Differentiating psoriasis from other diseases: Difference between revisions

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==Overview==
==Overview==
Psoriasis] must be differentiated from other diseases that cause erythematous, scaly rash such as Cutaneous T cell lymphoma/mycosis fungoides, Pityriasis rosea, Pityriasis rubra pilaris, Pityriasis lichenoides chronica, Nummular dermatitis, Secondary syphilis, Bowen’s disease, Exanthematous pustulosis, Hypertrophic lichen planus, Sneddon–Wilkinson disease, Small plaque parapsoriasis, Intertrigo, Langerhans cell histiocytosis, Dyshidrotic dermatitis, Tinea manuum/pedum/capitis, Seborrheic dermatitis.
Psoriasis must be differentiated from other diseases that cause [[erythematous]], scaly [[Rash erythematous|rash]] such as [[Cutaneous T cell lymphoma]]/[[mycosis fungoides]], [[pityriasis rosea]], [[pityriasis rubra pilaris]], [[pityriasis lichenoides chronica]], [[nummular dermatitis]], [[secondary syphilis]], [[bowen’s disease]], [[exanthematous pustulosis]], [[Lichen planus|hypertrophic lichen planus]], Sneddon–Wilkinson disease, [[Parapsoriasis|small plaque parapsoriasis]], [[intertrigo]], [[langerhans cell histiocytosis]], [[dyshidrotic dermatitis]], [[tinea manuum]]/pedum/[[Tinea capitis|capitis]] and [[seborrheic dermatitis]].


==Differentiating Psoriasis from other Diseases==
==Differentiating Psoriasis from other Diseases==
*Psoriasis must be differentiated from other diseases causing papulosquamous or erythematosquamous rash especially when the psoriatic lesions are localized in particular sites for example, palms, soles, scalp, body folds, penis and nails.
*Psoriasis must be differentiated from other diseases causing [[Papulosquamous disorder|papulosquamous]] or [[Erythematous rash|erythematosquamous rash]] especially when the psoriatic lesions are localized in particular sites for example, palms, soles, scalp, body folds, penis and nails.
*The differentials include:
*The differentials include:
**Cutaneous T cell lymphoma/mycosis fungoides
**[[Cutaneous T cell lymphoma]]/[[mycosis fungoides]]
**Pityriasis rosea
**[[Pityriasis rosea]]
**Pityriasis rubra pilaris  
**[[Pityriasis rubra pilaris]]
**Pityriasis lichenoides chronica
**[[Pityriasis lichenoides chronica]]
**Nummular dermatitis  
**[[Nummular dermatitis]]
**Secondary syphilis
**[[Secondary syphilis]]
**Bowen’s disease  
**[[Bowen’s disease]]
**Exanthematous pustulosis
**[[Exanthematous pustulosis]]
**Hypertrophic lichen planus  
**[[Lichen planus|Hypertrophic lichen planus]]
**Sneddon–Wilkinson disease
**Sneddon–Wilkinson disease
**Small plaque parapsoriasis
**[[Parapsoriasis|Small plaque parapsoriasis]]
**Intertrigo
**[[Intertrigo]]
**Langerhans cell histiocytosis
**[[Langerhans cell histiocytosis]]
**Dyshidrotic dermatitis
**[[Dyshidrotic dermatitis]]
**Tinea manuum/pedum/capitis  
**[[Tinea manuum]]/pedum/[[Tinea Capitis|capitis]]
**Seborrheic dermatitis
**[[Seborrheic dermatitis]]
{| class="wikitable"
{| class="wikitable"
!Disease
!Disease
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!Rash Appearance
!Rash Appearance
|-
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|Cutaneous T cell lymphoma/Mycosis fungoides<ref name="urlMycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute">{{cite web |url=https://www.cancer.gov/types/lymphoma/patient/mycosis-fungoides-treatment-pdq |title=Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute |format= |work= |accessdate=}}</ref>
|[[Cutaneous T cell lymphoma]]/[[Mycosis fungoides]]<ref name="urlMycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute">{{cite web |url=https://www.cancer.gov/types/lymphoma/patient/mycosis-fungoides-treatment-pdq |title=Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute |format= |work= |accessdate=}}</ref>
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** Premycotic phase: A scaly, red rash in areas of the body that usually are not exposed to the sun. This rash does not cause symptoms and may last for months or years.
