Anatomy 651
Oral Hygiene Instructions for Children 651
Infant positioning 651
Intention 651
School-age children 651
Congenital Fistulas of the Lower Lip 653
Double Lip 654
Ascher Syndrome 655
Angular Cheilitis 655
Cheilitis Glandularis 656
Melkersson–Rosenthal Syndrome and Cheilitis Granulomatosa 656
Contact Stomatitis and Cheilitis 658
Macroglossia 659
Lingua Plicata 660
Black Hairy Tongue (Lingua Pilosa Nigra) 661
Geographic Tongue (Annulus Migrans, Exfoliatio Mucosae Areata) 661
Median Rhomboid Glossitis 662
Glossitis 662
Glossodynia and Glossopyrosis 663
Xerostomia 663
Lymphatic Malformation (See also Ch. 20) 664
Benign Papular Lesions of the Tongue 665
Mucosal Cysts 665
Fordyce Spots 666
Mucocele 668
Epulis 668
Focal Epithelial Hyperplasia 669
Gingivostomatitis 669
Herpangina 669
Hand, Foot, and Mouth Disease 669
Herpetic Gingivostomatitis 670
Varicella-Zoster Infections 671
Acute Necrotizing Ulcerative Gingivitis 672
Oral Candidiasis 672
Acute candidiasis 673
Acute pseudomembranous candidiasis (thrush) 673
Acute atrophic oral candidiasis 673
Chronic candidiasis 673
Chronic hyperplastic candidiasis 673
Chronic atrophic candidiasis 673
Chronic mucocutaneous candidiasis 673
Chronic familial mucocutaneous candidiasis 673
Chronic localized mucocutaneous candidiasis 673
Candida endocrinopathy syndrome 673
Chronic diffuse mucocutaneous candidiasis 674
Desquamative Gingivitis 674
Oral-Facial-Digital Syndrome I (Papillon–Léage–Psaume Syndrome) 674
Oral-Facial-Digital Syndrome II (Mohr Syndrome) 675
Tricho-Dento-Osseous Syndrome 675
Böök Syndrome 675
Papillon–Lefèvre Syndrome 675
Acatalasemia 676
Congenital Generalized Hypertrichosis with Gingival Hyperplasia 677
Ulcerative Stomatitis with Neutropenia 677
Recurrent Aphthous Ulceration 678
Pigmented Lesions of the Mucosae 680
Diffuse Macular Pigmentation 680
Racial pigmentation 680
Addison’s disease 680
Widespread oral mucosal hyperpigmentation 680
Familial progressive hyperpigmentation 680
Universal acquired melanosis 681
Heavy metal pigmentation 681
Drug-induced hyperpigmentation 681
Focal Hyperpigmentation 681
Melanoma 681
Melanotic macules 681
Lentigines 682
Amalgam tattoo 682
Nevus of Ota 682
Mucosal Alterations Caused by Drugs 683
Phenytoin 683
Cyclosporine 683
Acetylsalicylic acid (aspirin) 683
Silver nitrate 683
Oral ulcerations secondary to cancer chemotherapy 684
Oral Manifestations of Systemic Diseases 684
Leukemia 684
Langerhans Cell Histiocytosis (Histiocytosis X) 685
Wegener’s Granulomatosis 685
Graft-Versus-Host Disease 686
Lupus Erythematosus 687
Kawasaki Disease 687
Disorders of Multiple Mucous Membranes 688
Leukoplakia 688
White Sponge Nevus of Cannon 689
Hereditary Benign Intraepithelial Dyskeratosis 690
Hereditary Mucoepithelial Dysplasia 690
Pachyonychia Congenita 690
Dyskeratosis Congenita 691
Hyalinosis Cutis ET Mucosae 692
Mucosal Neuroma Syndrome 693
Hereditary Hemorrhagic Telangiectasia 693
Blue Rubber Bleb Nevus Syndrome 694
Sjögren Syndrome 695
Behçet Syndrome 696
Reiter Syndrome 697
Erythema Multiforme Spectrum 698
Toxic Shock Syndrome 699
10 Pigmentary abnormalities 700
Melanocytes and Melanogenesis 700
Components of Normal Skin Color 701
DISORDERS OF HYPERPIGMENTATION 701
Primary Circumscribed Epidermal Hypermelanoses 701
Café-au-lait spots 702
Nevus spilus 703
Non-blaschkoid and blaschkoid segmental hypermelanoses 704
Lentigines and lentiginoses 705
Ephelides (freckles) 706
Periungual hyperpigmentation of newborns 706
Becker’s nevus 706
Primary Circumscribed Dermal Melanocytoses 707
Mongolian spot 707
Nevus of Ota/Ito 708
Acquired Dermal Circumscribed Melanoses 709
Ashy dermatosis 710
Idiopathic eruptive macular pigmentation 710
Confluent and reticulated papillomatosis 711
Terra-firma forme dermatosis 711
Melasma (chloasma) 711
Riehl’s melanosis (pigmented contact dermatitis) 712
acquired Diffuse hypermelanosis syndromes 713
Familial progressive hyperpigmentation 713
The carbon baby 713
Acromelanosis 713
Adrenoleukodystrophy (ALD) 713
Bronze baby syndrome 714
The Reticulated Melanotic Syndromes 714
Post-inflammatory hyperpigmentation 715
Sock-line hyperpigmentation of infancy 715
Prurigo pigmentosa (PP) 715
Hyperpigmentation due to heavy metals and medications 715
Hyperpigmentation in Systemic Disease 717
Adrenocortical insufficiency (Addison disease) 717
Acromegaly 718
Hemochromatosis 718
Childhood cirrhosis 718
Scleroderma 718
Renal failure 718
The H syndrome 718
Pregnancy in adolescence 719
Disorders of Hypopigmentation 719
Congenital Circumscribed Hypomelanosis 719
Hypopigmented Mosaicism 719
Epidemiology 720
Pathogenesis 720
Histology 720
Clinical features 720
Differential diagnosis 721
Treatment 721
