Table Of Content

Field Guide to Clinical Dermatology 2nd Edition DAVIDH.FRANKEL,M.D. AssistantClinicalProfessorofDermatology MountSinaiSchoolofMedicine AssistantAttending, NewYorkMethodistHospital Dermatologist, UNITEHEREHealthCenter MedicalEditor, TheJournalofUrbanHealth NewYorkAcademyofMedicine NewYork,NewYork AcquisitionsEditor:SonyaSeigafuse ManagingEditor:NancyWinter ProjectManager:JenniferHarper ManufacturingCoordinator:KathleenBrown MarketingDirector:SharonZinner DesignCoordinator:StephenDruding CoverDesigner:LarryDidona ProductionServices:LaserwordsPrivateLimited Printer:R.R.Donnelley,ShenzhenChina 2006byLIPPINCOTTWILLIAMS&WILKINS,aWoltersKluwerbusiness 530WalnutStreet Philadelphia,PA19106USA LWW.com 1stedition,1999LippincottWilliams&Wilkins Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybe reproducedinanyformorbyanymeans,includingphotocopying,orutilizedbyanyinformation storageandretrievalsystemwithoutwrittenpermissionfromthecopyrightowner,exceptfor briefquotationsembodiedincriticalarticlesandreviews.Materialsappearinginthisbook preparedbyindividualsaspartoftheirofficialdutiesasU.S.governmentemployeesarenot coveredbytheabove-mentionedcopyright. PrintedintheUSA LibraryofCongressCataloging-in-PublicationData Fieldguidetoclinicaldermatology/[editedby]DavidH.Frankel.—2nded. p.;cm. Includesindex. ISBN0-7817-5627-8 1.Skin—Diseases—Handbooks,manuals,etc.2.Primarycare(Medicine)—Handbooks, manuals,etc.I.Frankel,DavidH.II.Title.[DNLM:1.SkinDiseases—diagnosis—Handbooks. 2.SkinDiseases—therapy—Handbooks.WR39F4542007] RL74.F542007 616.5—dc22 2006008353 Carehasbeentakentoconfirmtheaccuracyoftheinformationpresented andtodescribegenerallyacceptedpractices.However,theauthors,editors,and publisherarenotresponsibleforerrorsoromissionsorforanyconsequences fromapplicationoftheinformationinthisbookandmakenowarranty,expressed orimplied,withrespecttothecurrency,completeness,oraccuracyofthecontents ofthepublication.Applicationofthisinformationinaparticularsituation remainstheprofessionalresponsibilityofthepractitioner. Theauthors,editors,andpublisherhaveexertedeveryefforttoensurethat drugselectionanddosagesetforthinthistextareinaccordancewithcurrent recommendationsandpracticeatthetimeofpublication.However,inviewof ongoingresearch,changesingovernmentregulations,andtheconstantflowof informationrelatingtodrugtherapyanddrugreactions,thereaderisurgedto checkthepackageinsertforeachdrugforanychangeinindicationsanddosage andforaddedwarningsandprecautions.Thisisparticularlyimportantwhenthe recommendedagentisaneworinfrequentlyemployeddrug. SomedrugsandmedicaldevicespresentedinthispublicationhaveFoodand DrugAdministration(FDA)clearanceforlimiteduseinrestrictedresearch settings.ItistheresponsibilityofthehealthcareprovidertoascertaintheFDA statusofeachdrugordeviceplannedforuseintheirclinicalpractice. Topurchaseadditionalcopiesofthisbook,callourcustomerservice departmentat(800)638-3030orfaxordersto(301)223-2320.International customersshouldcall(301)223-2300. VisitLippincottWilliams&WilkinsontheInternet:atLWW.com.Lippincott Williams&Wilkinscustomerservicerepresentativesareavailablefrom8:30amto 6pm,EST. 10 9 8 7 6 5 4 3 2 1 