** Premycotic phase: A scaly, red rash in areas of the body that usually are not exposed to the sun. This rash does not cause symptoms and may last for months or years.
** Patch phase: Thin, reddened, eczema -like rash.
** Patch phase: Thin, reddened, [[eczema]] -like rash.
** Plaque phase: Small raised bumps (papules) or hardened lesions on the skin, which may be reddened.
** Plaque phase: Small raised bumps ([[Papule|papules]]) or hardened lesions on the skin, which may be reddened.
** Tumor phase: Tumors form on the skin. These tumors may develop ulcers and the skin may get infected.
** Tumor phase: Tumors form on the skin. These tumors may develop [[Ulcer|ulcers]] and the skin may get infected.
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* Epidermal atrophy or poikiloderma
* [[Epidermis (skin)|Epidermal]] [[atrophy]] or poikiloderma


* Generalized itching (pruritus)
* Generalized itching ([[pruritus]])
* Pain in the affected area of the skin.  
* Pain in the affected area of the skin.  
* Insomnia  
* [[Insomnia]]
* Red (erythematous) patches scattered over the skin of the trunk and the extremities  
* Red([[erythematous]]) patches scattered over the skin of the [[trunk]] and the [[extremities]]
* Tumor-like lobulated outgrowths form on the skin in the latter part of the disease
* Tumor-like lobulated outgrowths form on the skin in the latter part of the disease
* Weight loss
* Weight loss
* Lymphadenopathy
* [[Lymphadenopathy]]
* Malaise and fatigue
* [[Malaise]] and [[fatigue]]
* Anemia
* [[Anemia]]
* May progress to Sezary syndrome (Skin involvement plus hematogenous dissemination)
* May progress to [[Sezary syndrome]] (Skin involvement plus hematogenous dissemination)
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* Sezary syndrome
* Sezary syndrome
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[[Image:Mycosis_fungoides.JPG|200px]]
[[Image:Mycosis_fungoides.JPG|200px]]
|-
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|Pityriasis rosea<ref name="pmid27512182">{{cite journal |vauthors=Mahajan K, Relhan V, Relhan AK, Garg VK |title=Pityriasis Rosea: An Update on Etiopathogenesis and Management of Difficult Aspects |journal=Indian J Dermatol |volume=61 |issue=4 |pages=375–84 |year=2016 |pmid=27512182 |pmc=4966395 |doi=10.4103/0019-5154.185699 |url=}}</ref>
|[[Pityriasis rosea]]<ref name="pmid27512182">{{cite journal |vauthors=Mahajan K, Relhan V, Relhan AK, Garg VK |title=Pityriasis Rosea: An Update on Etiopathogenesis and Management of Difficult Aspects |journal=Indian J Dermatol |volume=61 |issue=4 |pages=375–84 |year=2016 |pmid=27512182 |pmc=4966395 |doi=10.4103/0019-5154.185699 |url=}}</ref>
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* Pink or salmon in colour, which may be scaly, termed as "herald patch"
* Pink or salmon in colour, which may be scaly, termed as "herald patch"
* Oval in shape  
* Oval in shape  
* Long axis oriented along the clevage lines
* Long axis oriented along the clevage lines
* Distributed on the trunk and proximal extremities
* Distributed on the [[trunk]] and [[proximal extremities]]
* Squamous marginal collarette and a “fir-tree” or “Christmas tree” distribution on the posterior trunk
* Squamous marginal collarette and a “fir-tree” or “Christmas tree” distribution on the posterior trunk
* Develops after viral infection
* Develops after [[Virus|viral]] infection
* Resolves spontaneously after 6-8 weeks
* Resolves spontaneously after 6-8 weeks
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** Sore throat
** Sore throat
** Gastrointestinal disturbance
** Gastrointestinal disturbance
** Fever
** [[Fever]]
** Arthralgia
** [[Arthralgia]]
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* Infection by any of the following:<ref name="pmid19997691">{{cite journal |vauthors=Prantsidis A, Rigopoulos D, Papatheodorou G, Menounos P, Gregoriou S, Alexiou-Mousatou I, Katsambas A |title=Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea |journal=Acta Derm. Venereol. |volume=89 |issue=6 |pages=604–6 |year=2009 |pmid=19997691 |doi=10.2340/00015555-0703 |url=}}</ref>