Other Circumscribed Congenital Hypopigmented Lesions 721
Acquired Circumscribed Hypomelanosis 722
Post-inflammatory hypomelanosis 722
Differential diagnosis 722
Treatment 722
Lichen sclerosus et atrophicus and morphea 722
Lupus erythematosus 722
Sarcoidosis 723
Mycosis fungoides 723
Pityriasis alba 724
Progressive and confluent hypomelanosis 724
Kwashiorkor 725
Infectious Hypomelanosis 726
Tinea versicolor (pityriasis versicolor) 726
Leprosy 726
Treponematoses 727
Onchocerciasis, 727
Post-kala-azar hypopigmentation 728
Chemical and Drug-Induced Hypomelanosis 728
Vitiligo 730
Genetics 730
Statistics 730
Presenting History 730
Physical Examination 730
Skin 730
Hair, Nails, Teeth, and Mucous Membranes 730
Systemic Manifestations 731
Laboratory Findings 731
Pathophysiology and Histogenesis 731
Molecular, Biochemical, and Immunologic Basis 731
Histology 732
Differential Diagnosis 732
Therapeutics and Prognosis 732
Topical Therapy 732
Phototherapy 732
Other Therapy 733
Prognosis 733
Pediatric Aspects of the Disease 733
Vogt–Koyanagi–Harada Syndrome 733
Neoplastic Disorders of Melanocytes 734
Childhood Melanoma 734
Epidemiology 734
Risk Factors 734
Xeroderma pigmentosum 734
FAMM/dysplastic nevus syndrome 734
Congenital Melanoma 735
Childhood Melanoma Arising in Congenital Melanocytic Nevi 735
Clinical features 735
Principal subtypes of melanoma 735
Staging and prognosis 736
Sentinel lymph node biopsy (SLNB) 737
Treatment 737
Surgery 737
Immunotherapy 737
Chemotherapy 738
Radiation therapy 738
Precursors of Melanoma 738
Congenital Melanocytic Nevi 738
Clinical features 738
Histologic features 738
Complications 739
Malignant transformation to melanoma 739
Neurocutaneous melanosis 739
Management 740
Large/giant CMN 740
Medium CMN 740
Small CMN 740
Surveillance for neurocutaneous melanosis 740
Acquired Melanocytic Nevi 740
Variants of acquired nevi 741
Borderline Melanocytic Tumors of Childhood 743
Spitz Nevi 743
Background 743
Epidemiology 743
Clinical features 743
Histologic features 743
Differential diagnosis 743
Reed nevus (pigmented spindle cell nevus) 744
Atypical Spitz nevus 744
Management 745
11 Hair disorders 747
Congenital or Early Onset Alopecia 747
Diffuse Congenital Atrichia or Hypotrichosis 747
Hypotrichosis Occurring Alone or With Other Minor Abnormalities 747
Isolated congenital atrichia or hypotrichosis 747
Marie Unna hypotrichosis 748
Atrichia with papular lesions 748
Congenital hypotrichosis and milia 748
Hypotrichosis with juvenile macular dystrophy 748
Hypotrichosis with Ectodermal Dysplasias 748
Hypotrichosis with Ichthyoses 748
Ichthyoses presenting as the ‘collodion baby’ phenotype 748
Lamellar ichthyosis 749
Ichthyosis follicularis, congenital atrichia and photophobia (IFAP) 749
Peeling skin syndrome 749
Keratitis, ichthyosis and deafness syndrome (KID syndrome) 749
Congenital ichthyosis, follicular atrophoderma, hypotrichosis and hypohidrosis 750
Autosomal recessive ichthyosis with hypotrichosis (ARIH) syndrome 750
Hypotrichosis with Premature Aging Syndromes 750
Hypotrichosis with Immunodeficiency Syndromes 750
Hypotrichosis with Genetic Disorders of the Hair Shaft 750
Congenital Localized or Patchy Alopecia 750
Neonatal Occipital Alopecia 750
Scalp Injury 750
Temporal Triangular Alopecia 750
Localized Alopecia Associated with Other Nevoid Conditions 751
Congenital melanocytic nevus 751
Sebaceous nevus (of Jadassohn) (Fig. 11.4) 751
Aplastic nevus (syn. minus nevus) 751
Aplasia cutis 751
Cranial meningoceles, encephaloceles and heterotopic meningeal or brain tissue 751
Hypotrichosis with Congenital Forms of Cutis Verticis Gyrata 751
Localized Alopecia Associated with Syndromes 752
Hallermann–Streiff syndrome 752
X-linked dominant conditions 752
Hair Shaft Abnormalities 752
Monilethrix 752
Pseudomonilethrix 753
Pili Torti 754
Menkes Syndrome 754
Other syndromes with pili torti 755
Trichorrhexis Nodosa (TN) 756
Trichorrhexis nodosa with arginosuccinicaciduria (ASAU) 756
Trichothiodystrophy 756
Wooly Hair 757
Uncombable Hair 758
Pili Annulati 759
Pseudopili Annulati 760
Trichorrhexis Invaginata 760
Acquired Progressive Kinking of the Hair 761
Hypertrichosis 761
Diffuse Hypertrichosis 761
Primary hypertrichosis 761
Hypertrichosis lanuginosa 762
Ambras syndrome 762
X-linked dominant hypertrichosis 762
X-linked recessive hypertrichosis 762
Prepubertal hypertrichosis 762
Hypertrichosis as part of other genetically determined disorders 762
Drug-induced hypertrichosis 762
Hypertrichosis with systemic diseases 764
Localized Hypertrichosis 764
Nevoid hypertrichosis 764
Familial cervical hypertrichosis with kyphoscoliosis 764
Anterior cervical hypertrichosis 764
Hairy cutaneous malformations of palms and soles 764
Scrotal hair 765
