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[Encyclopedia of Differential Diagnosis in Dermatology] Paul Schneiderman, Marc E. Grossman - A Clinician\'s Guide to Dermatologic Differential Diagnosis, Volume 1 The Text (Encyclopedia of Differential Diagnosis in D

PHOTODERMATOSES
Disseminated superficial actinic porokeratosis
PRIMARY CUTANEOUS DISEASES
Acanthosis nigricans
Atopic dermatitis
Cholesteatoma – umbilical nodule
Cutis laxa – umbilical hernia 
Ped Derm 18:365–366, 2001
Epidermolysis bullosa – absent navel syndrome 
BJD 98:584,
1978
Epidermolytic hyperkeratosis
Erythema annulare centrifugum
Fox–Fordyce disease 
Rook p.2002, 1998, Sixth Edition
Ichthyosis bullosa of Siemens
Intertrigo
Lichen nitidus
Lichen sclerosus et atrophicus 
Rook p.2549–2551, 1998,
Sixth Edition
Mid-dermal elastolysis
Omphalith (omphalokeratolith) – the inspissated umbilical bolus
Rook p.3164, 1998, Sixth Edition; Cutis 40:144–146, 1987;
AD 103:221, 1971
Periumbilical (perforating) pseudoxanthoma elasticum 
JAAD
39:338–344, 1998; JAAD 26:642–644, 1992; South Med J
84:788–789, 1991; AD 115:300–303, 1979
Psoriasis
Pseudomyxoma peritonei – blue translucent umbilical lesion
AD 96:462–463, 1967
Seborrheic dermatitis (intertrigo) 
Rook p.3164, 1998,
Sixth Edition
Supraumbilical mid-abdominal raphe 
Ped Derm 10:71–76, 1998
Umbilicolith
PSYCHOCUTANEOUS DISEASES
Factitial dermatitis
SYNDROMES
Aarskog syndrome – prominent umbilicus with protruding
buttonlike central area surrounded by deep ovoid depression
J Pediatr 86:885–891, 1975
UMBILICAL LESIONS
669
Schneiderman page 600-722.qxd 5/16/2006 6:51 PM Page 669


