​Dermatology - Seborrheic Keratosis 
Benign epithelial tumors most commonly occur from seborrheic keratosis. The onset of lesions is delayed until age thirty and is inherited. Over the course of a lifetime, they continue to develop, ranging in size from a few dispersed lesions to literally hundreds in certain extremely old patients.

Lesions can vary in size from tiny, hardly noticeable papules to plaques that have a warty surface and seem to be "stuck on." The lesions are rarely itchy. If they have secondary infections, they become painful.
Damage
Little, scarcely elevated papules, measuring 1 to 3 mm, develop into bigger plaques, either with or without pigment.
The surface feels oily, the edge is strongly marginated, and fine stippling, resembling a thimble's surface, is frequently visible with a hand lens. By using liquid nitrogen to gently freeze the lesion, elevation can be seen. Late plaques appear "greasy" or "stuck on" and have a warty surface. Horn cysts are frequently visible using a hand lens; however, they are always visible and diagnostic through dermoscopy. These are flat, round, oval, brown, gray, black, or skin-colored nodules that range in size from 1 to 6 cm. Lesions can form on the face, trunk, upper limbs, and in women, usually in the submammary skin folds. They can be localized or widespread. Dermatosis papulosa nigra is the term for a group of tiny, black lesions on the face that appear in people with darker complexion. In sun-exposed areas where dermatoheliosis is present, seborrheic keratoses are most prevalent. They have the potential to congregate when numerous and dense.

In a clinical setting, diagnosis is made with ease. Make sure squamous cell carcinoma is not the cause. Malignant melanoma, pigmented basal cell carcinoma (BCC), squamous cell carcinoma, solar lentigo or spreading pigmented actinic keratosis, and verruca vulgaris (differentiated by the presence of thrombosed capillaries in verrucae) are among the conditions included in the differential.

Treatment is not necessary for benign lesions, unless they are for aesthetic purposes. It is possible to simply rub off the entire lesion with light electrocautery. To stop recurrence, the base can then be gently cauterized. However, this makes histopathologic verification of the diagnosis impossible and should only be carried out by a qualified diagnostician. Liquid nitrogen spray cryosurgery is only effective on flat lesions, and recurrences may be more common.
The optimum method is curettage with cryospray after a brief freezing period, which enables histopathologic analysis.

​Dermatology - Measles 
The symptoms of measles, a highly contagious viral illness, include fever, coryza, coughing, mucocutaneous rash, and conjunctivitis. The prevention of infection is greatly enhanced by immunization.
Significant morbidity and mortality are possible. Despite being rare in nations where vaccination is widely practiced, measles kills more than 150,000 people annually worldwide. Recent outbreaks have occurred in the US as vaccination refusal has grown. Aerosolized respiratory droplets from coughing and sneezing transmit the measles. Those who have the infection can spread to others up to five days after the lesions start to show.

A prodrome of fever, malaise, photophobia, conjunctivitis with lacrimation, upper respiratory symptoms (coryza, hacking cough similar to barking dogs), and periorbital edema is present. The rash appears and gets worse before these symptoms start to go away.
Damage
Clusters of tiny, bluish white dots on a red background that occur in the mouth cavity on the buccal mucosa on the second or third day of a feverish illness are known as Koplik spots and are a reliable indicator of measles. Erythematous macules and papules occur on the forehead behind the ears and along the hairline on the fourth febrile day. After that, by the third day, the rash has expanded inferiorly and centrifugally to encompass the face, torso, limbs, palms, and soles of the feet. Confluence of initially separate lesions is possible, particularly on the face, neck, and shoulders. Lesions eventually disappear in the order that they first develop, leaving behind a mild desquamation or a persistent yellow-tan stain.

The measles antigen can, but is not required to, be found in respiratory secretions to confirm the clinical diagnosis. Drug responses, scarlet fever, Kawasaki disease, and other viral exanthems are also included in the differential.

For the majority of cases, measles is a self-limiting infection. As you watch for potential consequences of infections (respiratory, ear), thrombocytopenia, and encephalitis, give supportive and symptomatic therapy.

​Dermatology - Cutaneous B Cell Lymphoma 
Cutaneous B Cell Lymphoma refers to a type of lymphoma that mostly affects the skin. 

The clonal expansion of B lymphocytes is infrequent, accounting for just 20% of all cutaneous lymphomas. This expansion can be limited to the skin or linked to systemic B cell lymphoma. The typical age of onset is usually in the sixth decade of life.

Abnormalities
The crops consist of nodules and plaques that are firm, smooth, and painless. They are red to plum in color and can be found on the skin or beneath it.
The diagnosis is established using gene-typing investigations that demonstrate rearrangement of immunoglobulin genes.
It is important to do a comprehensive investigation of patients to determine if they have nodal and extracutaneous disease. If such disease is present, bone marrow, lymph node, and peripheral blood investigations will reveal comparable morphologic, cytochemical, and immunologic characteristics as the cutaneous infiltrates.
The treatment involves administering x-ray therapy to specific lesions and chemotherapy for disease that has spread across the body.