Hypertrichosis cubiti 765
Hypertrichosis with spinal fusion abnormalities 765
Hypertrichosis with cranial meningoceles, encephaloceles and heterotopic meningeal or brain tissue 765
Hypertrichosis with focal facial dermal dysplasia 765
Hemihypertrophy with hypertrichosis 765
Localized hypertrichosis in association with other nevi or tumors 765
Congenital melanocytic nevus 765
Congenital smooth muscle hamartoma and Becker’s nevus 766
Eccrine angiomatous hamartoma 766
Plexiform neurofibroma 766
Sclerosing tufted angioma 766
Linear melorheostotic scleroderma 766
Hypertrichosis due to local heat and cutaneous hyperemia 766
Eruptive Vellus Hair Cysts 766
Abnormalities of Hair Color 767
Diffuse Hypopigmentation of Hair 767
Primary diffuse hypopigmentation of the hair 767
Premature canities 767
Acquired reversible diffuse hypopigmentation 768
Localized Hypopigmentation (Poliosis) 768
Alteration of Hair Color Due to Exogenous Agents 768
Non-Scarring Alopecia 768
Telogen Effluvium 769
Anagen Effluvium 770
Alopecia Areata 771
Clinical features 771
Diagnosis and differential diagnosis 772
Etiology and pathogenesis 772
Prognosis 773
Therapy 773
Traumatic Alopecia 776
Pressure-Induced Alopecia 776
Traction Alopecia 777
Trichotillomania 777
Diagnosis 778
Treatment 778
Loose Anagen Hair Syndrome 779
Androgenetic Alopecia 780
Scarring Alopecia 782
Keratosis Pilaris Atrophicans 782
Folliculitis Decalvans 784
Dissecting Cellulitis of the Scalp 785
Acne Keloidalis 786
Pseudopelade of Brocq 787
Alopecia Mucinosa 788
Lichen Planopilaris 789
Discoid Lupus Erythematosus (DLE) 790
Morphea 791
Tinea Capitis 792
Hirsutism 792
12 Nail and appendageal abnormalities 794
The Nail 794
Nail Anatomy 794
Nail Growth 796
Nail Composition 796
Alterations in the Nail Plate 797
Beau’s lines 797
Onychomadesis 798
Washboard nails 799
Koilonychia 799
Platyonychia and pincer nails 800
Pitting 800
Multiple longitudinal nail grooves 801
Onychorrhexis 801
Median nail dystrophy 802
Trachyonychia 802
20-nail dystrophy of childhood 802
Onychoschizia 803
Brittle nails 803
Onychauxis 804
Pachyonychia congenita 804
Alterations in Nail Shape 806
Clubbing 806
Shell nails 807
Racket nails 807
Alterations in Nail Size 808
Anonychia 808
Micronychia 809
Polyonychia 809
Nail-patella syndrome 809
Congenital onychodysplasia of the index fingers (COIF) 811
Diseases of the Nail Bed 811
Chromonychia 813
Yellow nail syndrome 815
Longitudinal pigmented bands (longitudinal melanonychia) 815
Ingrown nails 816
Paronychia 817
Nail biting 818
Dactylitis 819
Parakeratosis pustulosa 819
Onychomycosis 820
Nail Biopsy and Surgery 821
Diseases of Eccrine Sweat Glands 821
Functions of Eccrine Sweating 822
Anhidrosis 822
Hyperhidrosis 822
Bromhidrosis 824
Miliaria 824
Neutrophilic Eccrine Hidradenitis 824
Granulosis Rubra Nasi 825
Diseases of Apocrine Glands 825
Apocrine Bromhidrosis 825
Apocrine Chromhidrosis 825
Apocrine Miliaria 826
13 Acne 827
Introduction and Historical Note 827
Introduction 827
Historical Note 827
Epidemiology 827
Genetics 827
Statistics 828
Presenting History 828
Physical Examination 829
Obstructive (comedonal) lesions 829
Inflammatory lesions 830
Scars 830
Laboratory Findings 830
Pathophysiology and Histogenesis 832
Histology 832
Pathophysiology 832
Hormones and sebum production 832
Bacterial colonization 833
Host immune response 834
Abnormal keratinization 834
Differential Diagnosis 835
Therapeutics and Prognosis 835
Patient education 835
Medications 837
Topical therapies 837
Benzoyl peroxide 837
Topical antibiotics 837
Topical retinoids 838
Other topical agents 839
Systemic therapies 839
Oral antibiotics 839
Isotretinoin 840
Hormonal therapy 841
Office therapy 842
Complementary and alternative therapies 842
Diet and acne 842
Synthesis 842
Follow-Up 842
Acne Variants 842
Neonatal and Infantile Acne 842
Neonatal Cephalic Pustulosis 843
Acne in Childhood 844
Severe Inflammatory or Nodular Acne in Childhood 844
Acne Conglobata 844
Acne Fulminans 845
Pyoderma Faciale 846
Gram-Negative Folliculitis 846
Persistent Facial Edema 846
Acne Excoriée Des Jeunes Filles 846
Childhood Rosacea and Steroid Rosacea 847
Periorificial Dermatitis in Childhood 847
Acne Venenata 848
Acne cosmetica 848
Pomade acne 849
Occupational acne 849
Chloracne 849
Acneiform Eruptions Induced by Drugs 850
Disorders Associated with Acne 850
IV Reaction Patterns 851
14 Eczematous dermatitis 851
Introduction 851
Atopic Dermatitis 851
Historical Aspects 851
Definitions 851
Epidemiology 852
Incidence and prevalence 852
Genetic predisposition 854
Presenting History 855
Physical Examination 855
Infantile phase 855
Childhood phase 856
Adult phase 857
Associated Findings 857
Diagnosis 858
