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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

UMBILICATED LESIONS
AUTOIMMUNE DISEASES, AND DISEASES
OF IMMUNE DYSFUNCTION
Bowel-associated dermatitis arthritis syndrome – umbilicated
pustules 
BJD 142:373–374, 2000
Linear IgA disease
Lupus erythematosus – discoid lupus erythematosus –
umbilicated papular eruption of the back with acneform
hypertrophic follicular scars 
BJD 87:642–649, 1972
UMBILICATED LESIONS
671
Schneiderman page 600-722.qxd 5/16/2006 6:51 PM Page 671


Palisaded neutrophilic and granulomatous dermatitis of collagen
vascular diseases (rheumatoid arthritis); cutaneous
extravascular necrotizing granuloma; Churg–Strauss
granuloma, rheumatoid papule 
JAAD 47:251–257, 2002; JAAD
34:753–759, 1996; AD 130:1278–1283, 1994
CONGENITAL LESIONS
Dermoid cyst and sinus – central dimple 
JAAD 46:934–941, 2002
DRUG-INDUCED
Transepidermal elimination of collagen after steroid injections
AD 120:539–540, 1984
EXOGENOUS AGENTS
Caustic drilling fluid in petrochemical industry (acquired perforating
disease in oil field workers) – papules with central umbilication due
to perforation of calcium 
JAAD 14:605–611, 1986
Calcium-containing EEG paste – papules with central
umbilication due to perforation of calcium 
Neurology
15:477–480, 1965
Hydrocarbon (tar) keratosis – flat-topped papules of face and
hands; keratoacanthoma-like lesions on scrotum 
JAAD
35:223–242, 1996
Suture material, transepidermal elimination 
AD 120:539–540, 1984
INFECTIONS AND INFESTATIONS
African histoplasmosis (
Histoplasma duboisii ) – umbilicated
papules 
BJD 82:435–444, 1970
Alternaria alternata – molluscum contagiosum-like lesions
AD 121:901, 1985
Aspergillosis – primary cutaneous 
AD 128:1229–1232, 1992;
perforating aspergillosis 
JAAD 15:1305–1307, 1986; molluscum
contagiosum-like lesions
BCG vaccination, disseminated – umbilicated facial papules
Ped Derm 18:205–209, 2001; Ped Derm 14:365–368, 1997;
Ped Derm 13:451–454, 1996
Cladosporium carrioni – molluscum contagiosum-like lesions
Cowpox – umbilicated pustule; hemorrhagic pustule 
JAAD
44:1–14, 2001
Cryptococcosis – molluscum contagiosum-like lesions
AD 132:545–548, 1996; JAAD 26:122–124, 1992;
JAAD 13:845–852, 1985; AD 121:901–902, 1985;
keratoacanthoma-like 
Tyring p.340, 2002
Draining sinus tract
Eczema herpeticum (Kaposi’s varicelliform eruption) 
Cutis
75:33–36, 2005
Fire ant stings (
Solenopsis invicta) – clusters of vesicles evolve
into umbilicated pustules on red swollen base; crusting, heal
with scars; urticaria 
Ann Allergy Asthma Immunol 77:87–95,
1996; Allergy 50:535–544, 1995
Fusarium sepsis
Herpes simplex infection, including eczema herpeticum
Herpes zoster, including eczema herpeticum
Histoplasmosis with transepidermal elimination – molluscum
contagiosum-like lesions 
JAAD 13:842–844, 1985
Insect bites
Leishmaniasis
Leprosy – histoid leprosy 
Int J Lepr Other Mycobact Dis
65:101–102, 1997; Int J Dermatol 34:295–296, 1995;
lepromatous leprosy
Milker’s nodule
Molluscum contagiosum 
Tyring p.62–63, 2002
Monkeypox – exanthem indistinguishable from smallpox –
papulovesiculopustular; vesicles, umbilicated pustules, crusts
CDC Health Advisory, June 7,2003; JAAD 44:1–14, 2001;
J Infect Dis 156:293–298, 1987
Mycetoma – eumycetoma 
AD 141:793–794, 2005
Mycobacterium tuberculosis – congenital tuberculosis – red
papule with central necrosis 
AD 117:460–464, 1981; molluscum
contagiosum-like lesions; miliary tuberculosis 
JAAD
50:S110–113, 2004; Clin Inf Dis 23:706–710, 1996;
papulonecrotic tuberculid 
Indian J Dermatol Venereol Leprol
50:267–268, 1984; miliary
Orf – reddish-blue papule becomes hemorrhagic umbilicated
pustule or bulla surrounded by gray–white or violaceous rim
which is surrounded by a rim of erythema 
Tyring p.54, 2002;
AD 126:356–358, 1990; large lesions may resemble pyogenic
granulomas or lymphoma; rarely widespread papulovesicular or
bullous lesions occur 
Int J Dermatol 19:340–341, 1980
Paecilomyces lilacinus – resemble molluscum contagiosum
JAAD 39:401–409, 1998
Penicillium marneffei – molluscum contagiosum-like lesions
Tyring p.345, 2002; NEJM 344:1763, 2001; JAAD 37:450–472,
1997; Clin Inf Dis 18:246–247, 1994; JAAD 31:843–846, 1994
Perforating folliculitis
Plague (
Yersinia pestis) – umbilicated vesicles and pustules
J Infect Dis 129:S78–84, 1974
Pneumocystis carinii (molluscum contagiosum-like lesions)
AD 127:1699–1701, 1991
Scabies-associated acquired perforating dermatosis
JAAD 51:665–667, 2004
Smallpox
Smallpox vaccination site 
Clin Inf Dis 37:241–250, 2003;
generalized vaccinia – umbilicated vesicopustules 
Clin Inf Dis
37:251–271, 2003
Sporotrichosis – molluscum contagiosum-like lesions
Syphilis – extragenital chancre (KA-like) 
JAAD 13:582–584,
1985
Tanapox – umbilicated papule 
NEJM 350:361–366, 2004;
JAAD 44:1–14, 2001
Trombiculosis – fowl mite bites
Tungiasis – 
Tunga penetrans JAAD 20:941–944, 1989
Vaccinia – umbilicated vesicle (Jennerian vesicle)
JAAD 44:1–14, 2001
Varicella 
The Clinical Management of Itching; Parthenon
Publishing, 2000; p.xi; Rook p.1017–1018, 1998, Sixth Edition
Warts

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