Dermatology - Acute Necrotizing Ulcerative Gingivitis  
An oropharyngeal cavity infection is known as acute necrotizing ulcerative gingivitis. Poor dental hygiene, HIV/AIDS, immunosuppression, alcohol and tobacco use, and dietary deficiencies are risk factors.
Punched-out interdental papillae ulcers, gingival bleeding, excruciating pain, halitosis or bad odor, fever, lymphadenopathy, and loss of the alveolar bone are among the symptoms.
The differential includes injuries, infections, and cancers, and the diagnosis is clinical.

Administer systemic antibiotics, such as amoxicillin, metronidazole, or clindamycin, and advise patients on maintaining proper oral hygiene.

Dermatology - Tinea Corporis 
A particular class of fungus known as dermatiophytes is responsible for the infection of keratinized cutaneous tissues that causes tinea; arthrospores from these species can live for up to a year in skin scales.
The most prevalent ways for transmission are from person to person, from animals, and, less frequently, via soil. Dermatophytic infections of the trunk, arms, legs, and/or neck, excluding the hands, feet, and groin, are referred to as tinea corporis.

Lesions are arcuate or scaling, strongly marginated plaques with core clearance and peripheral expansion that form an annular structure with concentric rings; lesions fuse to form gyrate patterns. one lesion, and sporadically several scattered ones. There may be crusting at the borders, pustules, vesicles, or psoriasiform plaques.
Papules, pustules, or nodules may indicate folliculitis caused by Dermatophytes.
Fungal hyphae can be seen by direct microscopy of skin scrapings that have been taken using a no. 15 scalpel blade, the edge of a glass microscope slide, or a toothbrush (cervical or tooth brush) and covered with a drop of potassium hydroxide (KOH). Pityriasis rosea, pityriasis alba, tinea versicolor, erythema migrans, subacute lupus erythematosus, annular erythemas, psoriasis, seborrheic dermatitis, and cutaneous T cell lymphoma are among the conditions included in the differential.
Use imidazole powder, benzoyl peroxide wash, and dry skin to stop recurrences. If dermatophytic nail infection is present, make careful to treat it.

Use allylamine lotion (naftifin, terbinafine), naphthionate ointment (tolnaftate), imidazole creams (clotrimazole, miconazole, ketoconazole, econazole, oxiconizole, sudonizole, sertaconazole), or substituted pyridine (ciclopirox olamine).
Among oral antidermophytic agents, Systemic Terbinafine 250-mg tablet is the most effective allylamine. Fluconazole 100-, 150-, or 200-mg pills, or oral suspension (10 or 40 mg/mL), are substitutes for itraconazole 100-mg capsules or oral solution (10 mg/mL).

Dermatology - Nail Psoriasis 

The most prevalent dermatosis that affects the nail apparatus is psoriasis, which affects the nails in >50% of cases, up to 80–90% of cases over the course of a lifetime.

Elkonyxis, also known as pitting, will be present in the nail matrix. These small, shallow punctate depressions come in a variety of sizes and shapes. Though they can also occur as regular lines (transverse; long axis) or in grid-like patterns, their characteristics are isolation and depth.
Lesions in the toenails are rare. The nail is rough, brittle, and dull. Proximal nail matrix destruction is linked to sandpaper nails, or twenty-nail dystrophy; however, this is general and can also be observed in alopecia areata, lichen planus, and atopic dermatitis. 

Repeated transverse depressions may resemble the "washboard" nails of tic habits, where the cuticle is pushed back.
Longitudinal ridging, akin to melted wax, could exist. One or two millimeter white spots in the nail plate called punctate leukonychia are sometimes misdiagnosed as injuries.
An oval, salmon-colored nail bed called "oil" patches may be present, and onycholysis may develop as a result, affecting the hyponychium medially or laterally.
There could be secondary infections. Subungual hyperkeratosis, or raising of the nail plate off the hyponychium, is possible.

A clinical exam and history are used to make a diagnosis. Onycholysis, onychomycosis, trauma (toenail), eczema, and alopecia areata are among the differential diagnoses.

Intralesional triamcinolone 3-5 mg/mL may be useful for matrix involvement. Topical steroid (occluded) decreases hyperkeratosis in nail bed psoriasis. Nail apparatus psoriasis is frequently improved by systemic therapy, such as methotrexate, acitretin, or "biologics," though results may not show up for some months after treatment has finished.

​Dermatology - Acrodermatitis Enteropathica 
An autosomal recessive zinc absorption condition called acrodermatitis enteropathica can strike babies who are breastfed or bottle-fed cow's milk shortly after they are weaned.

