Contents Part I Genodermatoses 1 Hyperkeratotic Palms and Soles with Periorificial Keratosis............... 3 2 Indurated, Dark, Hairy Plaques, with Arthritis and Deafness.............. 9 3 Cleft Palate, with a Peculiar Limb Deformity............................ 25 4 Blisters, Hypodontia, Deafness and Alopecia............................ 31 5 Mucocutaneous Pigmentation, Alopecia and Candidiasis.................. 39 6 Congenital Alopecia Associated with Papular Eruption and Abnormal Lesions.............................................. 43 7 Photosensitivity, Lipodystrophy, Mental Retardation and Joint Contractures.............................................. 49 8 Dark, Thick Nipples and Areolas...................................... 55 9 Thick Nails, Palms and Soles......................................... 59 10 Eczema, Recurrent Abscesses and Recurrent Respiratory Tract Infections.................................................... 67 11 Senile at the Age of 20............................................... 73 12 Infantile Alopecia, Characteristic Facies and Sclerosed Atrophic Limbs..... 79 13 A Child with Sagging Cheeks......................................... 89 14 Acrodermatitis Enteropathica Like Eruption............................ 95 15 Acrodermatitis Enteropathica-Like Eruption, Another Unusual Cause...... 101 16 A Child with Hoarse Cry, Subcutaneous Nodules and Joint Contracture..... 107 17 Stubborn Leg Ulcers, Stiff Joints, Acral Sclerodermoid Changes and Fragile Skin................................................... 113 Part II Neutrophilic Dermatoses and Related Disorders 18 Unusual Presentations of an Uncommon Ulcerative Disorder.............. 121 Part III Vascular Disorders and Vasculitis 19 An Unexpected Cause of Leg Ulceration................................ 137 20 Limb Ulcer and Paresis; Acquired and Congenital....................... 143 xi
xii Contents 21 Recurrent Abortions and Atrophic Telangiectatic Leg Lesions with Ulcerations............................................. 149 22 Acral Necrosis in a Heavy Smoker..................................... 157 Part IV Vascular Malformations and Tumors 23 A Persistent Hemorrhagic Swelling.................................... 167 24 Peripheral Gangrene Affecting a Family................................ 173 25 Vascular Eruption in a Long-Standing Systemic Sclerosis................. 181 26 Pendulous Breasts with Reticulate, Vascular and Necrotic Plaques.......... 187 27 Disseminated Ulcerative Vascular Plaques in a Child..................... 193 28 Diffuse Congenital Vascular Lesions Affecting One Limb with Reduced Limb Size............................................. 201 29 Multiple Painless Bluish Nodules...................................... 207 30 A Painful Bluish Nodule............................................. 213 31 An Aggressive Lesion Involving the Scalp of an Elder..................... 219 Part V Cutaneous Lymphomas and Lymphocytic Infiltrate 32 An Unusual Differential Diagnosis of Leg Ulcer.......................... 231 33 A Disease Hiding in a Granuloma..................................... 237 34 Aggressive Follicular Lesions Involving Head and Neck................... 243 35 Non-resolving Chronic Eyelid Swelling................................. 255 36 Rapidly Growing Ulcers on the Face................................... 261 37 Persistent Papules and Nodules on the Side of the Tongue................. 267 38 Ulceration in the Flank of a Middle-Aged Man.......................... 273 39 Pyoderma Gangrenosum-Like Lesions................................. 281 40 Unexplained Anemia with Pyoderma Gangrenosum-Like Ulcer............ 287 41 A Long History of Panniculitis........................................ 293 42 Ulcerated Nodules in a Healthy Woman................................ 301 43 EBV-Associated Granulomatous Lesions............................... 309 Part VI Metabolic and Nutritional Disorders 44 Facial and Flexural Deposits Associated with Scalp Swelling............... 319 45 Generalized Mottled Hyper and Hypopigmentation, Without Systemic Abnormalities...................................... 327 Part VII Infections of the Skin 46 Two Infections Coexisting in One Patient............................... 335 47 An Atypical Presentation of a Cutaneous Infection....................... 343
