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Dermatology - Nummular Eczema (NE)
Nummular eczema is a persistent, itchy, inflammatory dermatitis that is most common on the extremities during the winter months when xerosis reaches its peak. People who are atopic frequently have this condition. Although S. aureus is frequently found, its pathogenic relevance is unknown.
Chronic sores that are extremely itchy might endure for weeks or months.
Lesions Coin-shaped plaques with an erythematous foundation that are clustered tiny papules and vesicles.
The differential includes fungal infections, contact dermatitis, psoriasis, mycosis fungoides, impetigo, and familial pemphigus. The diagnosis is made clinically.
Use moisturizers, topical glucocorticosteroids, or ointment containing 2–5% crude coal tar to hydrate your skin.
The UVB-311, or PUVA, therapy works wonders.
Nummular eczema is a persistent, itchy, inflammatory dermatitis that is most common on the extremities during the winter months when xerosis reaches its peak. People who are atopic frequently have this condition. Although S. aureus is frequently found, its pathogenic relevance is unknown.
Chronic sores that are extremely itchy might endure for weeks or months.
Lesions Coin-shaped plaques with an erythematous foundation that are clustered tiny papules and vesicles.
The differential includes fungal infections, contact dermatitis, psoriasis, mycosis fungoides, impetigo, and familial pemphigus. The diagnosis is made clinically.
Use moisturizers, topical glucocorticosteroids, or ointment containing 2–5% crude coal tar to hydrate your skin.
The UVB-311, or PUVA, therapy works wonders.
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Dermatology - Tinea Manuum
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. sometimes unilateral, tinea manuum occurs on the dominant hand and is sometimes confused with tinea pedis.
Tinea manuum often causes pruritus. It is possible for secondary infection to happen.
Lesions On the palmar hand, there are well-defined scaling patches, fissures, and hyperkeratosis; central clearing may also transpire. With dermatophytic folliculitis, the lesion may spread to the dorsum of the hand and manifest as pustules, nodules, and follicular papules. There is a dyshidrotic variety that has bullae, vesicles, and papules.
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). Atopic dermatitis, lichen simplex chronicus, allergic contact dermatitis, irritant contact dermatitis, and psoriasis vulgaris are among the conditions on 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).
The most potent oral antidermophytic medication is Terbinafine, an allylamine, which is administered systemically as a 250 mg tablet for a period of 14 days. Fluconazole 150–200 mg tablets daily for two to four weeks or itraconazole 200 mg daily for seven days are two substitutes.
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. sometimes unilateral, tinea manuum occurs on the dominant hand and is sometimes confused with tinea pedis.
Tinea manuum often causes pruritus. It is possible for secondary infection to happen.
Lesions On the palmar hand, there are well-defined scaling patches, fissures, and hyperkeratosis; central clearing may also transpire. With dermatophytic folliculitis, the lesion may spread to the dorsum of the hand and manifest as pustules, nodules, and follicular papules. There is a dyshidrotic variety that has bullae, vesicles, and papules.
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). Atopic dermatitis, lichen simplex chronicus, allergic contact dermatitis, irritant contact dermatitis, and psoriasis vulgaris are among the conditions on 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).
The most potent oral antidermophytic medication is Terbinafine, an allylamine, which is administered systemically as a 250 mg tablet for a period of 14 days. Fluconazole 150–200 mg tablets daily for two to four weeks or itraconazole 200 mg daily for seven days are two substitutes.
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Dermatology - Porphyria Cutanea Tarda
Porphyria cutanea tarda primarily affects adults and, in contrast to other forms of porphyria, does not present with acute life-threatening episodes. The onset often manifests between the ages of 30 and 50, with rare occurrences in youngsters. Women who are taking oral contraceptives and men who are undergoing estrogen therapy for prostate cancer have an increased risk.
Substances that can trigger porphyria cutanea tarda include ethanol, estrogen, hexachlorobenzene, chlorinated phenols, iron, and tetrachlorodibenzo-p-dioxin. Administration of high dosages of chloroquine might result in the development of clinical symptoms in individuals with "latent" instances, although modest doses are typically employed for therapeutic purposes.
Additional factors that increase the likelihood of a condition include diabetes mellitus (25%), hepatitis C virus, and hemochromatosis.
Patients do not exhibit a typical sensitivity to light, but instead report having "fragile skin," blisters, and large blisters, especially on the back of the hands, following small injuries.
