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Macule

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81. Pityriasis versicolor

a change to the mycelial (filamentous fungus or mould) state of dimorphic yeasts of the genus Malassezia . It leads to hypo- or hyperpigmented coalescing scaly macules on the trunk and upper arms. The eruption is most common in the summer months in adolescents and young adults, favours oily areas of the skin, and often has a relapsing nature requiring frequent treatment. Schwartz RA. Superficial fungal infections. Lancet. 2004 Sep 25-Oct 1;364(9440):1173-82. http://www.ncbi.nlm.nih.gov/pubmed/15451228 (...) presence of risk factors lack of pruritus or pain dyspigmentation macules or patches seborrhoeic distribution fine overlying scale yellow fluorescence under Wood lamp examination high ambient temperature and humidity adolescent and young adult age hyperhidrosis systemic corticosteroid or other immunosuppressant use participation in athletics greasy skin FHx of PV malnutrition use of oral contraceptives HIV infection and other immunosuppressive conditions use of occlusive ointments or creams Diagnostic

2017 BMJ Best Practice

82. Nevi

nevus are: high clinical suspicion of melanoma; history of change in the lesion, supported by physical examination; and/or high suspicion of atypical features suggestive of melanoma. Definition Melanocytic nevi are a group of benign neoplasms or hamartomas made up of melanocytes, the pigment-producing cells of the epidermis. They can present in a variety of ways, most commonly as small, brown, flat macules, raised mammillated dome-shaped papules, bluish-grey macules and papules, and even amelanotic (...) skin-coloured papules. Unless congenital, they first appear in childhood and are more common in people with light skin and eyes. McKee PH, Calonje E, Granter SR, eds. Pathology of the skin. 3rd ed. London: Elsevier; 2005. History and exam presence of risk factors presence since birth asymmetrical, indistinct or irregularly bordered, variably coloured papules with diameter >5 mm history of change in shape and colour asymptomatic (usually) multiple lesions flat, brown macule dome-shaped papule light

2017 BMJ Best Practice

83. Infantile spasms

identification and treatment of the spasms improves prognosis. History and exam presence of risk factors spasms head nodding neurodevelopmental delay or regression ash leaf macules onset age 3-12 months perinatal complication abnormal eye movements microcephaly motor system abnormalities brain malformation neurocutaneous syndrome antenatal or perinatal vascular event intrauterine or perinatal infections inherited metabolic disorder genetic disorders family history neonatal sinovenous thrombosis postnatal

2017 BMJ Best Practice

84. Granuloma annulare

-coloured, pink, or brown macules or small papules soft-tissue nodules perforating papules, crusting or ulcerated lesions erythematous patches diabetes mellitus haematological malignancy herpes zoster HIV hepatitis hyperlipidaemia thyroid disease medications Diagnostic investigations clinical diagnosis skin biopsy fasting blood sugar thyroid function tests lipid screening hepatitis screen HIV testing Treatment algorithm ACUTE Contributors Authors Assistant Professor Dermatology and Internal Medicine

2017 BMJ Best Practice

85. Discoid lupus erythematosus

Discoid lupus erythematosus Discoid lupus erythematosus - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Discoid lupus erythematosus Last reviewed: February 2019 Last updated: November 2017 Summary Most common form of chronic cutaneous lupus erythematosus. Lesions are well-demarcated erythematous macules or papules with a scaly surface, which frequently evolve into larger coin-shaped plaques; typically neither (...) antimalarials if no response. Definition Discoid lupus erythematosus (DLE) is a chronic inflammatory condition of the skin. DLE lesions begin as well-demarcated erythematous macules or papules with a scaly surface, and frequently evolve into larger coin-shaped plaques. In most DLE patients the condition remains confined to the skin; antinuclear antibodies (ANA) are often negative or present in a low titre. Provost TT. The relationship between discoid and systemic lupus erythematosus. Arch Dermatol. 1994;130

2017 BMJ Best Practice

86. Guidelines for the Management of Genital Herpes in New Zealand

. The area may be oedematous and can be extremely tender. Pain on urination is typical, particularly in women and spontaneous urination may be impossible. The ulcers dry to form crusts and later heal, leaving a transient red macule with minimal scarring (if any). Less commonly, lesions can pass through the blister phase quickly and blisters may not be noticed. Involvement of the cervix occurs but speculum examination may not be possible. Lesions may also appear extra-genitally, commonly on thighs (...) often caused by infections and sometimes drugs. Many cases have no obvious precipitating cause. It develops 3–14 days following HSV infection. Mild forms of this condition are common and start and present as macules, papules and urticarial lesions which reach up to 3cm on extremities. They especially affect the hands and feet, dorsum of elbows and knees, and less often the trunk. Some lesions develop into the classical “target” lesion with three colour zones: central dusky erythema, surrounded