ThiseditionisgivenforloveofJuliaandEli, mychildren. Itisformymother,mybrothersandforAnnie. Anditisfrommyhearttothememoryof RobertFrankel,M.D., myfather. CONTENTS GUIDETOTHEBOOK xiii CONTRIBUTINGAUTHORS xvii PREFACETOTHEFIRSTEDITION xix PREFACETOTHESECONDEDITION xxi ACKNOWLEDGMENTS xxiii SECTION I ■ WARNING:ANOTEONTOPICAL STEROIDS Chapter1 PROPERUSEOFTOPICALCORTICOSTEROIDS 1 SECTION II ■ RASHES A.Rashesthatitchalot Chapter2 ATOPICDERMATITIS 7 Chapter3 CONTACTDERMATITIS 11 Chapter4 SCABIES 13 Chapter5 PEDICULOSIS 16 Chapter6 DYSHIDROTICECZEMA 19 Chapter7 STASISDERMATITIS 21 Chapter8 PRURITUSANDEXCORIATIONSWITHNOPRIMARYSKIN LESIONS 23 v vi CONTENTS B.Redrashesontheface Chapter9 ACNEVULGARIS 26 Chapter10 PERIORALDERMATITIS 29 Chapter11 ROSACEA 31 Chapter12 SEBORRHEICDERMATITIS 33 Chapter13 LUPUSERYTHEMATOSUS 35 Chapter14 DERMATOMYOSITIS 38 C.Redrashes(notface) Chapter15 URTICARIA 41 Chapter16 ERYTHEMAMULTIFORME 44 Chapter17 DRUGERUPTION 47 Chapter18 ERYTHEMAMIGRANS/LYMEDISEASE 49 Chapter19 CANDIDOSIS 52 D.Scalingrashes Chapter20 PSORIASIS 54 Chapter21 PITYRIASISROSEA 57 Chapter22 LICHENPLANUS 59 CONTENTS vii Chapter23 TINEA 61 Chapter24 TINEAVERSICOLOR 64 Chapter25 SECONDARYSYPHILIS 66 SECTION III ■ BLISTERS Chapter26 BULLOUSPEMPHIGOID 69 Chapter27 IMPETIGO 71 Chapter28 HERPESSIMPLEX 73 Chapter29 HERPESZOSTER 76 Chapter30 PEMPHIGUSVULGARIS 78 Chapter31 TOXICEPIDERMALNECROLYSIS/STEVENS–JOHNSON SYNDROME 81 SECTION IV ■ BUMPS A.Bumpsyouthinkmaybecancer Chapter32 SEBORRHEICKERATOSIS 85 Chapter33 SQUAMOUSCELLCARCINOMA 87 Chapter34 ACTINICKERATOSIS 89 Chapter35 KERATOACANTHOMA 91 Chapter36 BASALCELLCARCINOMA 93 viii CONTENTS Chapter37 MELANOCYTICNEVUS 97 Chapter38 HALONEVUS 99 Chapter39 MALIGNANTMELANOMA 101 Chapter40 DYSPLASTICNEVUS 105 Chapter41 DERMATOFIBROMA 108 B.Skin-coloredbumps Chapter42 SKINTAGS 110 Chapter43 EPIDERMOIDCYSTANDPILARCYST 112 Chapter44 MOLLUSCUMCONTAGIOSUM 114 C.Redbumps Chapter45 CHERRYANGIOMA 116 Chapter46 GRANULOMAANNULARE 118 Chapter47 FOLLICULITIS 120 Chapter48 PYOGENICGRANULOMA 122 D.White,tinybumpsontheface Chapter49 MILIUM 124 Chapter50 SYRINGOMA 126 CONTENTS ix E.Redbumpsthathurt Chapter51 FURUNCLEANDCARBUNCLE 127 Chapter52 ERYTHEMANODOSUM 129 Chapter53 HIDRADENITISSUPPURATIVA 131 Chapter54 CHONDRODERMATITISNODULARISCHRONICAHELICIS 133 F.Scars Chapter55 KELOIDANDHYPERTROPHICSCAR 135 G.Soft,mushybumpsorlumps Chapter56 LIPOMA 137 H.Yellowbumps Chapter57 XANTHELASMA 139 Chapter58 XANTHOMA 141 Chapter59 WARTS 143 SECTION V ■ SPOTS A.Purple(itwon’tblanch) Chapter60 KAPOSI’SSARCOMA 147 Chapter61 ECCHYMOSIS/ACTINICPURPURA 149 Chapter62 CUTANEOUSVASCULITIS 151 x CONTENTS B.Light-coloredspots Chapter63 POSTINFLAMMATORYHYPOPIGMENTATION 153 Chapter64 LICHENSCLEROSUSETATROPHICUS 155 Chapter65 VITILIGO 157 Chapter66 MORPHEA(LOCALIZEDSCLERODERMA) 159 Chapter67 SCLERODERMA(PROGRESSIVESYSTEMICSCLEROSIS) 161 C.Darkspots Chapter68 LENTIGO 163 Chapter69 POSTINFLAMMATORYHYPERPIGMENTATION 166 SECTIONVI ■ LEGULCERS Chapter70 LEGULCERS 169 SECTIONVII ■ NAILSANDNAILFOLDS Chapter71 ONYCHOMYCOSIS 173 Chapter72 PSEUDOMONASNAILS 175 Chapter73 ACUTEANDCHRONICPARONYCHIA 177 SECTIONVIII ■ HAIRLOSS Chapter74 ALOPECIAAREATA 179 Chapter75 ANDROGENETICALOPECIA 182