Diseases that May Be More Severe in Atopic Dermatitis But Can Occur in Unaffected Subjects 862
Keratosis pilaris 862
Pityriasis alba 862
Lichen spinulosus 863
Dyshidrotic eczema 863
Nummular dermatitis 863
Eczema cracquele 864
Juvenile plantar dermatitis 864
Complications of Atopic Dermatitis 864
Histologic findings 866
Pathophysiology of Atopic Dermatitis 866
Barrier function 866
Dendritic cells in atopic dermatitis 867
T cells in atopic dermatitis 867
Staphylococcus aureus 868
Role of autoallergens 869
Differential Diagnosis of Atopic Dermatitis 869
Therapeutics 870
The role of education 870
Basic skin care 870
Overall therapeutic strategy 871
Glucocorticoids 872
Title calcineurin inhibitors (TCIs) 873
Skin barrier repair devices 874
Treatment of infection 874
Antihistamines and leukotriene inhibitors 875
Allergen avoidance 875
Phototherapy 875
Systemic immunosuppressive therapy 876
Cyclosporin 876
Azathioprine 876
Mycophenolate mofetil 876
Methotrexate 877
Biologics 877
Other treatments for AD 877
Prognosis and course of the disease 878
Diaper Dermatitis 878
Introduction 878
History of Diapering 879
Inflammatory Conditions 880
Irritant diaper dermatitis (IDD) 880
Treatment of IDD 881
Candida infection in IDD 882
Jacquet’s diaper dermatitis 882
Granuloma gluteale infantum 883
Perianal pseudoverrucous papules and nodules (PPPN) 883
Allergic contact diaper dermatitis (ACDD) 883
Intertrigo 883
Crohn’s disease in the diaper region 883
Infectious Causes of Diaper Eruptions 884
Bullous impetigo of the diaper region 884
Perianal streptococcal dermatitis (PSD) 884
Recurrent toxin-mediated perineal eruption 885
Nutritional deficiencies 885
Langerhans cell histiocytosis 885
Seborrheic dermatitis 885
Contact Dermatitis 887
Introduction 887
Pathophysiology 887
Irritant contact dermatitis 887
Allergic contact dermatitis 888
Prevalence rates of allergic contact dermatitis in children 888
Diagnosis 889
Pediatric patch testing 889
Special considerations in pediatric patch testing 892
Important contact allergens in childhood 892
Therapeutic Interventions 896
Photodermatitis 897
Autosensitization Dermatitis 897
Perioral Dermatitis 898
Lichen Striatus 899
Lichen Simplex Chronicus (Localized Neurodermatitis) 899
Prurigo Nodularis 900
Papular Urticaria 900
15 Papulosquamous diseases 901
Psoriasis Vulgaris 901
Epidemiology 901
Genetics 901
Statistics 902
Presenting History 903
Examination Findings 903
Laboratory findings 905
Pathophysiology and Histogenesis 906
Pathophysiology 906
Immune system 906
Skin 907
Triggering and exacerbating factors 908
Histologic findings 909
Differential diagnosis 909
Therapy and Prognosis 909
General principles 909
Topical therapy 910
Topical steroids 910
Calcipotriol (vitamin D) 910
Coal tar preparations 911
Anthralin 911
Tazarotene 911
Miscellaneous 911
Phototherapy and systemic therapy 911
Phototherapy 912
Systemic therapy 912
Antibiotics 912
Other systemic treatment 912
Retinoids 912
Cyclosporin 913
Biologics 913
Prognosis 914
Pustular Psoriasis 914
Epidemiology 914
Genetics 914
Statistics 914
Presenting History 915
Physical Examination 915
Associated findings 916
Laboratory findings 916
Pathophysiology and Histogenesis 916
Histologic findings 917
Differential diagnosis 917
Therapy and Prognosis 917
Localized pustular psoriasis 917
Generalized pustular psoriasis 917
Prognosis 918
Psoriatic Arthritis 918
Epidemiology 918
Genetics 918
Statistics 919
Presenting History 919
Physical Examination 919
Joints 919
Hair, nails, teeth, mucous membranes, and associated findings 919
Laboratory findings 920
Pathophysiology and Histogenesis 920
Histologic findings 920
Differential diagnosis 920
Therapy and Prognosis 921
Prognosis 921
Reiter Syndrome 921
Epidemiology 921
Genetics 921
Statistics 921
Presenting History 921
Physical Examination 921
Ocular 921
Joints 922
Genitourinary 922
Mucocutaneous 922
Other clinical findings 922
Laboratory findings 922
Pathophysiology and Histogenesis 922
Histologic findings 923
Differential diagnosis 923
Therapy and Prognosis 923
Prognosis 923
Geographic tongue (benign migratory glossitis, annulus migrans) 923
Epidemiology 923
Genetics 923
Statistics 923
Presenting History 923
V Neoplasms and Systemic Diseases 1135
20 Vascular birthmarks: 1135
Introduction 1135
Vascular Tumors 1135
Infantile Hemangiomas 1135
Etiology/pathogenesis 1136
Clinical characteristics 1137
Sites of involvement 1139
Natural history 1139
pathology 1141
Diagnosis and differential diagnosis 1141
Complications 1142
Ulceration 1142
Bleeding 1147
Infection 1147
Amblyopia 1147
Hemangiomas of the airway 1147
Hepatic Hemangiomas 1147
Diffuse neonatal hemangiomatosis and ‘benign cutaneous hemangiomatosis’ 1148