* Infection by any of the following:<ref name="pmid19997691">{{cite journal |vauthors=Prantsidis A, Rigopoulos D, Papatheodorou G, Menounos P, Gregoriou S, Alexiou-Mousatou I, Katsambas A |title=Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea |journal=Acta Derm. Venereol. |volume=89 |issue=6 |pages=604–6 |year=2009 |pmid=19997691 |doi=10.2340/00015555-0703 |url=}}</ref>
** HHV-6
** [[Human herpesvirus 6|HHV-6]]
** HHV-7
** [[HHV-7]]
** HHV-8
** [[HHV-8]]
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[[Image:Pityriasisrosea.png|200px]]
[[Image:Pityriasisrosea.png|200px]]
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|Pityriasis lichenoides chronica
|[[Pityriasis lichenoides chronica]]
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* Recurrent lesions are usually less evenly scattered than psoriasis
* Recurrent lesions are usually less evenly scattered than psoriasis
* Brownish red or orange-brown color
* Brownish red or orange-brown color
* Lesions are capped by a single detachable opaque mica-like scale
* Lesions are capped by a single detachable opaque mica-like scale
* Often leave hypopigmented macules
* Often leave [[Hypopigmented area|hypopigmented]] [[Macule|macules]]
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* High fever  
* High [[fever]]
* Malaise
* [[Malaise]]
* Myalgias
* [[Myalgias]]
* Skin burning
* Skin burning
* Pruritis
* [[Pruritis]]
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* Infection by any of the following:<ref name="pmid9109005">{{cite journal |vauthors=Smith KJ, Nelson A, Skelton H, Yeager J, Wagner KF |title=Pityriasis lichenoides et varioliformis acuta in HIV-1+ patients: a marker of early stage disease. The Military Medical Consortium for the Advancement of Retroviral Research (MMCARR) |journal=Int. J. Dermatol. |volume=36 |issue=2 |pages=104–9 |year=1997 |pmid=9109005 |doi= |url=}}</ref>
* Infection by any of the following:<ref name="pmid9109005">{{cite journal |vauthors=Smith KJ, Nelson A, Skelton H, Yeager J, Wagner KF |title=Pityriasis lichenoides et varioliformis acuta in HIV-1+ patients: a marker of early stage disease. The Military Medical Consortium for the Advancement of Retroviral Research (MMCARR) |journal=Int. J. Dermatol. |volume=36 |issue=2 |pages=104–9 |year=1997 |pmid=9109005 |doi= |url=}}</ref>
** Epstein-Barr virus (EBV)
** [[Epstein Barr virus|Epstein-Barr virus]] (EBV)
** ''Toxoplasma gondii''
** ''[[Toxoplasma gondii]]''
** Human immunodeficiency virus (HIV)
** [[Human Immunodeficiency Virus (HIV)|Human immunodeficiency virus]] (HIV)
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[[Image:PLEVA2.jpg|200px|courtesy http://www.regionalderm.com]]
[[Image:PLEVA2.jpg|200px|courtesy http://www.regionalderm.com]]
|-
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|Nummular dermatitis<ref name="pmid23517392">{{cite journal |vauthors=Jiamton S, Tangjaturonrusamee C, Kulthanan K |title=Clinical features and aggravating factors in nummular eczema in Thais |journal=Asian Pac. J. Allergy Immunol. |volume=31 |issue=1 |pages=36–42 |year=2013 |pmid=23517392 |doi= |url=}}</ref>
|[[Nummular dermatitis]]<ref name="pmid23517392">{{cite journal |vauthors=Jiamton S, Tangjaturonrusamee C, Kulthanan K |title=Clinical features and aggravating factors in nummular eczema in Thais |journal=Asian Pac. J. Allergy Immunol. |volume=31 |issue=1 |pages=36–42 |year=2013 |pmid=23517392 |doi= |url=}}</ref>
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* Multiple coinshaped eczematous lesions  
* Multiple coinshaped [[Eczematous Scaling|eczematous]] lesions  
* Commonly affecting the extremities (lower>upper) and trunk
* Commonly affecting the [[extremities]] (lower>upper) and [[trunk]]
