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 © 2001-2009, DermAtlas | Image Name: | calcinosis_cutis_1_090401 | File Type: | jpg | |
| Diagnosis: | CALCINOSIS CUTIS | Category: | deposition disorders / Metabolic disorders | ||
| Body Site: | elbow | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | Several white rock-hard papules are present on the extensor surface of one elbow. There were no other clinical findings. | ||||
| Comments: | This 10 year old girl presented with several rock-hard papules on the elbow region. These developed over months to years and were asymptomatic. She has no other medical problems. Calcinosis cutis is often dystrophic calcification, and in this location, likely secondary to trauma. Systemic disorders, such as dermatomyositis, in a child, may present with calcinosis cutis. Systemic hypercalcemia is a rare cause of calcinosis cutis in a child. | ||||
| Related Images: | calcinosis_cutis_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | calcinosis_cutis_2_090401 | File Type: | jpg | |
| Diagnosis: | CALCINOSIS CUTIS | Category: | deposition disorders / Metabolic disorders | ||
| Body Site: | elbow | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There are collections of basaloid granular material in the superficial dermis, with overlying epidermal hyperplasia. The material is basophilic and refractile, consistent with calcium (pyrophosphate). | ||||
| Comments: | This 10 year old girl presented with several rock-hard papules on the elbow region. These developed over months to years and were asymptomatic. She has no other medical problems. Calcinosis cutis is often dystrophic calcification, and in this location, likely secondary to trauma. Systemic disorders, such as dermatomyositis, in a child, may present with calcinosis cutis. Systemic hypercalcemia is a rare cause of calcinosis cutis in a child. | ||||
| Related Images: | calcinosis_cutis_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | perforating_disorder_renal_1_090401 | File Type: | jpg | |
| Diagnosis: | PERFORATING DISORDER OF RENAL DISEASE AND/OR DIABETES | Category: | perforating disorders / Metabolic disorders | ||
| Body Site: | hand / arm | Age: | 45 years | ||
| Contributors: | Patrick Keehan, D.O. Greg Hosler, MD, PhD | ||||
| Description: | Multiple hyperkeratotic brown papules and nodules are present on the extensor surfaces of the hands. Some have the appearance of having a central plug. These are non-tender. | ||||
| Comments: | This 45 year old man with end stage renal disease and diabetes mellitus developed scattered hyperkeratotic papules and nodules on the extensor surfaces of his upper extremities. A leson was biopsied to rule out various perforating disorders, such as Kyrle disease or perforating granuloma annulare. Acquired perforating disorders are commonly seen with chronic renal disease, liver disease and diabetes. The nomenclature has evolved, to include Kyrle disease, prforating folliculitis, perforating collagenosis, perforating disorder of renal disease and/or diabetes, etc, and likely represent the same process. This particular biopsied lesion fits with this disease spectrum, as it is clearly a perforating process, but further characterization is limited. | ||||
| Related Images: | perforating_disorder_renal_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | perforating_folliculitis_4_080801 | File Type: | jpg | |
| Diagnosis: | PERFORATING FOLLICULITIS / PERFORATING DISORDER, ACQUIRED | Category: | perforating disorders / Metabolic disorders | ||
| Body Site: | arm / leg hand | Age: | 57 years | ||
| Contributors: | Patrick Keehan, D.O. Greg Hosler, MD, PhD | ||||
| Description: | At the base of the transepidermal channel, there is a distorted follicle with a broken hair shaft. | ||||
| Comments: | This 57 year old African-American female presented with a 3-month history of eruptive hyperkeratotic papules and nodules on her proximal lower extremities, upper extremities, and dorsal hands. She has a history of renal failure with 7 years of hemodialysis. The patient was placed on topical tretinoin cream 0.05% and has had near complete clearance of these lesions within 6 weeks. The acquired perforating disorders overlap clinically and histologically. The terminology has evolved too, using Kyrle's disease, perforating disease of chronic renal/liver failure and/or diabetes, perforating folliculitis, etc. These may represent the same disease along a spectrum. Perforating collagenosis is separate, with different demographics and often a history of trauma. This case is best classified as perforating folliculitis as the biopsy was classic for this entity. It shows a distorted follicle with an overlying funnel-shaped transepidermal channel. | ||||
| Related Images: | All related Images perforating_folliculitis_1_080801 perforating_folliculitis_2_080801 perforating_folliculitis_3_080801 | ||||
 © 2001-2009, DermAtlas | Image Name: | perforating_folliculitis_3_080801 | File Type: | jpg | |
| Diagnosis: | PERFORATING FOLLICULITIS / PERFORATING DISORDER, ACQUIRED | Category: | perforating disorders / Metabolic disorders | ||
| Body Site: | arm / leg hand | Age: | 57 years | ||
| Contributors: | Patrick Keehan, D.O. Greg Hosler, MD, PhD | ||||
| Description: | The central portion of the biopsy has a cystic structure plugged with keratin and basophilic granular material. It is vaguely wedge- or funnel-shaped. A significant inflammatory infiltrate is not seen. | ||||
