TOXINS
Nicotine stomatitis
Tobacco chewing – diffuse epithelial hyperplasia
TRAUMA
Morsicatio buccarum (cheek biting) – oral papillomatosis due to
chronic buccal trauma
Cutis 43:254–257, 1989; cobblestoning
with biting papillomas
Bolognia p.1085, 2003; Dentate tongue –
scalloping
Papillary hyperplasia of the palate
VASCULAR
Lymphangioma circumscriptum
Rook p.2292,3066, 1998,
Sixth Edition; Otolaryngol Head Neck Surg 90:283, 1982
Lymphatic malformation
BJD 148:1279–1282, 2003
Pyogenic granuloma – verrucous or vegetative lesion
Wegener’s granulomatosis (gingival hyperplasia)
AD 130:861–867, 1994; JAMA 246:2610, 1981
COBBLESTONE APPEARANCE
OF SKIN
AUTOIMMUNE DISEASES, AND DISEASES
OF IMMUNE DYSFUNCTION
Dermatomyositis – cutaneous mucinosis
JAAD 14:1–18, 1986
Lupus erythematosus – discoid lupus erythematosus; papular
and nodular mucinosis with SLE
BJD 115:631–636, 1986
Scleroderma – cobblestoning of dorsum of hand
Rook p.2529,
1998, Sixth Edition
CONGENITAL LESIONS
Smooth muscle hamartoma
DRUG-INDUCED
Cyclosporine-induced folliculodystrophy – cobblestoned follicular
facial and earlobe papules (viral-associated trichodysplasia?)
JAAD 50:318–322, 2004) JAAD 50:310–315, 2004
EXOGENOUS AGENTS
Aquagenic syringeal acrokeratoderma (aquagenic palmoplantar
keratoderma, aquagenic keratoderma
BJD 152:394–395, 2005;
Dermatology 204:8, 2002; JAAD 45:124, 2001
Cold urticaria – positive ice cube test
Exogenous ochronosis (grainy appearance) – topical
application of hydroquinone
JAAD 22:529–531, 1990
INFECTIONS AND/OR INFESTATIONS
Blastomycosis-like pyoderma
Botryomycosis
JAAD 9:428–434, 1983
Condyloma acuminatum
Rook p.3216, 1998, Sixth Edition
Generalized deep dermatophytosis (trichophytic granuloma) –
Trichophyton rubrum AD 140:624–625, 2004
Leishmaniasis – post-kala-azar dermal leishmaniasis; rippled
skin
BJD 143:136–143, 2000
Leprosy, lepromatous
Lobomycosis
Molluscum contagiosum in AIDS
Ped Derm 20:436–439, 2003;
Rook p.2752, 1998, Sixth Edition
Pitted keratolysis
Protothecosis
BJD 146:713–715, 2002
Schistomiasis – vulvar cobblestoned nodule
Am J Surg Pathol
8:787–790, 1984
Small pox scarring
Verrucae vulgaris, including flat warts in AIDS – HPV 5, 6 or 11
Cutis 63:91–94, 1999; JAAD 23:978–981, 1990; warts in
Netherton’s syndrome
BJD 144:1044–1049, 2001
INFILTRATIVE
Amyloidosis – lichen amyloidosis
Rook p.2628–2630, 1998,
Sixth Edition; macular amyloid tumefactive (nodular) amyloidosis –
uncommon variant of cutaneous localized amyloid; female
predominance; deposits of amyloid in papillary and reticular
dermis and subcutaneous fat; 15% of these patients actually
have primary systemic amyloidosis
AD 124:769–774, 1988;
AD 102:8–19, 1970; BJD 82:129–136, 1970
Benign non-X histiocytosis – including xanthoma disseminatum,
generalized eruptive histiocytoma, or indeterminate cell disorder
JAAD 18:1282–1289, 1988
Colloid milium
Focal cutaneous mucinosis
Langerhans cell histiocytosis
Clin Exp Dermatol
27:135–137, 2002
Lichen myxedematosis
BJD 144:594–596, 2001;
scleromyxedema – associated with paraproteinemia
(IgG lambda light chains) (110 Kd 7S IgG); may be missing a
portion of the Fc fragment; not usually associated with myeloma
(those are IgG kappa light chains)
Cutis 39:219–223, 1987
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