Contents xiii 48 An Infection Presenting as a Connective Tissue Disease................... 349 49 Asymptomatic Acral Exanthem....................................... 355 50 Draining Ulcers in a Healthy Boy...................................... 359 51 A Child with Fever, Lymphadenitis and Rash........................... 365 52 An Extremely Rare Cause of Erythroderma............................. 371 53 Painless Disfiguring Tumors with Draining Sinuses....................... 379 54 Exquisitely Painful, Rapidly Progressing Lesions........................ 387 55 A Rare Cause of Mucocutaneous Ulceration............................ 393 56 A Rare and Severe Variant of a Common Disease........................ 401 57 Pyogenic Granuloma-Like Nodules in AIDS Patient...................... 409 58 A Scalp Abscess Without an Overlying Wound.......................... 415 59 An Unusual Kerion-Like Scalp Tumor................................. 421 Part VIII Disorders of Connective Tissue 60 Tiny Linear Yellowish Papules on the Neck............................. 429 61 Widespread Hardening of the Skin with Nodular Thickening and Leg Ulcers..................................................... 433 62 Dysmorphic Facies, Tight Skin and Early Death......................... 441 63 Atrophic Blaschkoid Lines Associated with Syndactyly................... 447 Part IX Tumors of Skin Surface and Skin Appendages 64 A Painful and Wet Purple Plaque..................................... 455 65 A Rare Epidermal Tumor Mimicking Seborrheic Keratosis................ 461 66 Enumerable Tiny Follicular Papules................................... 465 67 Bluish Discrete Follicular Papules of Gradual Onset...................... 475 68 Clinically Non-specific, Histologically Very Specific Tumor................ 481 69 A Slowly Growing Tumor in Elderly Females............................ 485 70 A Long Standing Ulcerative Large Tumor on the Scalp................... 493 71 An Eye Lid Tumour That Destroyed the Eye and Extended to the Scalp and Face................................................ 499 72 A Keratotic Penile Lesion............................................ 505 Part X Lichenoid Disorders 73 A Rare Violaceous and Reticulate Lichenoid Eruption with Greasy Scales on the Face.................................................. 515 Part XI Pigmentary Disorders 74 Diffuse Pigmentation with Guttate Hypomelanosis in an Anemic Patient................................................ 523
xiv Contents 75 Diffuse Hyperpigmentation with Guttate Hypomelanosis and Light Hair..................................................... 529 76 Recurrent Pruritic Eruption Resolving with Reticulate Pigmentation....... 539 77 A Child with Hypopigmented Skin, Grey Hair, Neurological and Immunological Defects.......................................... 545 78 Guttate Hypopigmentation and Punctate Palmoplantar Keratoderma....... 551 Part XII Blistering Disorders 79 An Adult with Blisters and Milia on Trauma-Prone Sites.................. 559 80 Traumatic Blisters on the Extremities and White Papules on the Lumbosacral Area of Early Onset............................... 567 81 Acral Blisters with Decreased Sensation and Muscle Wasting.............. 579 82 Extensive and Persistent Erosions Involving the Eyes, Oral Mucosa, Vulva and Skin..................................................... 587 83 Painful Blisters and Erosions on the Scalp.............................. 597 84 Extremely Pruritic Polymorphous Eruption in an Elderly Male............ 603 Part XIII Systemic Diseases and the Skin 85 Pruritus Without a Skin Lesion....................................... 613 86 Early-Onset Jaundice with Severe Pruritus............................. 619 87 Porcelain-Like Scars in a Sick Child................................... 625 88 Different Granulomatous and Pustular Skin Lesions Caused by One Underlying Disorder......................................... 631 89 A Healthy Female with Migratory Pruritic Figurate Erythema............. 645 Part XIV Neurogenic Disorders and Tumors 90 Post-traumatic Burning Pain, Swelling, and Vasomotor Dysfunction....................................................... 655 91 Middle-Aged Female with Asymptomatic Rapidly Growing Nodule.................................................... 663 92 Blueberry-Muffin Lesions in a Baby................................... 671 Part XV Fibrohistiocytic Tumors 93 A Young Woman with Red-White Plaques.............................. 679 94 A Rare Benign Bump on a Child s Digit................................ 685 95 A Recurrent Tender Nodule on the Tip of the Middle Finger............... 691 Part XVI Eosinophilic Disorders 96 Post-traumatic, Rapidly Expanding Tongue Lesion....................... 699
Contents xv 97 Recurrent Urticaria and Angioedema Associated with Persistent Eosinophilia.......................................... 703 Part XVII Histiocytoses 98 Self-Limited Ulcerative Lesions in an Infant............................ 717 99 Mucocutaneous Yellowish Papules and Polyuria......................... 723 Part XVIII Metastatic Tumors of the Skin 100 Hemorrhagic Papules and Nodules on a Male Breast.................... 733 101 A Hemorrhagic Nodule on the Scalp of an Elderly Woman............... 739 Index................................................................. 743
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