METABOLIC
Anasarca – with bullae
Cystic fibrosis – wrinkling of skin after immersion in water
Lancet ii:358–359, 1974
Diabetic finger pebbling (Huntley’s papules) (finger pebbles)
Cutis 69:298–300, 2002; JAAD 14:612–617, 1986
Osteomas – multiple miliary facial osteomas (miliary osteoma
cutis)
Cutis 69:383–386, 2002
Porphyria – erythropoietic protoporphyria
Eur J Pediatr
159:719–725, 2000; J Inherit Metab Dis 20:258–269, 1997;
BJD 131:751–766, 1994; Curr Probl Dermatol 20:123–134,
1991; Am J Med 60:8–22, 1976; porphyria cutanea tarda,
variegate porphyria
Pretibial myxedema – occurs in 1–10% of patients with Grave’s
disease. Often associated with exophthalmos
NEJM 352:918,
2005; JAAD 14:1–18,1986; AD 117:250–251, 1981;
elephantiasic pretibial myxedema
JAAD 46:723–726, 2002
Thyroid acropachy
Xanthomatosis – type II hypercholesterolemia – including
tuberous xanthomas of the eyelids
Eyelid and Conjunctival
Tumors, Shields JA and Shields CL, Lippincott Williams and
Wilkins p.139, 1999
NEOPLASTIC
Acquired digital fibrokeratoma
JAAD 48:S67–68, 2003
Bowen’s disease, vulvar
Ann DV 109:811–812, 1982;
Cancer 14:318–329, 1961
Bowenoid papulosis (vulvar)
Rook p.3234, 1998, Sixth Edition;
JAAD 29:644–646, 1993
Chordoma (sacral tumor) – non-tender, firm, flesh colored
smooth surfaced nodules; may be painful; tumors arising from
the notochord (embryonic precursor of axial skeleton); localize
in midline; sacrococcygeal (50%), non-sacral vertebrae (15%),
and at base of skull (35%); metastases may occur
JAAD 29:63–66, 1993
Clear cell acanthoma (velvety plaque) – usually on legs;
3–20 mm
JAAD 44:314–316, 2001; JAAD 21:313–315, 1989
Connective tissue nevus
Ped Derm 11:84–85, 1994; Curr Prob
Derm 8:137–188, 1996; disseminated collagenomas
Dermatofibrosarcoma protuberans – starts as indurated dermal
plaque which becomes cobblestoned or multilobulated; trunk
more common than proximal extremities or head and neck
JAAD 20:151–152, 1989
Eccrine syringofibroadenoma – acrosyringeal hamartoma; may
be solitary, dermatomal or multiple nevoid tumors; associated
with other eccrine tumors or ectodermal dysplasia syndromes;
face, back, abdomen, buttock, or extremities; tapioca pudding-
like surface; 0.1–25 cm papules, nodules, fleshy, spongy, or
verrucous plaques;
AD 126:945–949, 1990
Epidermal nevus – systematized (ichthyosis hystrix)
Granular cell tumor of the vulva – single or multiple; slow
growing solitary nodules or plaques with smooth or
hyperkeratotic surface; tongue (35%), head and neck (50%),
vulva (5.3%)
Ped Derm 10:153–155, 1993
Grzybowski’s eruptive keratoacanthomas – non-familial; crops
of pruritic lesions on head and neck; numerous lesions under
1 cm; heal with scarring
JAAD 21:1023–1024, 1989
Hamartomas – multiple hamartomas of the ears
JAAD 24:293–295, 1991
Hidrocystomas, multiple
Kaposi’s sarcoma
Leukemia – adult T-cell leukemia (HTLV-1 leukemia/lymphoma);
Southwest Japan, Caribbean, Southeast US, South America,
Africa; all areas where HTLV-1 is endemic; three-quarters of
patients have cutaneous involvement which resembles that
of CTCL; acute and progressive course; ATL cells are
suppressor T-cells and express Tac (IL-2R) on the cell surface
AD 134:439–444, 1998; JAAD 34:69–76, 1996; BJD
128:483–492, 1993; Am J Med 84:919–928, 1988;
JAAD 13:213–219, 1985
Lymphoma – cutaneous T-cell lymphoma
JAAD 23:653–662,
1990; Hodgkin’s disease AD 116:1038–1040, 1980
Melanocytic nevus – congenital melanocytic nevus –
Eyelid
and Conjunctival Tumors, Shields JA and Shields CL,
Lippincott Williams and Wilkins p.80, 1999;
Rook p.1733–1735, 1998, Sixth Edition
Metastases – bile duct carcinoma (rippled appearance) –
percutaneous biliary catheterization may disseminate tumor
cells along the catheter tract
JAAD 25:848–849, 1991
Mucinous nevus
BJD 148:1064–1066, 2003
Nevoid epidermoid cysts
Nevus lipomatosis superficialis
Ped Derm 20:313–314, 2003;
Arch Dermatol Syphilol 130:327, 1921
Nevus sebaceus
Bolognia p.1736, 2003
Osteoma cutis with unilateral linear basal cell nevus – may be
seen as multiple primary osteomas of the face of women,
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