Association with hypothyroidism 1148
Association of hemangiomas with structural malformations 1148
Management of infantile hemangiomas 1149
Systemic corticosteroids 1150
Intralesional corticosteroids 1150
Topical corticosteroids 1150
Oral propranolol 1151
Recombinant interferon alpha 1151
Surgery 1151
Other Vascular Tumors 1154
Congenital hemangiomas 1154
Lobular capillary hemangioma (pyogenic granuloma) 1155
Tufted angioma (angioblastoma of Nakagawa) and kaposiform hemangioendothelioma 1156
Kasabach–Merritt phenomenon 1156
Multifocal lymphangioendotheliomatosis with thrombocytopenia 1157
Spindle-cell hemangioendothelioma 1158
Congenital eccrine angiomatous hamartoma 1158
Hemosiderotic Targetoid Hemangioma 1159
Infantile Hemangiopericytoma 1159
Vascular Malformations 1159
Pathogenesis 1159
Capillary Malformations 1160
Salmon patches 1160
Port-wine stains (PWS, nevus flammeus) 1160
Sturge–Weber syndrome (SWS) (encephalotrigeminal angiomatosis) 1162
Klippel–Trenaunay (KT) syndrome (angio-osteohypertrophy) 1164
Macrocephaly–cutis marmorata syndrome (macrocephaly-CM syndrome (M-CM, OMIM 602501) 1165
Phakomatosis pigmentovascularis 1166
Telangiectasia 1166
Spider angioma (nevus araneus) 1166
Angioma serpiginosum 1167
Hereditary hemorrhagic telangiectasia (Osler–Weber–Rendu disease) 1167
Generalized essential telangiectasia 1168
Hereditary benign telangiectasia 1168
Unilateral nevoid telangiectasia 1168
Cutis marmorata telangiectatica congenita (CMTC, van Lohuizen syndrome, congenital generalized phlebectasia) 1168
Angiokeratomas 1169
Papular angiokeratoma 1169
Angiokeratoma circumscriptum 1170
Angiokeratoma of Mibelli 1170
Angiokeratoma of the scrotum and vulva (Fordyce) 1170
Angiokeratoma corporis diffusum 1170
Anderson–Fabry disease (Fabry disease; angiokeratoma corporis diffusum) 1170
Fucosidosis 1172
Miscellaneous disorders with angiokeratomas 1172
Venous Malformations 1172
Venous malformation cutaneous and mucosal syndrome (VMCM, OMIM 600195) 1174
Blue rubber bleb nevus syndrome (Bean syndrome) 1174
Glomuvenous malformations (GVM) (glomangioma, OMIM 138000) 1174
Bockenheimer syndrome (diffuse phlebectasia) 1175
Maffucci syndrome 1175
Arteriovenous Malformations (AVMS) 1175
Management 1176
Parkes Weber syndrome 1176
Cobb syndrome 1177
Capillary malformation–arteriovenous malformation syndrome (CM-AVM, OMIM 608354) 1177
Bonnet–Dechaume–Blanc and Wyburn–Mason syndromes 1177
Lymphatic Malformations 1177
Macrocystic lymphatic malformations 1178
Microcystic lymphatic malformations 1178
Lymphedema 1179
Combined Malformations 1179
Verrucous Hemangioma 1180
Gorham Syndrome (Gorham–Stout Syndrome) 1180
Bannayan–Riley–Ruvalcaba Syndrome 1180
Acknowledgments 1180
21 Benign and malignant tumors 1181
Introduction 1181
Clinical Approach 1181
Congenital Tumors 1181
Mosaicism 1181
Solitary versus Multiple 1182
Painful Tumors 1182
Benign versus Malignant 1182
Soft Tissue Tumors 1182
Tumors and Tumor-like Lesions of Subcutaneous Fat 1183
Benign Tumors 1183
Nevus lipomatosus superficialis 1183
Skin tag 1183
Generalized folded skin with underlying nevus lipomatosus 1184
Lipomas 1184
Solitary lipoma 1184
Lumbosacral lipoma 1184
Hibernoma 1184
Lipomatoses 1184
Encephalocraniocutaneous lipomatosis 1184
Infiltrating lipomatosis 1184
Fibrolipoma 1185
Lipofibromatosis 1185
Multiple familial lipomas 1185
Lipoblastoma and lipoblastomatosis 1185
Sarcomas 1185
Liposarcomas 1185
Tumors and Tumor-like Conditions of Fibroblasts and Myofibroblasts 1185
Reactive lesions 1185
Hypertrophic scars and keloids 1185
Nodular fasciitis 1185
Hamartomatous Lesions 1186
Connective tissue nevus 1186
Fibrous hamartoma of infancy 1187
Fibromatosis colli 1187
Juvenile hyaline fibromatosis 1187
Benign Lesions 1187
Dermatofibroma 1187
Dermatomyofibroma 1188
Solitary myofibroma and myofibromatosis 1188
Infantile digital fibromatosis 1188
Angiofibroma 1188
Gingival fibromatosis 1189
Fibroma of tendon sheath 1189
Giant cell tumor of tendon sheath 1189
Fibromatoses 1190
Superficial fibromatoses 1190
Deep or musculoaponeurotic fibromatoses 1190
Tumors of Intermediate Malignancy 1190
Dermatofibrosarcoma protuberans 1190
Giant cell fibroblastoma 1191
Plexiform fibrohistiocytic tumor 1191
Angiomatoid fibrous histiocytoma 1191
Sarcomas 1191
Malignant fibrous histiocytoma 1191
Fibrosarcoma 1192
Neural Tumors 1192
Benign Tumors 1192
Neurofibroma 1192
Neurilemmoma 1193
Neuroma 1193
Granular cell tumor 1193
Neurothekeoma 1194
Meningoceles and meningiomas 1194
Nasal glioma 1194
Ganglioneuroma 1194
Sarcomas 1194
Smooth Muscle Tumors 1194
Benign Tumors 1194
Congenital smooth muscle hamartoma 1194
Leiomyoma 1195
Angioleiomyoma 1195
Sarcomas 1195
Skeletal Muscle Tumors 1195