* May ooze fluid and become dry and crusty
* May ooze fluid and become dry and crusty
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* Lesions commonly relapse after occasional remission or may persist for long periods
* Lesions commonly relapse after occasional remission or may persist for long periods
* Pruritis
* [[Pruritis]]
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* Associated with:
* Associated with:
** Dry skin  
** Dry skin  
** Emotional stress
** Emotional stress
** Allergens(rubber chemicals, formaldehyde, neomycin, chrome, mercury and nickel)
** Allergens(rubber chemicals, [[formaldehyde]], [[neomycin]], chrome, [[Mercury (element)|mercury]] and [[nickel]])
** Staphylococcus infection  
** [[Staphylococcus]] infection  
** Seasonal variation
** Seasonal variation
** Alcohol  
** Alcohol  
** Drugs
** Drugs
** Atopy
** [[Atopy]]
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[[Image:Nummular_dermatitis_eczematous.jpg|200px]]
[[Image:Nummular_dermatitis_eczematous.jpg|200px]]
|-
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|Secondary syphilis<ref name="urlSTD Facts - Syphilis">{{cite web |url=https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm |title=STD Facts - Syphilis |format= |work= |accessdate=}}</ref>
|[[Secondary syphilis]]<ref name="urlSTD Facts - Syphilis">{{cite web |url=https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm |title=STD Facts - Syphilis |format= |work= |accessdate=}}</ref>
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* Round coppery red color lesions on palms and soles
* Round coppery red color lesions on palms and soles
* Papules with collarette of scales
* [[Papule|Papules]] with collarette of scales
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* Fever
* [[Fever]]
* Generalized lymphadenpathy
* Generalized [[lymphadenopathy]]
* Sore throat
* Sore throat
* Patchy hair loss
* Patchy hair loss
* Headaches
* Headaches
* Weight loss
* Weight loss
* Myalgia  
* [[Myalgia]]
* Fatigue
* [[Fatigue]]
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* Associated with:
* Associated with:
** Condylomata lata
** [[Condyloma latum|Condylomata lata]]
** Corona verinata
** Corona verinata
** Positive VDRL test
** Positive [[Venereal disease research laboratory (VDRL) test|VDRL]] test
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[[Image:Secondary_Syphilis.jpg|200px]]
[[Image:Secondary_Syphilis.jpg|200px]]
|-
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|Bowen’s disease<ref name="pmid28523295">{{cite journal |vauthors=Neagu TP, Ţigliş M, Botezatu D, Enache V, Cobilinschi CO, Vâlcea-Precup MS, GrinŢescu IM |title=Clinical, histological and therapeutic features of Bowen's disease |journal=Rom J Morphol Embryol |volume=58 |issue=1 |pages=33–40 |year=2017 |pmid=28523295 |doi= |url=}}</ref>
|[[Bowen’s disease]]<ref name="pmid28523295">{{cite journal |vauthors=Neagu TP, Ţigliş M, Botezatu D, Enache V, Cobilinschi CO, Vâlcea-Precup MS, GrinŢescu IM |title=Clinical, histological and therapeutic features of Bowen's disease |journal=Rom J Morphol Embryol |volume=58 |issue=1 |pages=33–40 |year=2017 |pmid=28523295 |doi= |url=}}</ref>
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* Erythematous little scaly plaque, which enlarges over time in an erratic manner
* [[Erythematous]] little scaly plaque, which enlarges over time in an erratic manner
* Scale is usually yellow or white and it is easily detachable without producing any bleeding  
* Scale is usually yellow or white and it is easily detachable without producing any bleeding  
* Well defined margins
* Well defined margins
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* Pruritis
* [[Pruritis]]
* Pain
* Pain
* Bleeding lesions
* Bleeding lesions