Abnormalities
The central facial skin gradually develops a purple-red discoloration, along with brown hypermelanosis, excessive hair growth (hypertrichosis), and scleroderma-like alterations and scars in exposed places. The presence of tense bullae and erosions on skin that seems normal gradually undergoes healing, resulting in the formation of pink atrophic scars. Additionally, milia measuring 1-2 mm can be observed on the dorsa of the hands and feet, as well as on the nose, forehead, or bald scalp.
The diagnosis is established through clinical assessment and verified by the detection of a pinkish-red fluorescence in the urine upon examination with a Wood lamp. The differential diagnosis comprises pseudoporphyria, chronic renal failure requiring hemodialysis, and epidermolysis bullosa acquisita.
Advise the patient to abstain from consuming ethanol, discontinue any medications that may trigger porphyria cutanea tarda (PCT), and prevent contact with chemicals such as chlorinated phenols and tetrachlorodibenzo-p-dioxin. Perform phlebotomy every one to two weeks for a duration of 5 to 12 months to extract 500 mL of blood and initiate remission. The occurrence of relapse within a year is infrequent, ranging from 5% to 10%. Low-dose chloroquine can achieve remission in individuals who are unable to undergo recurrent phlebotomies due to anemia. However, it should only be administered by a physician who has expertise in treating PCT.
Porphyria cutanea tarda primarily affects adults and, in contrast to other forms of porphyria, does not present with acute life-threatening episodes. The onset often manifests between the ages of 30 and 50, with rare occurrences in youngsters. Women who are taking oral contraceptives and men who are undergoing estrogen therapy for prostate cancer have an increased risk.
Substances that can trigger porphyria cutanea tarda include ethanol, estrogen, hexachlorobenzene, chlorinated phenols, iron, and tetrachlorodibenzo-p-dioxin. Administration of high dosages of chloroquine might result in the development of clinical symptoms in individuals with "latent" instances, although modest doses are typically employed for therapeutic purposes.
Additional factors that increase the likelihood of a condition include diabetes mellitus (25%), hepatitis C virus, and hemochromatosis.
Patients do not exhibit a typical sensitivity to light, but instead report having "fragile skin," blisters, and large blisters, especially on the back of the hands, following small injuries.
Abnormalities
The central facial skin gradually develops a purple-red discoloration, along with brown hypermelanosis, excessive hair growth (hypertrichosis), and scleroderma-like alterations and scars in exposed places. The presence of tense bullae and erosions on skin that seems normal gradually undergoes healing, resulting in the formation of pink atrophic scars. Additionally, milia measuring 1-2 mm can be observed on the dorsa of the hands and feet, as well as on the nose, forehead, or bald scalp.
The diagnosis is established through clinical assessment and verified by the detection of a pinkish-red fluorescence in the urine upon examination with a Wood lamp. The differential diagnosis comprises pseudoporphyria, chronic renal failure requiring hemodialysis, and epidermolysis bullosa acquisita.
Advise the patient to abstain from consuming ethanol, discontinue any medications that may trigger porphyria cutanea tarda (PCT), and prevent contact with chemicals such as chlorinated phenols and tetrachlorodibenzo-p-dioxin. Perform phlebotomy every one to two weeks for a duration of 5 to 12 months to extract 500 mL of blood and initiate remission. The occurrence of relapse within a year is infrequent, ranging from 5% to 10%. Low-dose chloroquine can achieve remission in individuals who are unable to undergo recurrent phlebotomies due to anemia. However, it should only be administered by a physician who has expertise in treating PCT.
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Dermatology - Halo Nevomelanocytic Nevus
Halo nevI are characterized by the presence of moles surrounded by a ring of leukoderma or loss of pigmentation. This occurs due to an autoimmune process that causes the death of nevus cells and melanocytes in the surrounding skin. Halo nevi are found in about 1% of the population. The presence of a white halo signifies regression, and halo nevi typically experience spontaneous involution.
The process consists of three stages: (1) the formation of a white halo around an existing NMN, which may be preceded by a faint redness, lasting for several months; (2) the gradual elimination of the NMN over a period of months to years; and (3) the subsequent repigmentation of the halo, also taking months to years.
Abnormalities
Papular brown moles, which are smaller than 5 mm, exhibit a distinct oval or round halo with well-defined hypomelanosis.
The diagnosis is based on clinical evaluation, and "halo" depigmentation can be observed surrounding several types of skin lesions, such as blue nevus, congenital melanocytic nevi, Spitz nevi, verruca plana, primary melanoma, melanoma metastases, dermatofibroma, and neurofibroma.