Beare–Stevenson syndrome – cutis gyrata (furrowed skin),
acanthosis nigricans, hypertelorism, swollen lips, swollen
fingers, prominent eyes, ear anomalies, and umbilical hernia
Ped Derm 20:358–360, 2003
Beckwith–Wiedemann syndrome – omphalocele or other
umbilical anomalies 
Syndromes of the Head and Neck,
1990:323–328
Carpenter syndrome (acrocephalosyndactyly) – omphalocele
Am J Med Genet 28:311–324, 1987
Coffin–Siris syndrome – webbed neck, bifid scrotum, umbilical
and inguinal hernias 
JAAD 46:161–183, 2002
Congenital total lipodystrophy (Lawrence–Seip syndrome
lipoatrophic diabetes; Berardinelli syndrome, Seip syndrome) –
umbilical hernia
; extreme muscularity and generalized loss of
body fat from birth, acanthosis nigricans, acromegalic features,
hyperinsulinemia (fasting and postprandial), early onset diabetes
mellitus or glucose intolerance, hypertriglyceridemia/low HDL-C
level, hirsutism, clitoromegaly 
J Clin Endocrinol Metab
85:1776–1782, 2000; AD 91:326–334, 1965
Cornelia de Lange syndrome – umbilical hernia 
Syndromes of
the Head and Neck, p.303, 1990
DeBarsey syndrome – umbilical hernia 
Ped Derm 18:365–366,
2001
Dup (3q) syndrome – omphalocele 
Birth Defects 14:191–217,
1978
Dyskeratosis congenita
Ehlers–Danlos syndrome type IX – umbilical hernia 
Ped Derm
18:365–366, 2001
Elejalde syndrome (acrocephalopolydactylous dysplasia) –
omphalocele 
Birth Defects 13:53–67, 1977
Goltz’s syndrome
Hunter’s syndrome – umbilical and inguinal hernias; reticulated
2–10-mm skin-colored papules over scapulae, chest, neck,
arms; X-linked recessive; MPS type II; iduronate-2 sulfatase
deficiency; lysosomal accumulation of heparin sulfate and
dermatan sulfate; short stature, full lips, coarse facies,
macroglossia, clear corneas (unlike Hurler’s syndrome),
progressive neurodegeneration, communicating hydrocephalus,
valvular and ischemic heart disease, lower respiratory tract
infections, adenotonsillar hypertrophy, otitis media, obstructive
sleep apnea, diarrhea, hepatosplenomegaly, skeletal
deformities (dysostosis multiplex), widely spaced teeth,
dolichocephaly, deafness, retinal degeneration 
Ped Derm
21:679–681, 2004
I-cell disease (mucolipidosis II) – umbilical hernia 
Helv Paediatr
Acta 35:85–95, 1980
Idaho syndrome – umbilical hernia; premature fusion of the
sagittal suture, micrognathia, anomalous pulmonary venous
return, anterior dislocation of the tibiae, contractures of PIP
joints 
J Neurosurg 47:886–898, 1977
Lethal omphalocele and cleft palate 
Hum Genet 64:99, 1983
Marshall–Smith syndrome – omphalocele 
Syndromes of the
Head and Neck, p.340–342, 1990
MC/MR syndrome with multiple circumferential skin creases –
multiple congenital anomalies including high forehead,
elongated face, bitemporal sparseness of hair, broad eyebrows,
blepharophimosis, bilateral microphthalmia and microcornea,
epicanthic folds, telecanthus, broad nasal bridge, puffy cheeks,
microstomia, cleft palate, enamel hypoplasia, micrognathia,
microtia with stenotic ear canals, posteriorly angulated ears,
short stature, hypotonia, pectus excavatum, inguinal and
umbilical hernias, scoliosis, hypoplastic scrotum, long fingers,
overlapping toes, severe psychomotor retardation, resembles
Michelin tire baby syndrome 
Am J Med Genet 62:23–25, 1996
Menke gene variant – umbilical hernia 
Ped Derm 18:365–366,
2001
Mucopolysaccharidoses (Hurler’s, Hurler–Schei, Sanfilippo,
Morquio, Maroteaux–Lamy, Sly syndromes) – umbilical hernias
Rook p.2624–2625, 1998, Sixth Edition
Occipital horn syndrome – umbilical hernia 
Ped Derm
18:365–366, 2001
Olmsted syndrome – periumbilical fissured keratotic plaques
Pseudoxanthoma elasticum
Rieger syndrome (hypodontia and prmary mesodermal
dysgenesis of the iris) – failure of periumbilical skin to involute;
exomphalos 
Br J Ophthalmol 67:529–534, 1983
Short stature, mental retardation, facial dysmorphism, short
webbed neck, skin changes, congenital heart disease – xerosis,
dermatitis, low-set ears, umbilical hernia 
Clin Dysmorphol
5:321–327, 1996
Simpson–Golabi–Behmel syndrome – pre- and post-natal
overgrowth, large cystic kidneys, limb abnormalities, wide
mouth, cleft palate, midline facial clefts, umbilical hernia,
supernumerary nipples 
Clin Genet 51:375–378, 1997
Sjögren–Larsson syndrome – verrucous hyperkeratosis of
flexures, neck, and periumbilical folds; mental retardation,
spastic diplegia, short stature, kyphoscoliosis, retinal changes,
yellow pigmentation, intertrigo – deficiency of fatty aldehyde
dehydrogenase 
Chem Biol Interact 130–132:297–307, 2001; Am
J Hum Genet 65:1547–1560, 1999; JAAD 35:678–684, 1996
Stein–Leventhal syndrome – hypertrichosis of umbilicus
Trisomy 13 syndrome (Patau syndrome) – omphalocele 
J Genet
Hum 23:83–109, 1975
TRAUMA
Hernia 
AD 139:1497–1502, 2003; incarcerated
hernias – umbilical nodules
Ileoumbilical fistula – after surgery for Crohn’s disease 
Dig Dis
Sci 24:316–318, 1979
Neonatal umbilical hemorrhage from slipped ligatures

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