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* Associated with:<ref name="pmid25201325">{{cite journal |vauthors=Murao K, Yoshioka R, Kubo Y |title=Human papillomavirus infection in Bowen disease: negative p53 expression, not p16(INK4a) overexpression, is correlated with human papillomavirus-associated Bowen disease |journal=J. Dermatol. |volume=41 |issue=10 |pages=878–84 |year=2014 |pmid=25201325 |doi=10.1111/1346-8138.12613 |url=}}</ref>
* Associated with:<ref name="pmid25201325">{{cite journal |vauthors=Murao K, Yoshioka R, Kubo Y |title=Human papillomavirus infection in Bowen disease: negative p53 expression, not p16(INK4a) overexpression, is correlated with human papillomavirus-associated Bowen disease |journal=J. Dermatol. |volume=41 |issue=10 |pages=878–84 |year=2014 |pmid=25201325 |doi=10.1111/1346-8138.12613 |url=}}</ref>
** Erythroplasia of Queyrat (Bowen's disease of the penis)
** [[Erythroplasia of Queyrat]] ([[Bowen's disease]] of the penis)
** Squamous cell carcinoma
** [[Squamous cell carcinoma]]
** Solar radiation and ultraviolet (UV) exposure
** Solar radiation and [[ultraviolet]] (UV) exposure
** Radiotherapy
** [[Radiation therapy|Radiotherapy]]
** Immunosuppression
** [[Immunosuppression]]
** Arsenic exposure
** [[Arsenic]] exposure
** Human papilloma virus (HPV) type 16
** [[Human papillomavirus|Human papilloma virus]] (HPV) type 16
** Merkel cell polyomavirus
** Merkel cell polyomavirus
** Sjögren’s syndrome
** [[Sjögren's syndrome|Sjögren’s syndrome]]
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[[Image:Bowen.jpg|200px]]
[[Image:Bowen.jpg|200px]]
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|Exanthematous pustulosis<ref name="pmid26354880">{{cite journal |vauthors=Szatkowski J, Schwartz RA |title=Acute generalized exanthematous pustulosis (AGEP): A review and update |journal=J. Am. Acad. Dermatol. |volume=73 |issue=5 |pages=843–8 |year=2015 |pmid=26354880 |doi=10.1016/j.jaad.2015.07.017 |url=}}</ref>
|[[Exanthematous pustulosis]]<ref name="pmid26354880">{{cite journal |vauthors=Szatkowski J, Schwartz RA |title=Acute generalized exanthematous pustulosis (AGEP): A review and update |journal=J. Am. Acad. Dermatol. |volume=73 |issue=5 |pages=843–8 |year=2015 |pmid=26354880 |doi=10.1016/j.jaad.2015.07.017 |url=}}</ref>
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* Numerous small, primarily non-follicular, sterile pustules, arising within large areas of edematous erythema
* Numerous small, primarily non-follicular, sterile pustules, arising within large areas of [[Edema|edematous]] [[erythema]]
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* Fever
* [[Fever]]
* Leukocytosis
* [[Leukocytosis]]
* Intracorneal, subcorneal, and/or intraepidermal pustules with papillary dermal edema containing neutrophils and eosinophils
* Intracorneal, subcorneal, and/or intraepidermal [[pustules]] with [[papillary]] [[dermal]] [[edema]] containing [[neutrophils]] and [[eosinophils]]
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* Associated with:<ref name="pmid12466124">{{cite journal |vauthors=Schmid S, Kuechler PC, Britschgi M, Steiner UC, Yawalkar N, Limat A, Baltensperger K, Braathen L, Pichler WJ |title=Acute generalized exanthematous pustulosis: role of cytotoxic T cells in pustule formation |journal=Am. J. Pathol. |volume=161 |issue=6 |pages=2079–86 |year=2002 |pmid=12466124 |pmc=1850901 |doi=10.1016/S0002-9440(10)64486-0 |url=}}</ref>
* Associated with:<ref name="pmid12466124">{{cite journal |vauthors=Schmid S, Kuechler PC, Britschgi M, Steiner UC, Yawalkar N, Limat A, Baltensperger K, Braathen L, Pichler WJ |title=Acute generalized exanthematous pustulosis: role of cytotoxic T cells in pustule formation |journal=Am. J. Pathol. |volume=161 |issue=6 |pages=2079–86 |year=2002 |pmid=12466124 |pmc=1850901 |doi=10.1016/S0002-9440(10)64486-0 |url=}}</ref>