To exclude melanoma, it is important to consider abnormal clinical characteristics such as asymmetry, irregular borders, variegation of color, big diameter, or growth in size of the nevus.
Halo nevI are characterized by the presence of moles surrounded by a ring of leukoderma or loss of pigmentation. This occurs due to an autoimmune process that causes the death of nevus cells and melanocytes in the surrounding skin. Halo nevi are found in about 1% of the population. The presence of a white halo signifies regression, and halo nevi typically experience spontaneous involution.
The process consists of three stages: (1) the formation of a white halo around an existing NMN, which may be preceded by a faint redness, lasting for several months; (2) the gradual elimination of the NMN over a period of months to years; and (3) the subsequent repigmentation of the halo, also taking months to years.
Abnormalities
Papular brown moles, which are smaller than 5 mm, exhibit a distinct oval or round halo with well-defined hypomelanosis.
The diagnosis is based on clinical evaluation, and "halo" depigmentation can be observed surrounding several types of skin lesions, such as blue nevus, congenital melanocytic nevi, Spitz nevi, verruca plana, primary melanoma, melanoma metastases, dermatofibroma, and neurofibroma.
To exclude melanoma, it is important to consider abnormal clinical characteristics such as asymmetry, irregular borders, variegation of color, big diameter, or growth in size of the nevus.
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Dermatology - Erythrasma
Erythasma is a result of the excessive proliferation of Corynebacterium minutissimum, a type of gram-positive bacillus known as a diphtheroid bacteria, which is often found on the surface of human skin. Overgrowth arises inside a humid environment, specifically in areas where there is occlusion and skin folds.
Erythasma typically lacks symptoms except for inconspicuous changes in coloration.
Abnormalities
The lesions are well-defined, evenly shaped spots that have a brown or pinkish color. Darker-skinned individuals may get postinflammatory hyperpigmentation. Maceration can occur in the interdigital areas of the foot.
The wood lamp inspection reveals a distinct red fluorescence, and the direct microscopy of skin scrapings using potassium hydroxide (KOH) does not show any presence of fungal microorganisms. The differential diagnosis encompasses intertriginous psoriasis, epidermal dermatophytosis, pityriasis versicolor, and Hailey-Hailey illness.
Advise patients to cleanse the affected area using benzoyl peroxide or sanitizing alcohol gel, and to ensure that the region remains dry to avoid the reappearance of the condition.
Erythasma is a result of the excessive proliferation of Corynebacterium minutissimum, a type of gram-positive bacillus known as a diphtheroid bacteria, which is often found on the surface of human skin. Overgrowth arises inside a humid environment, specifically in areas where there is occlusion and skin folds.
Erythasma typically lacks symptoms except for inconspicuous changes in coloration.
Abnormalities
The lesions are well-defined, evenly shaped spots that have a brown or pinkish color. Darker-skinned individuals may get postinflammatory hyperpigmentation. Maceration can occur in the interdigital areas of the foot.
The wood lamp inspection reveals a distinct red fluorescence, and the direct microscopy of skin scrapings using potassium hydroxide (KOH) does not show any presence of fungal microorganisms. The differential diagnosis encompasses intertriginous psoriasis, epidermal dermatophytosis, pityriasis versicolor, and Hailey-Hailey illness.
Advise patients to cleanse the affected area using benzoyl peroxide or sanitizing alcohol gel, and to ensure that the region remains dry to avoid the reappearance of the condition.
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Dermatology - Lymphangitis
Lymphangitis is an inflammation of the lymphatic vessels beneath the skin, which can be caused by bacterial, viral, or fungal diseases.
The location where entrance occurs is typically visible, and there is usually discomfort and/or redness in the surrounding area.
The lesions are characterized by red linear streaks and palpable lymphatic cords, which can be several centimeters wide. These streaks and cords run from the local lesion towards the regional lymph nodes. The lymph nodes are typically swollen and painful.
The presence of a sharp peripheral injury accompanied by proximal uncomfortable and painful red linear marks that extend towards nearby lymph nodes is indicative of the condition. If feasible, the microbial agent should be identified from the site of entrance.
Manage lymphangitis by administering systemic antibiotic therapy according to the specific causative organism.
Lymphangitis is an inflammation of the lymphatic vessels beneath the skin, which can be caused by bacterial, viral, or fungal diseases.
The location where entrance occurs is typically visible, and there is usually discomfort and/or redness in the surrounding area.