Acrodermatitis enteropathica causes growth failure, photophobia, and uncontrollable crying and whining in children. There is anemia, low zinc levels in the serum and plasma, and decreased zinc excretion in the urine.

Dry, scaly, strongly marginated, brilliantly red eczematous dermatitis patches and plaques eventually develop into vesiculobullous, pustular, erosive, and crusted lesions. Lesions first appear in the anogenital and perioral regions, then progress to the scalp, hands, feet, flexural regions, and trunk. Fingertips are shiny, erythematous, and show signs of secondary paronychia and fissures.
Wound healing is compromised when Candida albicans and S. aureus secondary infect lesions. In addition to paronychia, nail loss, and ridging of the nails, diffuse alopecia and graying of the hair also occur. There could be superficial erosions that resemble aphthous and a red, glossy tongue in the oral cavity.

The basis for the diagnosis is the combination of test and clinical data.
Zinc salt supplements taken orally or intravenously (IV) in two to three times the daily requirement can return zinc levels to normal in a matter of days to weeks. Severe erosive and infected skin lesions recover in 1-2 weeks after zinc replacement. Within 24 hours, the diarrhea stops and the irritation and mood sadness go better.

​Dermatology - Port Wine Stain 
A macular capillary malformation (CM) with an irregular shape, red or violaceous, that is present from birth and never goes away on its own is called a port-wine stain (PWS). It is frequent (affecting 0.3% of infants); the deformity is usually limited to the skin, though it can also be linked to leptomeninges (a condition that causes vascular abnormalities in the eye) and Sturge-Weber syndrome.

Macules that range in color from pink to purple are lesions. Large lesions are typically unilateral (85%), however they are not always, and they follow a dermatomal distribution. Lesions most frequently occur on the face, typically on the superior and middle branches of the trigeminal nerve. Mouth and conjunctival mucosa may become involved. CM might also touch other websites. As the patient ages, rubbery nodules or papules frequently appear, severely deforming the body.

Clinical diagnosis is made.
It is possible to conceal PWS with cosmetics during the macular phase. Treatment with copper vapor lasers or tunable dye is quite successful.

​Dermatology - Splinter Hemorrhages 

Psoriasis, atopic dermatitis, and moderate trauma are the most prevalent causes of distal splinter hemorrhages, occurring in up to 20% of the normal population. Trauma, sideropenic anemia, bacterial endocarditis, trichinosis, antiphospholipid antibody syndrome, and altitude sickness are the causes of proximal splinter hemorrhages.

Little linear structures, typically 2-3 mm in length, are positioned along the nail's long axis. When they first form, they are plum in color; after 1-2 days, they deepen to brown or black. With nail growth, local and distant splinter hemorrhages occur.Finding the root cause is the aim of diagnostics.

Determine the underlying illness and treat it.

Dermatology - Infective endocarditis 
The endocardium becomes inflamed with infectious endocarditis, which manifests as mucocutaneous symptoms.
During transitory bacteremia, the main cause is bacterial adhesion to damaged valves.
Septic embolization then happens to the brain, kidney, spleen, skin, and other organs.
Anorexia, fever, and malaise are common non-cardiac problems that patients bring with them. It is common to hear a murmur that is unfamiliar or has changed in tone.
Damage
Osler nodes are erythematous, painful nodules that typically develop on the pads of the fingers and toes. 15% of patients have Janeway lesions, which are nontender, erythematous, nodular lesions that are most frequently encountered on the palms and soles. Splinter hemorrhages are tiny, brown-colored, linear subungual hemorrhages that start off red in the middle part of the nail bed. Petechial lesions are tiny, reddish-brown, nonblanching macules that appear in clusters on the upper chest, extremities, and mucous membranes. They disappear in a few days (20–40%).
Roth spots are white patches of retina near the optic disk that are frequently encircled by hemorrhages; they are also associated with leukemia and pernicious anemia. Usually in the acral region, septic emboli are painful hemorrhagic macules, papules, or nodules.

Main aspects are the basis for diagnosis: A single positive blood culture or an IgG antibody titer >1>:800 for Coxiella burnetii;2) two separate or consistently positive blood cultures for typical microorganisms;3) indications of endocardial involvement, new valvular regurgitation, an echo showing an intracardiac mass, abscess, or valve dehiscence, and minor features
1) susceptibility to infective endocarditis; 2) fever; 3) vasculitis symptoms; 4) immunologic factors, such as glomerulonephritis or positive rheumatoid factor; 5) serologic indications of current infection. A diagnosis is deemed to be confirmed in the event where there are two majors, one major, three minors, or five minors. Three minor traits, or one major and one minor, are regarded as clinically suggestive. All other potential causes of mucocutaneous vasculitis are included in the differential.

Most of the time, parenteral antibiotics are administered for 4-6 weeks at a time. Surgery may be necessary in cases with refractive error.