** Antibiotics(penicillins, sulfonamides, tetracyclines)
** Antibiotics([[Penicillin|penicillins]], [[sulfonamides]], [[tetracyclines]])
** Carbamazepine
** [[Carbamazepine]]
** Calcium channel blockers(Diltiazem)
** [[Calcium channel blocker|Calcium channel blockers]]([[Diltiazem]])
** Hydroxychloroquine
** [[Hydroxychloroquine]]
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[[Image:Acute_generalized_exanthematous_pustulosis.jpg|200px]]
[[Image:Acute_generalized_exanthematous_pustulosis.jpg|200px]]
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|Hypertrophic lichen planus<ref name="pmid27222766">{{cite journal |vauthors=Ankad BS, Beergouder SL |title=Hypertrophic lichen planus versus prurigo nodularis: a dermoscopic perspective |journal=Dermatol Pract Concept |volume=6 |issue=2 |pages=9–15 |year=2016 |pmid=27222766 |pmc=4866621 |doi=10.5826/dpc.0602a03 |url=}}</ref>
|[[Lichen planus|Hypertrophic lichen planus]]<ref name="pmid27222766">{{cite journal |vauthors=Ankad BS, Beergouder SL |title=Hypertrophic lichen planus versus prurigo nodularis: a dermoscopic perspective |journal=Dermatol Pract Concept |volume=6 |issue=2 |pages=9–15 |year=2016 |pmid=27222766 |pmc=4866621 |doi=10.5826/dpc.0602a03 |url=}}</ref>
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* Classically involves shin and ankles and is characterized by hyperkeratotic plaques and nodules covered by a scale
* Classically involves shin and ankles and is characterized by [[Hyperkeratosis|hyperkeratotic]] [[Plaque|plaques]] and [[Nodule (medicine)|nodules]] covered by a scale
* Lesions may transform into hyperkeratotic thickened elevated purplish or reddish plaques and nodules
* Lesions may transform into [[Hyperkeratosis|hyperkeratotic]] thickened elevated purplish or reddish [[Plaque|plaques]] and [[nodules]]
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* Chronic pruritis
* Chronic [[pruritis]]
* Scaling
* Scaling
* May be asymptomatic
* May be asymptomatic
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* Associated with Hepatitis C virus infection<ref name="pmid19770446">{{cite journal |vauthors=Shengyuan L, Songpo Y, Wen W, Wenjing T, Haitao Z, Binyou W |title=Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis |journal=Arch Dermatol |volume=145 |issue=9 |pages=1040–7 |year=2009 |pmid=19770446 |doi=10.1001/archdermatol.2009.200 |url=}}</ref>
* Associated with [[Hepatitis C virus]] infection<ref name="pmid19770446">{{cite journal |vauthors=Shengyuan L, Songpo Y, Wen W, Wenjing T, Haitao Z, Binyou W |title=Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis |journal=Arch Dermatol |volume=145 |issue=9 |pages=1040–7 |year=2009 |pmid=19770446 |doi=10.1001/archdermatol.2009.200 |url=}}</ref>
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[[Image:Lichen_planus2.JPG|200px]]
[[Image:Lichen_planus2.JPG|200px]]
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|Sneddon–Wilkinson disease<ref name="pmid9564592">{{cite journal |vauthors=Lutz ME, Daoud MS, McEvoy MT, Gibson LE |title=Subcorneal pustular dermatosis: a clinical study of ten patients |journal=Cutis |volume=61 |issue=4 |pages=203–8 |year=1998 |pmid=9564592 |doi= |url=}}</ref>
|Sneddon–Wilkinson disease<ref name="pmid9564592">{{cite journal |vauthors=Lutz ME, Daoud MS, McEvoy MT, Gibson LE |title=Subcorneal pustular dermatosis: a clinical study of ten patients |journal=Cutis |volume=61 |issue=4 |pages=203–8 |year=1998 |pmid=9564592 |doi= |url=}}</ref>
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* Flaccid pustules were often generalized and have a tendency to involve the flexural areas
* [[Flaccid]] [[pustules]] that are often generalized and have a tendency to involve the flexural areas
* Have an annular configuration
* Have an annular configuration
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* Pruritis
* [[Pruritis]]
* May be asymptomatic
* May be asymptomatic
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* Associated with:
* Associated with:
