Schneiderman Prelims Vol-I. qxd

260
A CLINICIAN’S GUIDE TO DERMATOLOGIC DIFFERENTIAL DIAGNOSIS, VOLUME 1
Schneiderman page 200-300.qxd 5/16/2006 6:49 PM Page 260

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Liver disease, chronic – diffuse muddy gray hyperpigmentation
with accentuation in perioral, periorbital, and areolar regions
Rook p.2725, 1998, Sixth Edition
Malabsorption
Malnutrition – brown bands of nails 
Ghatan p.78, 2002,
Second Edition
Necrobiosis lipoidica diabeticorum 
Int J Derm 33:605–617,
1994; Rook p.2306, 1998, Sixth Edition; JAAD 18:530–537,
1988
Nutritional deficiencies, including vitamin B
12
Cutis 61:229–232,
1998
Ochronosis – generalized hyperpigmentation with accentuation
over cheeks, forehead, axillae, and genitalia, buccal mucosa,
nails; chromhidrosis 
Rook p.2649, 1998, Sixth Edition; brown
eyelids 
Rook p.2985, 1998, Sixth Edition
Pancreatic panniculitis – heal with post-inflammatory
hyperpigmented spots
Rook p.2414,2727, 1998, Sixth Edition;
JAAD 34:362–364, 1996; Arthritis Rheum 22:547–553, 1979;
Am J Gastroenterol 83:177–179, 1988
Pellagra – after acute photosensitivity subsides, dusky
red–brown hyperpigmentation remains 
Rook p.2659, 1998,
Sixth Edition
Pernicious anemia (vitamin B
12
deficiency) – diffuse or mottled
of face, hands, and feet 
J Dermatol 28:282–285, 2001; –
hyperpigmentation of the flexures; finger and palmar creases,
knuckles; pigmented bands of nails 
AD 122:896–899, 1986
Porphyrias – hereditary coproporphyia, congenital
erythropoietic porphyria 
Semin Liver Dis 2:154–63, 1982;
porphyria cutanea tarda – hyperpigmentation limited to the legs
AD 125:297–299, 1989; darkening of hair BJD 146:325–329,
2002; variegate porphyria Wien Klin Wochenschr 50:830–831,
1937; BMJ ii:89, 1955; hepatoerythropoietic porphyria AD
116:307–313, 1980
Pregnancy – hyperpigmentation including melasma, linea
nigra, neck, nipples, anogenital skin 
Rook p.1780,3269, 1998,
Sixth Edition; brown nails Ghatan p.78, 2002, Second Edition
Scurvy
Sickle cell anemia – hemosiderin deposition of legs 
Rook
p.1794,2736, 1998, Sixth Edition
Thalassemia – leg ulcers with shiny pigmented skin 
Rook
p.2266, 1998, Sixth Edition
Vitamin B
6
deficiency – scrotal hyperpigmentation 
Ped Derm
16:95–102, 1999