DermAtlas: Online Dermatology Image Library dermatology image,gangrene,ischemia,onychogryposis,ichthyosis, acquired,ichthyosis, acquired,ichthyosis, acquired,pruritus, HIV associated,lichenification,pruritus, HIV associated,pruritus, HIV associated,furrowed tongue,tongue, fissured (scrotal),tongue, white furrowed,nevus sebaceus,dermatitis, seborrheic,pityriasis alba

© 2001-2011, DermAtlas	*Image Name:*	Gangrene_1_110403	*File Type:*	jpg
	*Diagnosis:*	GANGRENE / ISCHEMIA	*Category:*	cutaneous sign of systemic disease / diabetes mellitus associated
	*Body Site:*	foot / toe	*Age:*	54 years
	*Contributor:*	Julie Jefferson, MD
	*Description:*	cool dry scally purple well demarcated plaques Middle-aged man with dry gangrene due in part to both polycythemia vera and severe peripheral vascular disease. Two types of gangrene exist, dry and wet gangrene. Dry gangrene is due to tissue ischemia. Many diverse etiologies exist including acute arterial blood clot, arteriosclerosis, and Buerger’s disease. Dry gangrene generally produces cool, dry, and discolored appendages with no oozing fluid or pus. In contrast, wet gangrene often produces an oozing fluid or pus. Wet gangrene results from an untreated (or inadequately treated) infection at a site where the local blood supply has been significantly reduced or stopped by tissue swelling, bacterial toxins, and/or local gas production. If left untreated, gas gangrene may result in sepsis and death within a few hours or days.
	*Comments:*	A 54-year-old diabetic developed ischemia and subsequent gangrene of the toes on his left foot.

© 2001-2011, DermAtlas	*Image Name:*	Onychogryphosis_2_110403	*File Type:*	jpg
	*Diagnosis:*	ONYCHOGRYPOSIS / ICHTHYOSIS, ACQUIRED	*Category:*	nail disorders / papulosquamous eruptions
	*Body Site:*	nail, foot / foot	*Age:*	69 years
	*Contributor:*	Julie Jefferson, MD
	*Description:*	long thickened nails and diffuse coarse scaling of the skin
	*Comments:*	A 69-year-old man developed hypertrophic curved toenails likely due in part to his inability to bend to groom his feet. Onychogryphosis occurs when the nail plate becomes hyperkeratotic and hypertrophic secondary to poor grooming and/or poorly fitting footwear. Onychogryphosis can also be associated with impaired peripheral circulation and psoriasis. This condition can cause pain.
	*Related Images:*	All related Images Onychogryphosis_1_110403 Onychogryphosis_3_110403

© 2001-2011, DermAtlas	*Image Name:*	Onychogryphosis_3_110403	*File Type:*	jpg
	*Diagnosis:*	ONYCHOGRYPOSIS / ICHTHYOSIS, ACQUIRED	*Category:*	nail disorders / papulosquamous eruptions
	*Body Site:*	nail, foot / foot	*Age:*	69 years
	*Contributor:*	Julie Jefferson, MD
	*Description:*	long thickened nails and diffuse coarse scaling of the skin
	*Comments:*	A 69-year-old man developed hypertrophic curved toenails likely due in part to his inability to bend to groom his feet. Onychogryphosis occurs when the nail plate becomes hyperkeratotic and hypertrophic secondary to poor grooming and/or poorly fitting footwear. Onychogryphosis can also be associated with impaired peripheral circulation and psoriasis. This condition can cause pain.
	*Related Images:*	All related Images Onychogryphosis_1_110403 Onychogryphosis_2_110403

© 2001-2011, DermAtlas	*Image Name:*	Onychogryphosis_1_110403	*File Type:*	jpg
	*Diagnosis:*	ONYCHOGRYPOSIS / ICHTHYOSIS, ACQUIRED	*Category:*	nail disorders / papulosquamous eruptions
	*Body Site:*	nail, foot / foot	*Age:*	69 years
	*Contributor:*	Julie Jefferson, MD
	*Description:*	long thickened nails and diffuse coarse scaling of the skin
	*Comments:*	A 69-year-old man developed hypertrophic curved toenails likely due in part to his inability to bend to groom his feet. Onychogryphosis occurs when the nail plate becomes hyperkeratotic and hypertrophic secondary to poor grooming and/or poorly fitting footwear. Onychogryphosis can also be associated with impaired peripheral circulation and psoriasis. This condition can cause pain.
	*Related Images:*	All related Images Onychogryphosis_3_110403 Onychogryphosis_2_110403

© 2001-2011, DermAtlas	*Image Name:*	HIVAssociated_Pruritus_1_110403	*File Type:*	jpg
	*Diagnosis:*	PRURITUS, HIV ASSOCIATED / LICHENIFICATION	*Category:*	immunodeficiency related / papulosquamous eruptions
	*Body Site:*	hand	*Age:*	46 years
	*Contributor:*	Julie Jefferson, MD
	*Description:*	broad, confluent, excoriated, lichenified plaquesExcoriated lichenified plaques
	*Comments:*	A 46-year-old man with HIV/AIDS (CD4 count 6, HIV Viral Load 134,530) complained of chronic pruritus. Excoriated lichenified plaques were present on the hands, face, neck, trunk, axillae, bilateral arms, abdomen, groin, buttocks, and legs. One year earlier he was diagnosed with crusted scabies and underwent treatment with a topical scabicide. Repeat evaluation for scabies did not reveal any mites, ova, or feces. He was diagnosed with HIVassociated pruritus. Pruritus occurs in up to 30% of patients with HIV. Evaluation of pruritus should include a careful examination of the skin, hair, nails, and mucous membranes to establish a primary dermatologic diagnosis. If a dermatologic diagnosis is not found, a systemic or medication related cause should be sought. Idiopathic HIV-associated pruritus is a diagnosis of exclusion. Pruritus may be intractable and provoke scratching, picking, disfigurement, sleep loss, and significant psychological stress. Phototherapy has been found to be useful in the treatment of several HIV associated dermatoses and idiopathic pruritus.
	*Related Images:*	All related Images HIVAssociated_Pruritus_3_110403 HIVAssociated_Pruritus_2_110403