The lesions are characterized by red linear streaks and palpable lymphatic cords, which can be several centimeters wide. These streaks and cords run from the local lesion towards the regional lymph nodes. The lymph nodes are typically swollen and painful.
The presence of a sharp peripheral injury accompanied by proximal uncomfortable and painful red linear marks that extend towards nearby lymph nodes is indicative of the condition. If feasible, the microbial agent should be identified from the site of entrance.
Manage lymphangitis by administering systemic antibiotic therapy according to the specific causative organism.
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Dermatology - Raynaud's phenomenon
Raynaud phenomenon is a condition characterized by reduced blood flow to the fingers or toes, resulting in ischemia, which can be triggered by exposure to cold temperatures and/or mental stress. Vibration-induced injury can manifest in those who frequently utilize vibrating instruments, such as construction workers, butchers, typists, and pianists. Primary Raynaud phenomenon is characterized by the absence of an identifiable reason, whereas secondary Raynaud phenomenon is associated with an underlying disease as the causative factor. The causes of secondary Raynaud phenomenon include connective tissue diseases (such as scleroderma, lupus, dermatomyositis, vasculitis), atherosclerosis, thromboembolism, drugs and toxins including β-adrenergic blockers, ergotamines, and bleomycin, carpal tunnel syndrome, vibration injuries, cryoproteinemia, and cold agglutinins.
The fingers or toes exhibit blanching or cyanosis, which can be observed from the tip to different levels of the digits. The finger located beyond the area of reduced blood flow appears pale or cyanotic and has a lower temperature; the skin closer to the body looks rosy and has a higher temperature. Upon reheating the digits, the blanching may be substituted by cyanosis due to sluggish blood circulation. At the conclusion of the episode, the digits may regain their original color or exhibit a crimson hue, indicating the reactive hyperemic phase. Patients frequently have a continuous vasospasm instead of sporadic episodes. The skin undergoes trophic changes characterized by the development of tight, thin skin, pterygium formation, and clubbing and shortening of the terminal phalanges.
Acrogangrene is a condition that is not commonly seen, but it is frequently observed in individuals with Raynaud phenomenon that is caused by scleroderma. In such cases, the terminal phalanges may become separated or gangrene may develop, which can result in the fingertips being self-amputated.
The diagnosis is primarily based on clinical evaluation, with the key focus being the identification of any underlying etiology, particularly scleroderma.
Calcium channel blockers, anti-adrenergic medications, intravenous prostacyclin, bosentan (an endothelin receptor antagonist), and local botox injections are effective in avoiding episodes.
Raynaud phenomenon is a condition characterized by reduced blood flow to the fingers or toes, resulting in ischemia, which can be triggered by exposure to cold temperatures and/or mental stress. Vibration-induced injury can manifest in those who frequently utilize vibrating instruments, such as construction workers, butchers, typists, and pianists. Primary Raynaud phenomenon is characterized by the absence of an identifiable reason, whereas secondary Raynaud phenomenon is associated with an underlying disease as the causative factor. The causes of secondary Raynaud phenomenon include connective tissue diseases (such as scleroderma, lupus, dermatomyositis, vasculitis), atherosclerosis, thromboembolism, drugs and toxins including β-adrenergic blockers, ergotamines, and bleomycin, carpal tunnel syndrome, vibration injuries, cryoproteinemia, and cold agglutinins.
The fingers or toes exhibit blanching or cyanosis, which can be observed from the tip to different levels of the digits. The finger located beyond the area of reduced blood flow appears pale or cyanotic and has a lower temperature; the skin closer to the body looks rosy and has a higher temperature. Upon reheating the digits, the blanching may be substituted by cyanosis due to sluggish blood circulation. At the conclusion of the episode, the digits may regain their original color or exhibit a crimson hue, indicating the reactive hyperemic phase. Patients frequently have a continuous vasospasm instead of sporadic episodes. The skin undergoes trophic changes characterized by the development of tight, thin skin, pterygium formation, and clubbing and shortening of the terminal phalanges.
Acrogangrene is a condition that is not commonly seen, but it is frequently observed in individuals with Raynaud phenomenon that is caused by scleroderma. In such cases, the terminal phalanges may become separated or gangrene may develop, which can result in the fingertips being self-amputated.
The diagnosis is primarily based on clinical evaluation, with the key focus being the identification of any underlying etiology, particularly scleroderma.
Calcium channel blockers, anti-adrenergic medications, intravenous prostacyclin, bosentan (an endothelin receptor antagonist), and local botox injections are effective in avoiding episodes.