Benign Tumors 1195
Striated muscle hamartoma 1195
Rhabdomyoma 1196
Sarcomas 1196
Rhabdomyosarcoma 1196
Epithelioid sarcoma 1196
Epithelial Tumors 1196
Actinic Damage 1197
Actinic Keratoses 1198
Squamous Cell Carcinoma 1198
Basal Cell Carcinoma 1198
Adnexal Tumors 1199
Tumors with Follicular Differentiation 1199
Pilomatricoma and cysts 1199
Trichoblastoma and trichoepithelioma 1199
Trichofolliculoma 1200
Trichilemmoma 1200
Fibrofolliculoma 1200
Tumors with Sweat Gland Differentiation 1200
Cylindroma 1200
Syringoma 1201
Eccrine nevus 1201
Eccrine poroma 1201
Eccrine spiradenoma 1201
Hidrocystoma 1202
Syringocystadenoma papilliferum 1202
Other tumors 1202
Tumors of Sebaceous Glands 1202
Nevus sebaceus 1202
Eruptive vellus hair cysts and steatocystoma multiplex 1202
Other tumors 1203
Lymphocytic Disorders 1203
Benign Disorders 1203
Pityriasis lichenoides 1203
Pigmented purpuric dermatoses 1204
Follicular mucinosis 1204
Atypical lobular lymphocytic panniculitis 1204
Pseudolymphoma 1204
Lymphoproliferative Disorders 1205
Lymphomatoid papulosis 1205
Lymphomas 1205
Cutaneous Lymphomas 1205
Mycosis fungoides 1205
Anaplastic large cell lymphoma 1206
Subcutaneous panniculitic T-cell lymphoma 1206
Hydroa-like cutaneous T-cell lymphoma 1206
Marginal zone lymphoma 1207
Systemic Lymphomas Secondarily Involving the Skin 1207
Precursor B-cell lymphoblastic lymphoma 1207
Burkitt lymphoma 1207
Leukemias 1207
Acute Leukemias 1207
Acute lymphoblastic leukemia 1207
Acute myeloid leukemia 1208
Chronic Leukemias 1208
Leukemic Skin Lesions 1209
Neuroblastoma 1209
Ewing Family of Tumors 1210
Metastases 1211
Histiocytic Disorders 1211
Langerhans Cell Disease 1211
Introduction 1211
Presenting history 1212
Physical examination 1212
Histologic findings 1213
Other diagnostic methods 1213
Differential diagnosis 1214
Clinical score and prognosis 1214
Therapeutics and prognosis 1214
Xanthogranuloma Family 1214
Juvenile xanthogranuloma 1215
Progressive nodular histiocytosis 1216
Benign cephalic histiocytosis 1216
Generalized eruptive histiocytosis 1216
Xanthoma disseminatum 1216
Papular xanthoma 1216
Other Histiocytic Disorders 1217
Sinus histiocytosis with massive lymphadenopathy 1217
Indeterminate cell histiocytosis 1217
Gammopathy-associated xanthomas 1217
Dermal dendrocytomas 1217
Hemophagocytic syndrome 1218
22 Cutaneous manifestations of endocrine, metabolic, and nutritional disorders 1219
Thyroid Disorders 1219
Hypothyroidism 1219
Epidemiology 1219
Presenting history 1219
Physical examination 1219
Laboratory findings 1221
Pathophysiology and histogenesis 1221
Differential diagnosis 1221
Therapy 1221
Pediatric aspects 1222
Hyperthyroidism 1222
Presenting history 1222
Physical examination 1222
Laboratory findings 1222
Pathophysiology and pathogenesis 1222
Differential diagnosis 1223
Therapy and prognosis 1223
Pediatric aspects 1223
Growth Hormone Disorders 1223
Growth Hormone Deficiency 1223
Growth Hormone Excess (Gigantism and Acromegaly) 1224
Gonadal Dysgenesis 1224
Epidemiology 1224
Presenting history 1225
Physical examination 1225
Laboratory findings 1226
Pathophysiology and histogenesis 1226
Differential diagnosis 1226
Therapy and prognosis 1227
Pediatric aspects 1227
Adrenal Disorders 1227
Adrenocortical Insufficiency 1227
Epidemiology 1227
Presenting history 1227
Physical examination 1227
Laboratory findings 1228
Pathophysiology and histogenesis 1228
Differential diagnosis 1228
Therapy 1228
Adrenocortical Excess 1229
Presenting history 1229
Physical examination 1229
Laboratory findings 1230
Pathophysiology 1230
Differential diagnosis 1230
Therapy and prognosis 1230
Disorders of Androgen Excess 1231
Epidemiology 1231
Clinical features 1231
Physical examination 1231
Laboratory findings 1232
Pathophysiology 1232
The ovary 1232
The adrenal gland 1233
Premature adrenarche 1234
Congenital adrenal hyperplasia 1234
Peripheral metabolism of androgens 1235
Therapy and prognosis 1235
Disorders of Insulin Resistance 1236
Introduction 1236
Acanthosis Nigricans 1236
Physical examination 1236
Laboratory findings 1236
Pathophysiology and histogenesis 1236
Differential diagnosis 1237
Therapy and prognosis 1237
Pediatric aspects of the disease 1237
Insulin Resistance Syndromes 1237
Leprechaunism 1237
Rabson–Mendenhall syndrome 1238
The lipodystrophies 1238
Generalized lipodystrophies 1239
Familial partial lipodystrophies (FPLD) 1239
HIV-associated lipodystrophy 1239
Polycystic ovary syndrome (PCOS) 1239
Laboratory findings 1240
Pathophysiology 1240
Therapy and prognosis 1240
Pediatric aspects of the disease 1241
Diabetes Mellitus 1241
Epidemiology 1241
Presenting history 1241
Physical examination 1241
Primary skin disease associated with diabetes mellitus 1242