© 2001-2011, DermAtlas	*Image Name:*	HIVAssociated_Pruritus_2_110403	*File Type:*	jpg
	*Diagnosis:*	PRURITUS, HIV ASSOCIATED / LICHENIFICATION	*Category:*	immunodeficiency related / papulosquamous eruptions
	*Body Site:*	hand	*Age:*	46 years
	*Contributor:*	Julie Jefferson, MD
	*Description:*	broad, confluent, excoriated, lichenified plaquesExcoriated lichenified plaques
	*Comments:*	A 46-year-old man with HIV/AIDS (CD4 count 6, HIV Viral Load 134,530) complained of chronic pruritus. Excoriated lichenified plaques were present on the hands, face, neck, trunk, axillae, bilateral arms, abdomen, groin, buttocks, and legs. One year earlier he was diagnosed with crusted scabies and underwent treatment with a topical scabicide. Repeat evaluation for scabies did not reveal any mites, ova, or feces. He was diagnosed with HIVassociated pruritus. Pruritus occurs in up to 30% of patients with HIV. Evaluation of pruritus should include a careful examination of the skin, hair, nails, and mucous membranes to establish a primary dermatologic diagnosis. If a dermatologic diagnosis is not found, a systemic or medication related cause should be sought. Idiopathic HIV-associated pruritus is a diagnosis of exclusion. Pruritus may be intractable and provoke scratching, picking, disfigurement, sleep loss, and significant psychological stress. Phototherapy has been found to be useful in the treatment of several HIV associated dermatoses and idiopathic pruritus.
	*Related Images:*	All related Images HIVAssociated_Pruritus_3_110403 HIVAssociated_Pruritus_1_110403

© 2001-2011, DermAtlas	*Image Name:*	HIVAssociated_Pruritus_3_110403	*File Type:*	jpg
	*Diagnosis:*	PRURITUS, HIV ASSOCIATED / LICHENIFICATION	*Category:*	immunodeficiency related / papulosquamous eruptions
	*Body Site:*	hand	*Age:*	46 years
	*Contributor:*	Julie Jefferson, MD
	*Description:*	broad, confluent, excoriated, lichenified plaquesExcoriated lichenified plaques
	*Comments:*	A 46-year-old man with HIV/AIDS (CD4 count 6, HIV Viral Load 134,530) complained of chronic pruritus. Excoriated lichenified plaques were present on the hands, face, neck, trunk, axillae, bilateral arms, abdomen, groin, buttocks, and legs. One year earlier he was diagnosed with crusted scabies and underwent treatment with a topical scabicide. Repeat evaluation for scabies did not reveal any mites, ova, or feces. He was diagnosed with HIVassociated pruritus. Pruritus occurs in up to 30% of patients with HIV. Evaluation of pruritus should include a careful examination of the skin, hair, nails, and mucous membranes to establish a primary dermatologic diagnosis. If a dermatologic diagnosis is not found, a systemic or medication related cause should be sought. Idiopathic HIV-associated pruritus is a diagnosis of exclusion. Pruritus may be intractable and provoke scratching, picking, disfigurement, sleep loss, and significant psychological stress. Phototherapy has been found to be useful in the treatment of several HIV associated dermatoses and idiopathic pruritus.
	*Related Images:*	All related Images HIVAssociated_Pruritus_2_110403 HIVAssociated_Pruritus_1_110403

© 2001-2011, DermAtlas	*Image Name:*	White_Tongue_1_110403	*File Type:*	jpg
	*Diagnosis:*	FURROWED TONGUE / TONGUE, FISSURED (SCROTAL) / TONGUE, WHITE FURROWED	*Category:*	dental/oral disorder
	*Body Site:*	tongue	*Age:*	44 years
	*Contributor:*	Julie Jefferson, MD
	*Description:*	white furrowed tongue
	*Comments:*	A 44-year-old womandemonstrates a white furrowed tongue probably resulting from poor oral hygiene. Her tongue improved with regular brushing and generally improved dental care.

© 2001-2011, DermAtlas	*Image Name:*	Sebaceous_Nevus_1_110403	*File Type:*	jpg
	*Diagnosis:*	NEVUS SEBACEUS	*Category:*	neonatal dermatology
	*Body Site:*	face / cheek / cheek	*Age:*	1 days
	*Contributor:*	Jon Liss, MD
	*Description:*	linear blashkoid clustered 1-2 mm hypopigmented papules
	*Comments:*	This lesion was present at birth in a healthy newborn.

© 2001-2011, DermAtlas	*Image Name:*	Petaloid_Seborrheic_Dermatitis_2_110403	*File Type:*	jpg
	*Diagnosis:*	DERMATITIS, SEBORRHEIC / PITYRIASIS ALBA	*Category:*	hypopigmentation, depigmentation / papulosquamous eruptions
	*Body Site:*	face / scalp	*Age:*	24 months
	*Contributor:*	David Doyle, Jr., MD
	*Description:*	symmetric well demarcated minimally scaly hypopigmented patches
	*Comments:*	A 24-year-old dark pigmented man complained of months of occasionally pruritic hypopigmented patches on his face. He improved with topical ketoconazole shampoo and occasional applications of pimecrolimus cream
	*Related Images:*	Petaloid_Seborrheic_Dermatitis_3_110403