** Monoclonal gammopathy, usually an IgA paraproteinemia<ref name="pmid3056995">{{cite journal |vauthors=Kasha EE, Epinette WW |title=Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) in association with a monoclonal IgA gammopathy: a report and review of the literature |journal=J. Am. Acad. Dermatol. |volume=19 |issue=5 Pt 1 |pages=854–8 |year=1988 |pmid=3056995 |doi= |url=}}</ref>
** [[Monoclonal gammopathy]], usually an IgA paraproteinemia<ref name="pmid3056995">{{cite journal |vauthors=Kasha EE, Epinette WW |title=Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) in association with a monoclonal IgA gammopathy: a report and review of the literature |journal=J. Am. Acad. Dermatol. |volume=19 |issue=5 Pt 1 |pages=854–8 |year=1988 |pmid=3056995 |doi= |url=}}</ref>
** Crohn's disease<ref name="pmid1357895">{{cite journal |vauthors=Delaporte E, Colombel JF, Nguyen-Mailfer C, Piette F, Cortot A, Bergoend H |title=Subcorneal pustular dermatosis in a patient with Crohn's disease |journal=Acta Derm. Venereol. |volume=72 |issue=4 |pages=301–2 |year=1992 |pmid=1357895 |doi= |url=}}</ref>
** [[Crohn's disease]]<ref name="pmid1357895">{{cite journal |vauthors=Delaporte E, Colombel JF, Nguyen-Mailfer C, Piette F, Cortot A, Bergoend H |title=Subcorneal pustular dermatosis in a patient with Crohn's disease |journal=Acta Derm. Venereol. |volume=72 |issue=4 |pages=301–2 |year=1992 |pmid=1357895 |doi= |url=}}</ref>
** Osteomyelitis
** [[Osteomyelitis]]
** Adalimumab<ref name="pmid23489057">{{cite journal |vauthors=Sauder MB, Glassman SJ |title=Palmoplantar subcorneal pustular dermatosis following adalimumab therapy for rheumatoid arthritis |journal=Int. J. Dermatol. |volume=52 |issue=5 |pages=624–8 |year=2013 |pmid=23489057 |doi=10.1111/j.1365-4632.2012.05707.x |url=}}</ref>
** [[Adalimumab]]<ref name="pmid23489057">{{cite journal |vauthors=Sauder MB, Glassman SJ |title=Palmoplantar subcorneal pustular dermatosis following adalimumab therapy for rheumatoid arthritis |journal=Int. J. Dermatol. |volume=52 |issue=5 |pages=624–8 |year=2013 |pmid=23489057 |doi=10.1111/j.1365-4632.2012.05707.x |url=}}</ref>
|
|
[[Image:Snedden.jpg|200px]]
[[Image:Snedden.jpg|200px]]
|-
|-
|Small plaque parapsoriasis<ref name="pmid7026622">{{cite journal |vauthors=Lambert WC, Everett MA |title=The nosology of parapsoriasis |journal=J. Am. Acad. Dermatol. |volume=5 |issue=4 |pages=373–95 |year=1981 |pmid=7026622 |doi= |url=}}</ref>
|[[Parapsoriasis|Small plaque parapsoriasis]]<ref name="pmid7026622">{{cite journal |vauthors=Lambert WC, Everett MA |title=The nosology of parapsoriasis |journal=J. Am. Acad. Dermatol. |volume=5 |issue=4 |pages=373–95 |year=1981 |pmid=7026622 |doi= |url=}}</ref>
|
|
* Erythematous plaques which are covered with fine scale.  
* [[Erythematous]] [[plaques]] which are covered with fine scale.  
* May present with elongated, finger-like patches symmetrically distributed on the flanks, also known as digitate dermatosis
* May present with elongated, finger-like patches symmetrically distributed on the flanks, also known as digitate dermatosis
|
|
* Lesions may be asymptomatic  
* Lesions may be asymptomatic  
* May be mildly pruritic  
* May be mildly [[Itch|pruritic]]
* May fade or disappear after sun exposure during the summer season, but typically recur during the winter
* May fade or disappear after sun exposure during the summer season, but typically recur during the winter
|
|
* May progress to mycosis fungoides<ref name="pmid16191852">{{cite journal |vauthors=Väkevä L, Sarna S, Vaalasti A, Pukkala E, Kariniemi AL, Ranki A |title=A retrospective study of the probability of the evolution of parapsoriasis en plaques into mycosis fungoides |journal=Acta Derm. Venereol. |volume=85 |issue=4 |pages=318–23 |year=2005 |pmid=16191852 |doi=10.1080/00015550510030087 |url=}}</ref>
