Skin Disease

Animation of skin wound inflammation.

Created by Drew Berry for E.O.Wilson’s Life on Earth interactive textbook of biology (2014) available free from iBook Store
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This is a video on cutaneous diseases that originate from inflammatory, hypersensitivity, and autoimmune origins.

I created this presentation with Google Slides.
Images were created or taken from Wikimedia Commons
I created this video with the YouTube Video Editor.

Acne vulgaris
Rosacea
Perioral dermatitis
AKA periorificial dermatitis, steroid rosacea
, may also include perinasal, nasolabial, or
Atopic dermatitis
AKA atopic eczema
Inflammation of the skin that results in itchy, red, swollen, and dry and/or cracked skin, sometimes with clear fluid released from affected area
Wide range of severity
Spares the nose (unlike acne vulgaris, rosacea)
Epi: common in developed countries (hygiene hypothesis). Up to 20% of children, 3% of adults
Often clears by adulthood in children
Often associated with other atopic dz (allergic rhinitis, asthma)
Presents with itch, and scratching the itch exacerbates the rash (remission-exacerbation cycles)
Lesions begin as erythematous papules, which grow and coalesce into plaques → weep, scale, crust
Contact dermatitis
Pityriasis alba
Variant of AD that occurs in children and presents with dry, scaling, pale/hypopigmented patches on the face
Usually presents asymptomatically, found in darker skinned or tan children
Benign and fades with time, usually self limited
Treatment: unnecessary, can use sunscreen to minimize tanning to
Seborrheic dermatitis
AKA seborrheic eczema or seborrhea
Mild dermatitis that presents with scaly, greasy, flaky, itchy, red skin, affecting sebaceous glands of skin, often on nasolabial fold, scalp, hairline, eyelids, eyebrows, central face, external auditory canals, central chest
Can be hypopigmented in dark skin
Nummular dermatitis
AKA discord dermatitis/eczema, microbial eczema, nummular eczema, nummular neurodermatitis
Asteatotic dermatitis
AKA asteatotic eczema, xerotic eczema, winter itch/eczema
Type of dermatitis characterized by changes in weather → cold
Irritant diaper dermatitis
Presents as redness, erosions in diaper area sparing the skin folds; might have ulcerations
Affects convex surfaces, limited to exposed areas
Moist skin is more easily irritated
Stasis dermatitis
AKA varicose eczema
Skin changes including brown macules or patches, petechiae, red
Dyshidrotic eczema
AKA dyshidrosis, pompholyx
Type of dermatitis with itchy blisters on palms of hands and sides of feet and toes
Tapioca pudding appearance of fluid
Pityriasis rosea
AKA pityriasis rosea Gibert
Urticaria
hives
Dermatographism: subtype with sharply localized wheals appearing seconds after physical trauma
Angioedema
AKA angiooedema, Quincke’s edema, angioneurotic edema
Rapid swelling of dermis, subcutaneous tissue, mucosa, and submucosa tissues
Similar etiology and pathophysiology to urticaria, but swelling here occurs in deeper layers
Psoriasis
Autoimmune disease in which skin patches and red/itchy/scaly skin forms
Epi: 2% of US, frequently starts at ages 20-30 and 50-60
Types/morphologies
Plaque: scaly, red patches, papules, plaques, sometimes itchy
Associated with psoriatic arthritis in 10-25% (seronegative spondyloarthropathy), affecting DIP joints most commonly → especially associated with nail pitting
Vitiligo
Skin condition characterized by patches of skin losing pigment. Patches become white and depigmented with sharp margins.
Caused by autoimmune attack on melanocytes
Pemphigus vulgaris
Chronic blistering autoimmune skin disease caused by type II hypersensitivity
Antibody formation against desmosomes (desmogleins 1 and 3) that keep cells bound together in epidermis
Presents with superficial bullae and erosions, extensive across body
Bullous pemphigoid
Acute or chronic autoimmune skin disease caused by type II hypersensitivity
Necrobiosis lipoidica
AKA necrobiosis lipoidica diabeticorum (NLD)
Necrotising skin condition, usually occurs with diabetes
Sweet’s syndrome
AKA acute febrile neutrophilic dermatosis
Skin disease characterized by sudden onset of fever, elevated WBC, tender, red, well demarcated papules and plaques that show dense
Erythema nodosum
Inflammatory condition characterized by inflammation of the fat cells under the skin (panniculitis) → tender red nodules or bumps
Often on lower legs, without ulceration
Calciphylaxis
AKA calcific uremic arteriolopathy (CUA)
Vascular calcification, thrombosis, and skin necrosis caused by extraskeletal calcification, often occurring in pts with ESRD on lower extremities and trunk
Drug induced hypersensitivity syndrome (DIHS)
AKA drug reaction with eosinophilia and systemic symptoms or DRESS syndrome
Stevens–Johnson syndrome / toxic epidermal necrolysis
Life threatening skin emergency caused by adverse reaction to drugs in which epidermis detaches from dermis, leaving body susceptible to infection
SJS is less than 10% BSA, TEN is greater than 30% BSA, in between is mixed