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Field Guide to Clinical Dermatology 2nd Edition DAVIDH.FRANKEL,M.D. AssistantClinicalProfessorofDermatology MountSinaiSchoolofMedicine AssistantAttending, NewYorkMethodistHospital Dermatologist, UNITEHEREHealthCenter MedicalEditor, TheJournalofUrbanHealth NewYorkAcademyofMedicine NewYork,NewYork AcquisitionsEditor:SonyaSeigafuse ManagingEditor:NancyWinter ProjectManager:JenniferHarper ManufacturingCoordinator:KathleenBrown MarketingDirector:SharonZinner DesignCoordinator:StephenDruding CoverDesigner:LarryDidona ProductionServices:LaserwordsPrivateLimited Printer:R.R.Donnelley,ShenzhenChina 2006byLIPPINCOTTWILLIAMS&WILKINS,aWoltersKluwerbusiness 530WalnutStreet Philadelphia,PA19106USA LWW.com 1stedition,1999LippincottWilliams&Wilkins Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybe reproducedinanyformorbyanymeans,includingphotocopying,orutilizedbyanyinformation storageandretrievalsystemwithoutwrittenpermissionfromthecopyrightowner,exceptfor briefquotationsembodiedincriticalarticlesandreviews.Materialsappearinginthisbook preparedbyindividualsaspartoftheirofficialdutiesasU.S.governmentemployeesarenot coveredbytheabove-mentionedcopyright. PrintedintheUSA LibraryofCongressCataloging-in-PublicationData Fieldguidetoclinicaldermatology/[editedby]DavidH.Frankel.—2nded. p.;cm. Includesindex. ISBN0-7817-5627-8 1.Skin—Diseases—Handbooks,manuals,etc.2.Primarycare(Medicine)—Handbooks, manuals,etc.I.Frankel,DavidH.II.Title.[DNLM:1.SkinDiseases—diagnosis—Handbooks. 2.SkinDiseases—therapy—Handbooks.WR39F4542007] RL74.F542007 616.5—dc22 2006008353 Carehasbeentakentoconfirmtheaccuracyoftheinformationpresented andtodescribegenerallyacceptedpractices.However,theauthors,editors,and publisherarenotresponsibleforerrorsoromissionsorforanyconsequences fromapplicationoftheinformationinthisbookandmakenowarranty,expressed orimplied,withrespecttothecurrency,completeness,oraccuracyofthecontents ofthepublication.Applicationofthisinformationinaparticularsituation remainstheprofessionalresponsibilityofthepractitioner. Theauthors,editors,andpublisherhaveexertedeveryefforttoensurethat drugselectionanddosagesetforthinthistextareinaccordancewithcurrent recommendationsandpracticeatthetimeofpublication.However,inviewof ongoingresearch,changesingovernmentregulations,andtheconstantflowof informationrelatingtodrugtherapyanddrugreactions,thereaderisurgedto checkthepackageinsertforeachdrugforanychangeinindicationsanddosage andforaddedwarningsandprecautions.Thisisparticularlyimportantwhenthe recommendedagentisaneworinfrequentlyemployeddrug. SomedrugsandmedicaldevicespresentedinthispublicationhaveFoodand DrugAdministration(FDA)clearanceforlimiteduseinrestrictedresearch settings.ItistheresponsibilityofthehealthcareprovidertoascertaintheFDA statusofeachdrugordeviceplannedforuseintheirclinicalpractice. Topurchaseadditionalcopiesofthisbook,callourcustomerservice departmentat(800)638-3030orfaxordersto(301)223-2320.International customersshouldcall(301)223-2300. VisitLippincottWilliams&WilkinsontheInternet:atLWW.com.Lippincott Williams&Wilkinscustomerservicerepresentativesareavailablefrom8:30amto 6pm,EST. 10 9 8 7 6 5 4 3 2 1 