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Dermatology - X-linked Ichthyosis
X-linked ichthyosis is a genetic disorder that is inherited through the X chromosome and is characterized by a deficit in steroid sulfatase. This condition primarily affects boys and leads to the buildup of keratin on the skin, known as retention hyperkeratosis, while the growth of the outer layer of the skin remains normal.
The onset occurs shortly after birth.
20% of individuals with the illness experience cryptoorchidism. Age does not contribute to improvement, and the condition typically deteriorates in temperate areas, particularly during the winter season.
The presence of extensive, firmly attached scales that have a brown or soiled appearance is particularly prominent on the back of the neck, the outer surfaces of the arms, the inner elbows, the back of the knees, and the trunk. Palm, sole, and face are not affected. Comma-shaped stromal corneal opacities can be found in 50% of adult males' eyes. These opacities are asymptomatic and can also be present in certain female carriers.
The diagnosis is made based on the family history and clinical observations. Prenatal diagnosis can be achieved using amniocentesis and chorionic villus sample. The differential diagnosis encompasses all types of ichthyosis, including syndromic ichthyoses.
The most effective way to manage this is by hydrating the affected area through immersion in a bath, followed by the application of petrolatum. Urea-based creams effectively retain moisture in the outermost layer of the skin, known as the stratum corneum. A solution containing 44-60% propylene glycol in water, along with 6% salicylic acid in propylene glycol and alcohol, when applied under a plastic covering, will effectively hydrate the skin. However, caution should be exercised to avoid hypersalicylism.
Hydroxy acids, specifically lactic acid and glycolic acid, are able to regulate the process of scaling. Preparations that contain urea in concentrations ranging from 2% to 10% have proven to be helpful. Retinoids, namely isotretinoin and acitretin, have high efficacy; nonetheless, diligent monitoring for potential harm is necessary. Intermittent therapy may be necessary only for severe instances.
X-linked ichthyosis is a genetic disorder that is inherited through the X chromosome and is characterized by a deficit in steroid sulfatase. This condition primarily affects boys and leads to the buildup of keratin on the skin, known as retention hyperkeratosis, while the growth of the outer layer of the skin remains normal.
The onset occurs shortly after birth.
20% of individuals with the illness experience cryptoorchidism. Age does not contribute to improvement, and the condition typically deteriorates in temperate areas, particularly during the winter season.
The presence of extensive, firmly attached scales that have a brown or soiled appearance is particularly prominent on the back of the neck, the outer surfaces of the arms, the inner elbows, the back of the knees, and the trunk. Palm, sole, and face are not affected. Comma-shaped stromal corneal opacities can be found in 50% of adult males' eyes. These opacities are asymptomatic and can also be present in certain female carriers.
The diagnosis is made based on the family history and clinical observations. Prenatal diagnosis can be achieved using amniocentesis and chorionic villus sample. The differential diagnosis encompasses all types of ichthyosis, including syndromic ichthyoses.
The most effective way to manage this is by hydrating the affected area through immersion in a bath, followed by the application of petrolatum. Urea-based creams effectively retain moisture in the outermost layer of the skin, known as the stratum corneum. A solution containing 44-60% propylene glycol in water, along with 6% salicylic acid in propylene glycol and alcohol, when applied under a plastic covering, will effectively hydrate the skin. However, caution should be exercised to avoid hypersalicylism.
Hydroxy acids, specifically lactic acid and glycolic acid, are able to regulate the process of scaling. Preparations that contain urea in concentrations ranging from 2% to 10% have proven to be helpful. Retinoids, namely isotretinoin and acitretin, have high efficacy; nonetheless, diligent monitoring for potential harm is necessary. Intermittent therapy may be necessary only for severe instances.
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Dermatology - Pyogenic Granuloma
Pyogenic granuloma is a frequently occurring vascular lesion that typically develops quickly in response to modest injury.
A pyogenic granuloma is a vascular lesion that becomes degraded and bleeds either spontaneously or after minimal trauma. The lesion exhibits a sleek texture, either with or without scabs, and may or may not have erosion. The lesion manifests as a vivid red, dark red, purplish, or dark brown-black bump with an overgrowth of the outer layer of skin at the bottom. It can be found on the fingers, lips, mouth, torso, and toes.
The diagnosis is made based on clinical examination, and it is important to exclude the possibility of amelanocytic nodular cancer.