* May progress to [[mycosis fungoides]]<ref name="pmid16191852">{{cite journal |vauthors=Väkevä L, Sarna S, Vaalasti A, Pukkala E, Kariniemi AL, Ranki A |title=A retrospective study of the probability of the evolution of parapsoriasis en plaques into mycosis fungoides |journal=Acta Derm. Venereol. |volume=85 |issue=4 |pages=318–23 |year=2005 |pmid=16191852 |doi=10.1080/00015550510030087 |url=}}</ref>
|
|
[[Image:Small_plaque_parapsoriasis.jpg|200px|courtesy http://www.regionalderm.com]]
[[Image:Small_plaque_parapsoriasis.jpg|200px|courtesy http://www.regionalderm.com]]
|-
|-
|Intertrigo<ref name="pmid16156342">{{cite journal |vauthors=Janniger CK, Schwartz RA, Szepietowski JC, Reich A |title=Intertrigo and common secondary skin infections |journal=Am Fam Physician |volume=72 |issue=5 |pages=833–8 |year=2005 |pmid=16156342 |doi= |url=}}</ref>
|[[Intertrigo]]<ref name="pmid16156342">{{cite journal |vauthors=Janniger CK, Schwartz RA, Szepietowski JC, Reich A |title=Intertrigo and common secondary skin infections |journal=Am Fam Physician |volume=72 |issue=5 |pages=833–8 |year=2005 |pmid=16156342 |doi= |url=}}</ref>
|
|
* Red and fleshy looking lesion in skin folds
* Red and fleshy looking lesion in skin folds
Line 231: Line 231:
* May be sore
* May be sore
|
|
* Pruritis
* [[Pruritis]]
* Musty odor
* Musty odor
|
|
* Associated with:
* Associated with:
** Infections (Fungal, bacterial, viral)
** Infections (Fungal, bacterial, viral)
** Allergies
** [[Allergies]]
** Diabetes
** [[Diabetes Mellitus|Diabetes]]
** Obesity
** [[Obesity]]
|
|
[[Image:Axillary_intertrigo.png|200px]]
[[Image:Axillary_intertrigo.png|200px]]
|-
|-
|Langerhans cell histiocytosis<ref name="pmid18577030">{{cite journal |vauthors=Satter EK, High WA |title=Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society |journal=Pediatr Dermatol |volume=25 |issue=3 |pages=291–5 |year=2008 |pmid=18577030 |doi=10.1111/j.1525-1470.2008.00669.x |url=}}</ref>
|[[Langerhans cell histiocytosis]]<ref name="pmid18577030">{{cite journal |vauthors=Satter EK, High WA |title=Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society |journal=Pediatr Dermatol |volume=25 |issue=3 |pages=291–5 |year=2008 |pmid=18577030 |doi=10.1111/j.1525-1470.2008.00669.x |url=}}</ref>
|
|
* Scaling and crusting of the scalp
* Scaling and crusting of the scalp
|
|
* Pathological fractures<ref name="pmid1636041">{{cite journal |vauthors=Stull MA, Kransdorf MJ, Devaney KO |title=Langerhans cell histiocytosis of bone |journal=Radiographics |volume=12 |issue=4 |pages=801–23 |year=1992 |pmid=1636041 |doi=10.1148/radiographics.12.4.1636041 |url=}}</ref>
* Pathological fractures<ref name="pmid1636041">{{cite journal |vauthors=Stull MA, Kransdorf MJ, Devaney KO |title=Langerhans cell histiocytosis of bone |journal=Radiographics |volume=12 |issue=4 |pages=801–23 |year=1992 |pmid=1636041 |doi=10.1148/radiographics.12.4.1636041 |url=}}</ref>
* Visceromegaly (hepatomegaly, spleenomegaly)
* Visceromegaly ([[hepatomegaly]], [[spleenomegaly]])
* Chronic cough
* Chronic cough
* Dyspnea<ref name="pmid17527085">{{cite journal |vauthors=Sholl LM, Hornick JL, Pinkus JL, Pinkus GS, Padera RF |title=Immunohistochemical analysis of langerin in langerhans cell histiocytosis and pulmonary inflammatory and infectious diseases |journal=Am. J. Surg. Pathol. |volume=31 |issue=6 |pages=947–52 |year=2007 |pmid=17527085 |doi=10.1097/01.pas.0000249443.82971.bb |url=}}</ref>
* [[Dyspnea]]<ref name="pmid17527085">{{cite journal |vauthors=Sholl LM, Hornick JL, Pinkus JL, Pinkus GS, Padera RF |title=Immunohistochemical analysis of langerin in langerhans cell histiocytosis and pulmonary inflammatory and infectious diseases |journal=Am. J. Surg. Pathol. |volume=31 |issue=6 |pages=947–52 |year=2007 |pmid=17527085 |doi=10.1097/01.pas.0000249443.82971.bb |url=}}</ref>
* Lymphadenopathy
* [[Lymphadenopathy]]
|
|
* Associated with:
* Associated with:
** Diabetes insipidus<ref name="pmid16047354">{{cite journal |vauthors=Grois N, Pötschger U, Prosch H, