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Papule

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162. 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

163. 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

164. Blepharitis

. It typically occurs bilaterally. Disease is usually chronic with intermittent exacerbations. History and exam burning sensation itching sensation foreign body sensation crusting of eyelids dry eye lid erythema, telangiectasias collarettes around lashes capped meibomian glands conjunctival hyperaemia unstable tear film with rapid tear break-up time chalazion scalp changes photophobia facial telangiectasias, erythema, pustules, papules depigmentation of lashes trichiasis madarosis lid margin thickening

2017 BMJ Best Practice

165. Lichen planus

Lichen planus Lichen planus - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Lichen planus Last reviewed: February 2019 Last updated: December 2017 Summary An idiopathic inflammatory disease affecting the skin, hair, nails, and mucous membranes, usually self-limiting in nature. Characteristic eruption consists of itchy, shiny, flat-topped violaceous papules and plaques favouring the extremities. White net-like patches (...) the skin, mucous membranes, genitalia, scalp (lichen planopilaris), and nails. Pittelkow MR, Daoud MS. Lichen planus. In: Wolff K, Goldsmith LA, Katz SI, et al, eds. Fitzpatrick's dermatology in general medicine. Vol One. 7th ed. New York, NY: McGraw-Hill Companies, Inc.; 2008:244-255. Boyd AS, Neldner KN. Lichen planus. J Am Acad Dermatol. 1991 Oct;25(4):593-619. http://www.ncbi.nlm.nih.gov/pubmed/1791218?tool=bestpractice.com History and exam pruritus violaceous, flat-topped papules or plaques

2017 BMJ Best Practice

166. Granuloma annulare

Granuloma annulare Granuloma annulare - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Granuloma annulare Last reviewed: February 2019 Last updated: December 2017 Summary Typically asymptomatic, and presents as small grouped papules in an annular configuration. Localised disease is the most common subtype; patients are often women in their 30s. Most cases are self-limiting, with 50% resolving within 2 years. However (...) =bestpractice.com Lesions are typically described as dermal papules, which coalesce to form rings, and may be skin-coloured, pink, or violaceous; commonly found on the back of hands, ankles, knees, and elbows. [Figure caption and citation for the preceding image starts]: Classic localised granuloma annulare From the collection of Susmita Mukherjee, BSc, MBBS, MRCP; used with permission [Citation ends]. A number of clinical variants exist. Piette EW, Rosenbach M. Granuloma annulare: clinical and histologic

2017 BMJ Best Practice

167. Seborrhoeic keratosis

Seborrhoeic keratosis Seborrhoeic keratosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Seborrhoeic keratosis Last reviewed: February 2019 Last updated: December 2018 Summary Lesions are common, multiple, benign tumours of the skin. Most people over the age of 50 years are affected. They appear as well-circumscribed 'stuck-on' plaques or papules and may look like warts. They are usually asymptomatic but can

2017 BMJ Best Practice

168. Genital Skin Lesions (Non-Ulcerative)

be referred for a specialist opinion before any treatment occurs. Normal anatomical variants Males • Pearly penile papules (coronal papillae), Fordyce glands. Females • Vestibular papillomatosis, Fordyce glands Genital warts Exophytic skin lesions that vary in size/shape and number. Males • Typically at leading edge of prepuce, on frenulum, or more sporadically in coronal sulcus, on penile shaft. Less frequently on scrotum or in pubic area or perianal. Females • Usually vulval (often posteriorly

2017 New Zealand Sexual Health Society

169. Guidelines for the Management of Genital, Anal and Throat HPV Infection in New Zealand

-47 although the extent to which recurrence is due to re-infection is not known. Vaccine HPV vaccine is a very effective method of preventing HPV acquisition – see HPV Vaccines section, page 28.7 EXTERNAL GENITAL WARTS – CLINICAL PRESENTATION AND DIAGNOSIS KEY POINTS • Genital warts vary widely in appearance and distribution in the anogenital area. • The differential diagnosis includes normal anatomical findings such as vestibular papillomatosis and pearly penile papules, dermatoses (...) infection and is not recommended. Genital warts are visible lesions that occur in the anogenital area and there is good correlation between physical findings and histological studies. There are four variants of genital warts: 1. Skin-coloured filiform warts (condyloma acuminata) occur on moist mucosal skin. 2. Skin-coloured raised papules with a rough warty surface (verruca vulgaris) arise on drier areas of genital skin. 3. On either dry or moist skin, smooth flat-topped papules which may be pink, red

2017 New Zealand Sexual Health Society

170. Sexually Transmitted Infections

transmissible infections. Unusual lesions, including pigmented lesions, should be referred for a specialist opinion before any treatment occurs. Normal anatomical variants Males • Pearly penile papules (coronal papillae), Fordyce glands. Females • Vestibular papillomatosis, Fordyce glands Genital warts Exophytic skin lesions that vary in size/shape and number. Males • Typically at leading edge of prepuce, on frenulum, or more sporadically in coronal sulcus, on penile shaft. Less frequently on scrotum

2017 New Zealand Sexual Health Society

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

markedly with severe cases having lesions lasting up to 3 weeks. The prodrome (if experienced) is signalled by flu-like symptoms of fever, headache and general myalgia, accompanied by local tingling, irritation and/or pruritus or pain in the genital region. Rapidly, pruritic erythematous papules appear, followed by multiple small vesicles that contain clear to cloudy fluid. These vesicles rupture within 1–2 days to form painful, sloughy, shallow ulcers with irregular margins, which may become confluent (...) 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

172. British Association of Dermatologists' guidelines for the management of lichen sclerosus

symptoms and urinary incontinence are reported by women with LS, 44,45 but have been shown to be less common than inthe general population inanother study. 45,46 The typical lesions are porcelain-white papules and plaques, often associated with areas of ecchymosis. Follicular delling may be prominent, and occasionally hyperkeratosis is a promi- nent feature. The characteristic sites are the interlabial sulci, labia minora, clitoral hood, clitoris and perineal body. LS is a scarring dermatosis and may (...) , ulceration, papule or nodule) should be biopsied. Patients with urinary symptoms should be referred to a urologist for ?ow rate and postvoid residual volume measurement to identify urethral involvement by LS; ultimately, referral to a specialist urologist for management of a urethral stricture or meatal stenosis may be needed. Where medical treatment has failed, patients should be offered referral to discuss other surgical treatment options such as division of coronal adhesions, frenuloplasty and glans

2018 British Association of Dermatologists

173. CRACKCast E191 – Weapons of Mass Destruction

Cutaneous form Spores introduced into the skin (patients already have open wounds or abrasions) After an incubation period of 1 to 5 days, a papule develops, progressing to form a large vesicle during the next several days. Severe edema occurs around the lesion and is associated with regional lymphadenitis. The lesions are not tender, and the patient may or may not be febrile. After approximately 1 week, the lesion ruptures, forming a black eschar (thus the name anthrax, from the Greek word for “coal

2018 CandiEM

174. CRACKCast Episode 183 – The Immunocompromised Patient

Clinical Findings in Neutropenia That May Be Associated with Infection with Specific Pathogens Characteristic Clinical Finding Suspect Pathogens Ulcerative lesions in the mouth Viridans streptococci, herpes simplex, Candida, anaerobes Necrotizing skin lesions Pseudomonas aeruginosa, Aeromonas hydrophila, Aspergillus, Mucor Nontender subcutaneous nodules Nocardia, Cryptococcus Nontender pink skin papules Candida Black eschar of nose or palate Aspergillus, Mucor Generalized macular red rash Viridans

2018 CandiEM

176. UK National Guideline for the management of Donovanosis

[8]. Clinical features The first sign of infection is usually a firm papule or subcutaneous nodule that later ulcerates. Four types of donovanosis are described classically [9]: 1) Ulcerogranulomatous is the most common variant; non tender, fleshy, exuberant, single or multiple, beefy red ulcers that bleed readily when touched. 2) Hypertrophic or verrucous type, an ulcer or growth with a raised irregular edge, sometimes with a walnut appearance. 3) Necrotic, usually a deep foul smelling ulcer

2018 British Association for Sexual Health and HIV

177. Acne - Guidelines for Prescribing Topical Treatment

Acne - Guidelines for Prescribing Topical Treatment Acne - Guidelines for Prescribing Topical Treatment - medSask Home - College of Pharmacy and Nutrition - University of Saskatchewan Toggle Menu Search the U of S Search Acne - Guidelines for Prescribing Topical Treatment Acne vulgaris (acne) is the formation of comedones, papules, pustules, nodules, and/or cysts as a result of obstruction and inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland (...) , neck, chest, upper back, and upper arms. Presence of comedones. Closed comedones are called whiteheads. Whiteheads are flesh-colored or whitish raised bumps 1 to 3 mm in diameter. Blackheads are open comedones with a dark center (oxidized keratin, dead cells). Comedones are not infected. Presence of inflammatory lesions such as: Papules (small red, round or oval raised bumps) Pustules (papules containing pus) Nodules (tender, red swellings with undefined borders) Cysts (deep pustules) You will also

2018 medSask

178. Shingles

, does not cross the body midline May involve any area of skin, but thoracic, cranial ( ), lumbar and cervical dermatomes most common Rash typically consists of macules or papules that evolve into vesicles or pustules: Begins with macule formation, quickly turns into papules Clear vesicles form within 1-2 days of rash onset; new ones appear over 3-5 days Vesicles evolve into pustules within 1 week Lesions ulcerate and crust 3-5 days later Healing occurs within 2 to 4 weeks (but may take longer (...) for treating Typical presentation includes a rapidly enlarging, swollen, warm, tender and painful lesion. Does not follow dermatomes. Refer for medical assessment, oral antibiotic treatment may be indicated Insect bites and stings Candidiasis May occur on the trunk and consists of many papules with a random distribution. Does not follow dermatomes. Typically occurs in skin folds (under breast, buttocks, armpits, between toes / fingers) Autoimmune blistering disease such as bullous pemphigoid 1 to 4 cm

2018 medSask

179. Ocular rosacea

vessels with a spidery appearance) papules, pustules and hypertrophy of sebaceous glands rhinophyma (bullous nose) in severe cases Differential diagnosis Tear deficiency Interstitial keratitis Infectious keratitis Other causes of chronic blepharitis Management by optometrist Practitioners should recognise their limitations and where necessary seek further advice or refer the patient elsewhere GRADE* Level of evidence and strength of recommendation always relates to the statement(s) immediately above

2018 College of Optometrists

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