| Comments: | This 57 year old African-American female presented with a 3-month history of eruptive hyperkeratotic papules and nodules on her proximal lower extremities, upper extremities, and dorsal hands. She has a history of renal failure with 7 years of hemodialysis. The patient was placed on topical tretinoin cream 0.05% and has had near complete clearance of these lesions within 6 weeks. The acquired perforating disorders overlap clinically and histologically. The terminology has evolved too, using Kyrle's disease, perforating disease of chronic renal/liver failure and/or diabetes, perforating folliculitis, etc. These may represent the same disease along a spectrum. Perforating collagenosis is separate, with different demographics and often a history of trauma. This case is best classified as perforating folliculitis as the biopsy was classic for this entity. It shows a distorted follicle with an overlying funnel-shaped transepidermal channel. | ||||
| Related Images: | All related Images perforating_folliculitis_1_080801 perforating_folliculitis_2_080801 perforating_folliculitis_4_080801 | ||||
 © 2001-2009, DermAtlas | Image Name: | perforating_folliculitis_2_080801 | File Type: | jpg | |
| Diagnosis: | PERFORATING FOLLICULITIS / PERFORATING DISORDER, ACQUIRED | Category: | perforating disorders / Metabolic disorders | ||
| Body Site: | arm / leg hand | Age: | 57 years | ||
| Contributors: | Patrick Keehan, D.O. Greg Hosler, MD, PhD | ||||
| Description: | A close-up view demonstrates this central keratotic plug with a rim of hypopigmentation. | ||||
| Comments: | This 57 year old African-American female presented with a 3-month history of eruptive hyperkeratotic papules and nodules on her proximal lower extremities, upper extremities, and dorsal hands. She has a history of renal failure with 7 years of hemodialysis. The patient was placed on topical tretinoin cream 0.05% and has had near complete clearance of these lesions within 6 weeks. The acquired perforating disorders overlap clinically and histologically. The terminology has evolved too, using Kyrle's disease, perforating disease of chronic renal/liver failure and/or diabetes, perforating folliculitis, etc. These may represent the same disease along a spectrum. Perforating collagenosis is separate, with different demographics and often a history of trauma. This case is best classified as perforating folliculitis as the biopsy was classic for this entity. It shows a distorted follicle with an overlying funnel-shaped transepidermal channel. | ||||
| Related Images: | All related Images perforating_folliculitis_1_080801 perforating_folliculitis_3_080801 perforating_folliculitis_4_080801 | ||||
 © 2001-2009, DermAtlas | Image Name: | perforating_folliculitis_1_080801 | File Type: | jpg | |
| Diagnosis: | PERFORATING FOLLICULITIS / PERFORATING DISORDER, ACQUIRED | Category: | perforating disorders / Metabolic disorders | ||
| Body Site: | arm / leg hand | Age: | 57 years | ||
| Contributors: | Patrick Keehan, D.O. Greg Hosler, MD, PhD | ||||
| Description: | The dorsa of the hands have several discrete hyperkeratotic papules and nodules. These have a central keratotic plug with a rim of hypopigmentation. | ||||
| Comments: | This 57 year old African-American female presented with a 3-month history of eruptive hyperkeratotic papules and nodules on her proximal lower extremities, upper extremities, and dorsal hands. She has a history of renal failure with 7 years of hemodialysis. The patient was placed on topical tretinoin cream 0.05% and has had near complete clearance of these lesions within 6 weeks. The acquired perforating disorders overlap clinically and histologically. The terminology has evolved too, using Kyrle's disease, perforating disease of chronic renal/liver failure and/or diabetes, perforating folliculitis, etc. These may represent the same disease along a spectrum. Perforating collagenosis is separate, with different demographics and often a history of trauma. This case is best classified as perforating folliculitis as the biopsy was classic for this entity. It shows a distorted follicle with an overlying funnel-shaped transepidermal channel. | ||||
| Related Images: | All related Images perforating_folliculitis_2_080801 perforating_folliculitis_3_080801 perforating_folliculitis_4_080801 | ||||
 © 2001-2009, DermAtlas | Image Name: | Acute_polyarticular_gout_1_071207 | File Type: | jpg | |
| Diagnosis: | GOUT / ARTHRITIS, GOUTY | Category: | orthopedic disorders / Metabolic disorders | ||
| Body Site: | foot | Age: | 76 years | ||
| Contributor: | Nikolaos Sferopoulos, MD | ||||
| Description: | asymmetric swelling and erythema with loss of landmarks | ||||
| Comments: | A 76-year-old woman developed acute onset of polyarticular gout of the left foot. Note the swelling, erythema, and loss of landmarks. | ||||
 © 2001-2009, DermAtlas | Image Name: | carotenemia_1_071124 | File Type: | jpg | |
| Diagnosis: | CAROTENEMIA | Category: | Metabolic disorders / normal physiologic variant | ||
| Body Site: | face / total body | Age: | 10 months | ||
| Contributor: | Bernard Cohen, MD | ||||
| Description: | diffuse yellow-orange color | ||||
| Comments: | This healthy boy demonstrates diffuse yellow color of skin with white conjunctivae and father's skin for comparison. He enjoyed his carrots, sweat potatoes, and squash. | ||||
 © 2001-2009, DermAtlas | Image Name: | papillomatosis_confluent_reticulated_4_071019 | File Type: | jpg | |
| Diagnosis: | CONFLUENT AND RETICULATED PAPILLOMATOSIS (OF GOUGEROT AND CARTEAUD) / PAPILLOMATOSIS, CONFLUENT AND RETICULATED | Category: | hyperpigmentation / papulosquamous eruptions / Metabolic disorders | ||
| Body Site: | trunk / cheek | Age: | 15 years | ||
| Contributor: | Bernard Cohen, MD | ||||
| Description: | symmetric disctete and confluent reticulated dark brown minimally scaly papules and plaques | ||||
| Comments: | This adolescent girl was embarrassed by a progressive brown scaly eruption on her chest and back. Note velvety brown plaques on her neck typical of acanthosis nigricans. | ||||
| Related Images: | All related Images papillomatosis_confluent_reticulated_1_071019 papillomatosis_confluent_reticulated_2_071019 papillomatosis_confluent_reticulated_3_071019 | ||||
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