ThiseditionisgivenforloveofJuliaandEli, mychildren. Itisformymother,mybrothersandforAnnie. Anditisfrommyhearttothememoryof RobertFrankel,M.D., myfather. CONTENTS GUIDETOTHEBOOK xiii CONTRIBUTINGAUTHORS xvii PREFACETOTHEFIRSTEDITION xix PREFACETOTHESECONDEDITION xxi ACKNOWLEDGMENTS xxiii SECTION I ■ WARNING:ANOTEONTOPICAL STEROIDS Chapter1 PROPERUSEOFTOPICALCORTICOSTEROIDS 1 SECTION II ■ RASHES A.Rashesthatitchalot Chapter2 ATOPICDERMATITIS 7 Chapter3 CONTACTDERMATITIS 11 Chapter4 SCABIES 13 Chapter5 PEDICULOSIS 16 Chapter6 DYSHIDROTICECZEMA 19 Chapter7 STASISDERMATITIS 21 Chapter8 PRURITUSANDEXCORIATIONSWITHNOPRIMARYSKIN LESIONS 23 v vi CONTENTS B.Redrashesontheface Chapter9 ACNEVULGARIS 26 Chapter10 PERIORALDERMATITIS 29 Chapter11 ROSACEA 31 Chapter12 SEBORRHEICDERMATITIS 33 Chapter13 LUPUSERYTHEMATOSUS 35 Chapter14 DERMATOMYOSITIS 38 C.Redrashes(notface) Chapter15 URTICARIA 41 Chapter16 ERYTHEMAMULTIFORME 44 Chapter17 DRUGERUPTION 47 Chapter18 ERYTHEMAMIGRANS/LYMEDISEASE 49 Chapter19 CANDIDOSIS 52 D.Scalingrashes Chapter20 PSORIASIS 54 Chapter21 PITYRIASISROSEA 57 Chapter22 LICHENPLANUS 59 CONTENTS vii Chapter23 TINEA 61 Chapter24 TINEAVERSICOLOR 64 Chapter25 SECONDARYSYPHILIS 66 SECTION III ■ BLISTERS Chapter26 BULLOUSPEMPHIGOID 69 Chapter27 IMPETIGO 71 Chapter28 HERPESSIMPLEX 73 Chapter29 HERPESZOSTER 76 Chapter30 PEMPHIGUSVULGARIS 78 Chapter31 TOXICEPIDERMALNECROLYSIS/STEVENS–JOHNSON SYNDROME 81 SECTION IV ■ BUMPS A.Bumpsyouthinkmaybecancer Chapter32 SEBORRHEICKERATOSIS 85 Chapter33 SQUAMOUSCELLCARCINOMA 87 Chapter34 ACTINICKERATOSIS 89 Chapter35 KERATOACANTHOMA 91 Chapter36 BASALCELLCARCINOMA 93 viii CONTENTS Chapter37 MELANOCYTICNEVUS 97 Chapter38 HALONEVUS 99 Chapter39 MALIGNANTMELANOMA 101 Chapter40 DYSPLASTICNEVUS 105 Chapter41 DERMATOFIBROMA 108 B.Skin-coloredbumps Chapter42 SKINTAGS 110 Chapter43 EPIDERMOIDCYSTANDPILARCYST 112 Chapter44 MOLLUSCUMCONTAGIOSUM 114 C.Redbumps Chapter45 CHERRYANGIOMA 116 Chapter46 GRANULOMAANNULARE 118 Chapter47 FOLLICULITIS 120 Chapter48 PYOGENICGRANULOMA 122 D.White,tinybumpsontheface Chapter49 MILIUM 124 Chapter50 SYRINGOMA 126 CONTENTS ix E.Redbumpsthathurt Chapter51 FURUNCLEANDCARBUNCLE 127 Chapter52 ERYTHEMANODOSUM 129 Chapter53 HIDRADENITISSUPPURATIVA 131 Chapter54 CHONDRODERMATITISNODULARISCHRONICAHELICIS 133 F.Scars Chapter55 KELOIDANDHYPERTROPHICSCAR 135 G.Soft,mushybumpsorlumps Chapter56 LIPOMA 137 H.Yellowbumps Chapter57 XANTHELASMA 139 Chapter58 XANTHOMA 141 Chapter59 WARTS 143 SECTION V ■ SPOTS A.Purple(itwon’tblanch) Chapter60 KAPOSI’SSARCOMA 147 Chapter61 ECCHYMOSIS/ACTINICPURPURA 149 Chapter62 CUTANEOUSVASCULITIS 151 x CONTENTS B.Light-coloredspots Chapter63 POSTINFLAMMATORYHYPOPIGMENTATION 153 Chapter64 LICHENSCLEROSUSETATROPHICUS 155 Chapter65 VITILIGO 157 Chapter66 MORPHEA(LOCALIZEDSCLERODERMA) 159 Chapter67 SCLERODERMA(PROGRESSIVESYSTEMICSCLEROSIS) 161 C.Darkspots Chapter68 LENTIGO 163 Chapter69 POSTINFLAMMATORYHYPERPIGMENTATION 166 SECTIONVI ■ LEGULCERS Chapter70 LEGULCERS 169 SECTIONVII ■ NAILSANDNAILFOLDS Chapter71 ONYCHOMYCOSIS 173 Chapter72 PSEUDOMONASNAILS 175 Chapter73 ACUTEANDCHRONICPARONYCHIA 177 SECTIONVIII ■ HAIRLOSS Chapter74 ALOPECIAAREATA 179 Chapter75 ANDROGENETICALOPECIA 182

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