Dermatology
Folliculitis Decalvans
* An inflammatory reaction of the hair follicles
* Leads to cicatricial alopecia
* Small pustules surround the follicles
* Erythema, scaling, and smooth shiny depressed scars are apparent
* Pseudopelade
* When the pustules have healed and scarring remains –pseudopelade occurs
* Note intact follicles and single hairs growing
* May occur on axillae and groin as well
* Etiology is unknown
* Scarring alopecia in a middle-aged man, associated with a hyperkeratotic scale-crust with follicular hyperkeratosis and erythema
* TREATMENT:
* Cephalosporins, dicloxacillin, and azithromycin and rifampin may be added to therapy for better long-term control
* Oral zinc or vitamin C supplementation may enhance response
* Chronic inflammation reactions may be helped with topical steroids and by intralesional triamcinolone
* Thick, asbestos-like (amiantaceous), shiny scales attached to the lower part of the hair shaft, rather like tiles overlapping on a roof
* Crusting may be localized or, less commonly generalized over the entire scalp
* There are no structural changes in the hair, but in some patches where the crusting is thick, there may be purulent exudate under the crust and temporary alopecia may occur
Tinea Amiantacea
* Etiology is likely secondary to an infection occurring in seborrheic dermatitis or inverse psoriasis
* Treatment should be shampoo daily or every other day with selenium sulfide susupension, or a tar shampoo , for a few weeks
* Prior application of Baker’s P&S liquid is helpful to remove scale and crust
* Derma-Smoothe and FS shampoo are also effective
Keratosis Follicularis Contagiosa
* Also known as epidemic acne, epidemic follicular eruption, epidemic follicular keratosis, and Brooke’s disease
* Unknown etiology
* Occurs in children
Keratosis Follicularis Contagiosa
* Eruption is widespread and symmetrical, affecting chiefly the back of the neck, the shoulders, and the extensor surfaces of the extremities
* Onset is acute, may affect large numbers of patients in a localized geographic area , and spontaneously involutes over a 3-to-6-week period
* There is a horny thickening of these areas, especially pronounced about the follicles, where small black corneous may be discerned
* Etiology has been hypothesized to be infectious- but not proven
Folliculitis Nares Perforans
Perforating Folliculitis
Kyrle’s Disease
Reactive Perforating Collagenosis
Trichrome stain
Perforating Disease of Hemodialysis
Traumatic Anserine Folliculosis
Disseminate and Recurrent Infundibulofolliculitis
Lichen Spinulosus
Histology:
Treatment:
Hyperhidrosis
Gustatory Hyperhidrosis
Other Localized Forms of Hyperhidrosis
Generalized Hyperhidrosis
Treatment:
Anhidrosis= absence of sweating
Bromidrosis= fetid sweat
Chromhidrosis
Fox-Fordyce Disease
Apocrine gland sweating does not occur in areas of involvement
Treatment is difficult-No form of therapy is uniformly effective
Granulosis Rubra Nasi
Hidradenitis
Neutrophilic Eccrine Hidradenitis
Recurrent Palmoplantar Hidradenitis
Sagittal view of nail unit
Lichen Planus of Nails
Treatment is unsatisfactory-
Psoriatic Nails
Darier’s Disease
Onychomadesis
Beau’s Lines
Half and Half Nails
Muehrcke’s Lines
Mees’ Lines
Terry’s Nails
Onychorrhexis (Brittle Nails)
Onychoschizia
Pitted Nails (Stippled Nails)
Racquet Nails (Nail en Raquette)
Chevron Nail (Herringbone Nail)
Hapalonychia
Platonychia
Nail-Patella Syndrome
Other bone features
Median Nail Dystrophy
Pterygium Unguis
Onychogryphosis
Anonychia
Onychoatrophy
Onychomadesis
Beau’s Lines
Half and Half Nails
Mees’ Lines
Terry’s Nails
Onychorrhexis (Brittle Nails)
Onychoschizia
Pitted Nails (Stippled Nails) .......
Leukonychia or White Nails
Nail-Patella Syndrome
Median Nail Dystrophy
Pterygium Unguis
Pterygium Inversum Unguis
Hangnail
Pincer Nails
Onychophagia
Onychotillomania
Dermatology.ppt
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