2017 New Zealand Sexual Health Society

87. Care of Adults with Neurofibromatosis Type 1

evaluation because of clinical signs (e.g., café- au-lait macules); 5) diagnostic evaluation after detection of an NF1 variant of uncertain significance from ahereditary cancer predisposition gene panel. METHODS At the request of the American College of Medical Genetics and Genomics (ACMG) Professional Practice and Guidelines (PP&G) committee, a work group of experts was convened in July 2015 to develop a Clinical Practice Resource for the clinical care of adults with NF1. Work-group members were

2018 American College of Medical Genetics and Genomics

88. Shingrix vaccine for herpes zoster

may be preceded by prodromal pain or itching, after which erythematous macules or papules appear. These progress into vesicular lesions, then into pustules. The pustules typically crust over within the course of about ten days. In many patients, the HZ rash heals and painful symptoms resolve entirely within about four weeks. 6 In up to about thirty percent of patients, however, the pain will persist for months beyond the initial rash, known as postherpetic neuralgia (PHN). 3 PHN is conventionally

2018 Therapeutics Letter

89. Fungal skin infection - body and groin : What else might it be?

versicolor — well-demarcated multiple round or oval macules of variable colours most commonly on the back, chest, and upper arms. Surface may have a fine scale. May be more noticeable in the summer months if patches fail to tan. Lesions may fluoresce a bright yellow-green or gold colour on Wood lamp examination. See the CKS topic on for more information. Psoriasis — chronic plaque psoriasis typically presents as monomorphic, erythematous plaques covered by adherent silvery-white scale, usually (...) satellite lesions. See the CKS topic on for more information. Erythrasma — typically small, red-brown macules that may coalesce into larger patches with sharp borders; may be slight scaling. Fluoresces a bright coral-red on Wood lamp examination due to the causative organism Corynebacterium minutissimum . Flexural psoriasis — typically affects areas such as the groin, genital area, axillae, inframammary folds, abdominal folds, sacral and gluteal cleft. Lesions are often well-defined, red and glazed

2018 NICE Clinical Knowledge Summaries

90. Warts - anogenital: What else might it be?

, and sexually active adults and is caused by a virus. It is self-limiting, with lesions persisting for up to 6 months. For more information, see the CKS topic on . Condylomata lata — moist warty whiteish papules which may secrete fluid. Associated systemic signs and symptoms include: fever, malaise, adenopathy, and weight loss. They occur in secondary syphillis and are highly contagious. Carcinoma in situ — multifocal erythematous macules, lichenoid, or pigmented papules which may form plaques

2018 NICE Clinical Knowledge Summaries

91. Scabies: What else might it be?

itchy and the vesicles are often excoriated. Folliculitis — suggested by multiple follicular erythematous papules or pustules, most commonly on the chest and back. For more information, see the CKS topic on . Grover's disease (acantholytic dermatosis) — this mainly affects the trunk in elderly or middle-aged people and presents as an acute eruption of discrete, itchy, grey-pink papules or papulovesicles and papules. It is of unknown aetiology. Impetigo — suggested by macules which develop

2018 NICE Clinical Knowledge Summaries

92. Guidelines on autopsy practice: Industrial/occupational-related lung disease deaths including asbestos

macules (impalpable) secondary dust nodules (palpable) diffuse interstitial fibrosis. · complicated coal workers pneumoconiosis progressive massive fibrosis (lesions >1 cm). · coal dust tattoos · diffuse interstitial fibrosis. [Level of evidence: B.] 4 Specific health and safety aspects Subjects with silicosis are at increased risk of tuberculosis. [Level of evidence: B.] No other aspects beyond standard health and safety standards. [Level of evidence: GPP.] 5 Clinical information relevant (...) post mortem confirmed to examination of the thoracic cavity is considered sub-optimal. [Level of evidence: GPP.] 7 Specific significant organ systems Organ Pathology Agent Skin Linear tattoos Coal Corns (knuckles, finger tips) Asbestos Thorax/lungs Adult respiratory distress syndrome (shock lung) Smoke, fumes Emphysema Coal Macules Coal, silicates, iron Nodular fibrosis Coal, silica Silicate (talc, mica) Progressive massive fibrosis Coal, silica, silicates Diffuse interstitial fibrosis, lower zone

2017 Royal College of Pathologists

93. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy Full Text available with Trip Pro

presentations vary with focal to diffuse distributions, including flexural, inverse, and erythrodermic variants. Pruritus can be severe and is the most common associated symptom. Vitiligo presents as well-demarcated depigmented macules and patches, reported exclusively in patients with melanoma. Besides varying clinical presentation, the time to onset varies greatly among these rashes, as vitiligo can appear months after treatment initiation; however, the inflammatory dermatoses usually present within

2018 American Society of Clinical Oncology Guidelines

94. Bruising

eruptions Allergic contact dermatitis. See the Prodigy topic on for more information. Phytophotodermatitis — an inflammatory and pigmentary reaction of the skin to light, following contact with phototoxic substances from certain plants, such as giant hogweed. Stretch marks (striae). Non-linear eruptions Slate-grey naevi (Mongolian blue spots) — macular blue-grey non-tender macules present at birth on the sacrum and buttocks in normal dark-skinned infants. Haemangiomas — benign congenital cutaneous

2017 Prodigy

95. Diagnosis of Idiopathic Pulmonary Fibrosis

pneumonitis (e.g., bronchiolocentric distribution with lymphocyte-rich bronchiolitis, extensive peribronchiolar metaplasia, poorly formed nonnecrotizing granulomas in peribronchiolar interstitium), acute exacerbation of IPF or acute interstitial pneumonia (i.e., hyaline membranes), cicatricialvariantsofcryptogenicorganizing pneumonia with ?brosis (prominent organizing pneumonia), pneumoconiosis (e.g., asbestos bodies, prominent dust macules and/or silicotic nodules), sarcoidosis (prominent well-formed

2018 American Thoracic Society

96. Phenotypic variability among café-au-lait macules in neurofibromatosis type 1. Full Text available with Trip Pro

Phenotypic variability among café-au-lait macules in neurofibromatosis type 1. Café-au-lait macules (CALMs) in neurofibromatosis type 1 (NF1) are an early and accessible phenotype in NF1, but have not been extensively studied.We sought to more fully characterize the phenotype of CALMs in patients with NF1.In all, 24 patients with a diagnosis of NF1 confirmed through clinical diagnosis or molecular genetic testing were recruited from patients seen in the genetics department at the University

2010 Journal of American Academy of Dermatology

97. The Impact of In Vivo Reflectance Confocal Microscopy on the Diagnostic Accuracy of Lentigo Maligna and Equivocal Pigmented and Nonpigmented Macules of the Face. Full Text available with Trip Pro

The Impact of In Vivo Reflectance Confocal Microscopy on the Diagnostic Accuracy of Lentigo Maligna and Equivocal Pigmented and Nonpigmented Macules of the Face. Limited studies have reported the in vivo reflectance confocal microscopy (RCM) features of lentigo maligna (LM). A total of 64 RCM features were scored retrospectively and blinded to diagnosis in a consecutive series of RCM sampled, clinically equivocal, macules of the face (n=81 LM, n=203 benign macules (BMs)). In addition

2010 Journal of Investigative Dermatology

98. A Population-Based Study of Acquired Bilateral Nevus-of-Ota-Like Macules in Shanghai, China. Full Text available with Trip Pro

A Population-Based Study of Acquired Bilateral Nevus-of-Ota-Like Macules in Shanghai, China. Acquired bilateral nevus-of-Ota-like macule (ABNOM) is a common skin dyspigmentation in Asian females. Although its clinical characteristics are well defined, its epidemiology and pathogenesis remain unclear. A large population-based cross-sectional study was conducted to determine the prevalence and risk factors of ABNOM. A total of 8,680 subjects (ages ranging from newborn to 99 years old; 54% female

2010 Journal of Investigative Dermatology

99. Acquired Bilateral Nevus of Ota-like Macules: An Immunohistological Analysis of Dermal Melanogenic Paracrine Cytokine Networks. (Abstract)

Acquired Bilateral Nevus of Ota-like Macules: An Immunohistological Analysis of Dermal Melanogenic Paracrine Cytokine Networks. Acquired bilateral naevus of Ota-like macules (ABNOM) is similar to melasma with regard to their clinical features, including female predominance, acquired onset, and predominant involvement of the malar area. The similar clinical features suggest the possibility of a shared pathogenesis. Dermal factors including vascularity and melanogenic paracrine networks

2010 British Journal of Dermatology

100. The UK guidelines for management and surveillance of Tuberous Sclerosis Complex Full Text available with Trip Pro

is available should be considered for treatment with an mTOR inhibitor. Those likely to benefit from an mTOR inhibitor according to current evidence are those with progressive deterioration in lung function and those with chylous complications. Skin Skin involvement is common in TSC. Lesions such as facial angiofibromatosis, hypomelanotic macules, shagreen patches, forehead fibrous plaques, skin tags and periungual fibromas are observed in individuals with TSC. Facial angiofibromas can affect approximately

2018 Tuberous Sclerosis Association

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