The recommended treatment involves surgically removing the affected area or using a technique called curettage with electrodesiccation at the base.
Pyogenic granuloma is a frequently occurring vascular lesion that typically develops quickly in response to modest injury.
A pyogenic granuloma is a vascular lesion that becomes degraded and bleeds either spontaneously or after minimal trauma. The lesion exhibits a sleek texture, either with or without scabs, and may or may not have erosion. The lesion manifests as a vivid red, dark red, purplish, or dark brown-black bump with an overgrowth of the outer layer of skin at the bottom. It can be found on the fingers, lips, mouth, torso, and toes.
The diagnosis is made based on clinical examination, and it is important to exclude the possibility of amelanocytic nodular cancer.
The recommended treatment involves surgically removing the affected area or using a technique called curettage with electrodesiccation at the base.
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Dermatology - Dysplastic Melanocytic Nevus
Dysplastic nevi (DN) are distinct acquired pigmented lesions characterized by the abnormal growth of melanocytes, which can potentially develop into superficial spreading melanoma. They can appear spontaneously or as a component of a compound melanocytic nevus. These nevi are clinically different from common acquired nevi, since they are larger, have more varied colors, asymmetrical outlines, and uneven borders. They also have distinct histologic findings.
Lesions typically develop in later infancy compared to common acquired nevomelanocytic nevi (NMN), which initially manifest in late childhood, shortly before puberty. Additional lesions persistently emerge over an extended period of time. While common moles typically exhibit a similar stage of growth in a certain area of the body, such as being junctional, compound, or dermal, dysplastic nevi (DN) tend to deviate from this pattern. For instance, DN may have a combination of large and small, flat and raised, tan, and extremely dark lesions.
The diagnosis is established through the clinical identification of characteristic and unique skin lesions, which are then further validated using dermoscopy. Once a diagnosis of DN is confirmed in a family member, it is advisable to also assess siblings, children, and parents for the condition. The differential diagnosis include congenital nevomelanocytic nevi, common acquired nevomelanocytic nevi (moles), superficial spreading malignant melanoma, melanoma in situ, lentigo maligna, Spitz nevus, and pigmented basal cell carcinoma.
Dysplastic nevus (DN) should be surgically removed with precise margins. The use of laser or other physical destruction methods should be avoided since they do not allow for histopathologic verification of diagnosis. It is crucial to closely monitor patients with DN in the context of familial melanoma, and it is essential to conduct regular photographic follow-up. It is important to educate patients about the distinct characteristics of DN, malignant melanoma, and typical acquired NMN as digital dermoscopy is the most dependable method. Advise patients to abstain from sunbathing or using tanning salons and to apply sunscreens while being exposed to the outdoors.
Dysplastic nevi (DN) are distinct acquired pigmented lesions characterized by the abnormal growth of melanocytes, which can potentially develop into superficial spreading melanoma. They can appear spontaneously or as a component of a compound melanocytic nevus. These nevi are clinically different from common acquired nevi, since they are larger, have more varied colors, asymmetrical outlines, and uneven borders. They also have distinct histologic findings.
Lesions typically develop in later infancy compared to common acquired nevomelanocytic nevi (NMN), which initially manifest in late childhood, shortly before puberty. Additional lesions persistently emerge over an extended period of time. While common moles typically exhibit a similar stage of growth in a certain area of the body, such as being junctional, compound, or dermal, dysplastic nevi (DN) tend to deviate from this pattern. For instance, DN may have a combination of large and small, flat and raised, tan, and extremely dark lesions.
The diagnosis is established through the clinical identification of characteristic and unique skin lesions, which are then further validated using dermoscopy. Once a diagnosis of DN is confirmed in a family member, it is advisable to also assess siblings, children, and parents for the condition. The differential diagnosis include congenital nevomelanocytic nevi, common acquired nevomelanocytic nevi (moles), superficial spreading malignant melanoma, melanoma in situ, lentigo maligna, Spitz nevus, and pigmented basal cell carcinoma.
Dysplastic nevus (DN) should be surgically removed with precise margins. The use of laser or other physical destruction methods should be avoided since they do not allow for histopathologic verification of diagnosis. It is crucial to closely monitor patients with DN in the context of familial melanoma, and it is essential to conduct regular photographic follow-up. It is important to educate patients about the distinct characteristics of DN, malignant melanoma, and typical acquired NMN as digital dermoscopy is the most dependable method. Advise patients to abstain from sunbathing or using tanning salons and to apply sunscreens while being exposed to the outdoors.