Diabetic hand, limited joint-mobility syndrome, waxy skin, and finger pebbles 1242
Diabetic dermopathy 1242
Necrobiosis lipoidica diabeticorum (NLD) 1242
Granuloma annulare 1243
Diabetic skin changes primarily found in adults 1243
Bullosis diabeticorum 1243
Scleredema 1243
Perforating disorders 1243
Diabetic ulcers 1243
Skin disorders secondary to metabolic changes in diabetes mellitus 1243
Eruptive xanthomas 1243
Local lipodystrophy at injection sites and local reactions to insulin 1243
Infections associated with diabetes mellitus 1244
Other disorders associated with diabetes mellitus 1244
Lipodystrophies 1244
Hemochromatosis 1244
Pathophysiology and histogenesis 1244
Therapy 1244
Disorders of G Protein Signal Transduction 1244
Introduction 1244
Pseudohypoparathyroidism 1245
Polyostotic Fibrous Dysplasia with Multiple Endocrine Abnormalities and Café-Au-Lait Spots (Mccune–Albright Syndrome) 1246
Autoimmune Polyendocrine Syndromes 1247
Multiple Endocrine Neoplasia (Men) Syndromes 1247
Carney Complex 1248
Vitamin D Resistance and Alopecia 1250
Anorexia and Bulimia Nervosa 1250
Disorders of Pregnancy 1251
Pemphigoid Gestationis (Herpes Gestationis) 1253
Pruritic Urticarial Papules and Plaques of Pregnancy (Polymorphous Eruption of Pregnancy) 1253
Prurigo of Pregnancy 1254
Pruritic Folliculitis of Pregnancy 1254
Atopic Eruption of Pregnancy (AEP) 1254
Impetigo Herpetiformis (Pustular Psoriasis of Pregnancy) 1254
Cholestasis of pregnancy (CP) 1255
Systemic Disorders Exacerbated by Pregnancy 1255
Disorders of Minerals and Co-Factors 1255
Zinc 1255
Epidemiology 1255
Presenting history 1256
Physical examination 1256
Laboratory findings 1256
Pathophysiology and histogenesis 1256
Differential diagnosis 1258
Therapy and prognosis 1258
Copper 1258
Wilson’s disease (hepatolenticular degeneration) 1258
Menkes’ kinky hair disease 1259
Biotin deficiency and multiple carboxylase deficiencies 1260
Epidemiology 1260
Presenting history 1260
Physical findings 1260
Laboratory findings 1260
Etiology and pathogenesis 1261
Therapy 1261
Differential diagnosis 1261
Hypoxanthine-guanine phosphoribosyltransferase deficiency 1261
Essential fatty acid Deficiency 1262
Pathophysiology and histogenesis 1262
Laboratory findings 1262
Differential diagnosis 1262
Protein Energy Malnutrition 1262
Kwashiorkor 1263
Marasmus 1264
Vitamins 1264
Vitamin A 1264
Thiamine (B1) 1265
Riboflavin (B2) 1265
Pyridoxine (B6 Group) 1266
Pantothenic Acid 1266
Niacin (B3) 1266
Vitamin B12 1267
Vitamin C (Ascorbic Acid) 1267
Vitamin K 1268
Acknowledgment 1268
23 Rheumatic diseases in children, autoinflammatory syndromes in children, and selected systemic diseases with skin manifestations 1269
Connective Tissue Diseases and Arthritides 1269
Lupus Erythematosus 1269
Epidemiology 1269
Etiology 1270
Physical Examination 1271
Laboratory Findings 1273
Pathogenesis 1274
Differential Diagnosis 1276
Therapy 1276
Prognosis 1277
Neonatal Lupus Erythematosus 1278
Presenting History and Physical Examination 1279
Laboratory Findings 1280
Pathogenesis 1280
Treatment 1280
Prognosis 1280
Juvenile Systemic Sclerosis (JSS) (Formerly Progressive Systemic Sclerosis, PSS; Scleroderma) 1281
Laboratory Findings 1282
Pathogenesis 1282
Differential Diagnosis 1283
Treatment 1283
Prognosis 1283
Eosinophilic Fasciitis 1284
Laboratory Findings 1284
Pathogenesis 1284
Differential Diagnosis 1284
Treatment 1285
Juvenile Dermatomyositis 1285
Incidence 1285
Presenting Complaint 1285
Physical Findings 1286
Skin 1286
Muscles and arteries 1288
Techniques for Diagnosis 1288
Etiology and Pathogenesis 1289
prognosis 1290
treatment 1290
Mixed Connective Tissue Disease (MCTD) 1292
Laboratory Findings 1292
Prognosis 1292
Treatment 1292
Sjögren Syndrome 1293
Laboratory Findings 1293
Differential Diagnosis 1294
Treatment 1294
Juvenile Idiopathic Arthritis (JIA) 1294
Epidemiology 1296
Etiology and Pathogenesis 1296
Laboratory Findings 1296
Clinical Syndromes of JIA 1297
Systemic arthritis 1297
Clinical course 1297
Oligoarthritis 1298
Clinical course 1298
Polyarthritis 1298
VI Infections and Infestations 1331
24 Bacterial infections 1331
Overview 1331
Mechanisms of Skin Infection 1331
Diagnosis of Skin Infection 1334
Treatment of Skin Infections 1335
Antibiotic Treatment 1335
Topical agents 1335
Penicillins 1336
Methicillin resistance 1336
Macrolides 1336
Cephalosporins 1336
First-generation cephalosporins 1337
Second-generation cephalosporins 1337
Third-generation cephalosporins 1337
Quinolones 1337
Linezolid 1337
Parenteral antibiotic therapy 1337
Skin Infections Caused Predominantly by Staphylococcus Aureus 1337
Impetigo 1337
Epidemiology 1337
Presenting history 1338
Physical examination 1338
Laboratory findings 1339
Pathophysiology 1339
Differential diagnosis 1339
Therapeutics and prognosis 1340
Bacterial Folliculitis 1341
Epidemiology 1341
Presenting history 1341
Physical examination 1341
Laboratory findings 1341
Differential diagnosis 1341
Therapeutics and prognosis 1341
Abscesses 1341
Furuncle and Carbuncle 1342
Epidemiology 1342
Presenting history 1342
Physical examination 1342
Pathophysiology 1342
Laboratory findings 1342
Differential diagnosis 1342
Therapeutics and prognosis 1343
Community-Acquired Methicillin-Resistant Staphylococcus Aureus 1343
Epidemiology 1343
Presenting history 1343
Physical examination 1343
Laboratory findings 1343
Pathophysiology 1343
Therapeutics and prognosis 1344
Botryomycosis 1344
Epidemiology 1344
VII Injury and Responses 1642
29 Physical injury and environmental hazards 1642
Introduction 1642
Adverse Reactions to Solar Radiation 1642
Immunologic Changes due to Ultraviolet Radiation 1642
Sunburn 1642
Idiopathic Photosensitive Disorders 1644
Polymorphic (Polymorphous) Light Eruption 1644
Epidemiology 1644
History and physical examination 1644
Investigations 1645
Pathophysiology 1645
Differential diagnosis 1646
Management 1646
Actinic Prurigo 1646
Epidemiology 1646
History and physical examination 1647
Pathophysiology 1647
Investigation 1647
Histology 1648
Differential diagnosis 1648
Therapy and prognosis 1648
Hydroa Vacciniforme 1648
Epidemiology 1648
History and physical examination 1648
Pathophysiology 1649
Histology 1649
Investigation 1649
Differential diagnoses 1650
Therapy 1650
Adverse Reactions to Cold 1650
Frostnip and Frostbite 1650
Frostnip 1650
Frostbite 1650
Epidemiology 1650
History and clinical findings 1650
Pathophysiology 1651
Histology 1651
Investigations 1651
Therapy and prognosis 1651
Immersion Foot (Trench Foot) 1652
Adverse Reactions to Heat 1652
Burns 1652
Pressure Ulcers 1652
Epidemiology 1652
Pathophysiology 1653
History and physical examination 1657
Prevention 1657
Treatment 1658
Airbag Injury to the Skin 1658
Sports-Related Injury 1658
Friction Blisters 1658
Lichenified Plaques and Nodules 1658
Rower’s rump 1658
Surfer’s nodules 1659
Cyclist’s nodules 1659
Chafing and Abrasions 1659
Traumatic Hemorrhage 1659
Calluses 1660
Piezogenic Papules 1660
Artefactual Skin Disease (Dermatitis Artefacta, Dermatitis Artifacta) 1661
Clinical presentations 1661
Physical injury 1661
Induction of purpura 1661
Chemical injury 1662
Thermal injury 1662
Cold injury 1662
Application of pigment 1663
Introduction of foreign material 1663
Dermatitis neglecta 1663
Simulation of exudates 1663
Hair cutting or shaving 1664
Nail damage (factitial onychodystrophy) 1664
Diagnosis 1664
Pathophysiology 1664
Differential diagnosis 1665
Management 1665
Cutaneous Manifestations of Child Abuse 1665
Physical Abuse 1666
Bruises 1666
Mimics of abusive bruising 1667
Abrasions and Lacerations 1668
Punctures and Incisions 1668
Burns 1668
Thermal burns 1668
Chemical burns 1669
Electrical burns 1669
Friction burns 1669
Mimics of abusive burns 1669
Alopecia 1671
Intra-Oral Manifestations of Child Abuse 1671
Sexual Abuse 1671
Mimics of sexual abuse 1672
Neglect 1672
Cultural Practices Leading to Injury 1672
Cupping 1672
Coining (coin rubbing, cao giao) 1672
Spooning (quat sha) 1672
Moxibustion 1673
Maquas 1673
Salting 1673
Oral suction over the fontanelle 1673
Munchausen by Proxy Syndrome 1674
Aquatic Hazards 1674
Marine Injuries 1674
Cnidaria 1674
Portuguese man-of-war (blue-bottle) 1674
Box jellyfish 1675
Coral 1675
Venomous fish 1676
Bony fish 1676
Stingrays 1676
Sea snakes 1676
Sponges 1677
Echinoderms 1677
Sea urchins 1677
Starfish 1677
Sea cucumber 1677
Molluscs 1677
Gastropods 1677
Cephalopods 1678
Aquatic Dermatitis 1678
Seaweed dermatitis 1678
Cercarial dermatitis (swimmer’s itch) 1678
Estuary dermatitis 1679
Seabather’s eruption 1679
Dogger bank itch (coral dermatitis) 1680
Ghost anemone dermatitis 1680
Red tide dermatitis 1680
Aquatic Infections 1680
Vibrio species 1680
Chromobacterium violaceum 1681
Aeromonas hydrophila 1681
Pseudomonas species 1681
Swimmer’s ear 1681
Pseudomonal folliculitis (hot tub folliculitis) 1681
Pseudomonas hot hand–foot syndrome 1682
Mycobacterium marinum 1682
Miscellaneous minor conditions 1683
Pool Palms 1683
Aquagenic Wrinkling of the Palms 1683
Aquagenic Syringeal Acrokeratoderma 1683
Hazards of Selected Arthropods 1683
Insects 1683
Bees and Wasps 1684
Fire Ants 1684
Mosquitoes, Biting Midges (Sand Flies) and Fleas 1684
Caterpillars 1685
Centipedes and Millipedes 1686
Arachnids 1686
Ticks 1686
Scorpions 1687
Clinical presentation 1687
Treatment 1687
Spiders 1687
Brown spiders (Loxoscelidae) 1688
Clinical presentation 1688
Diagnosis 1689
Index i1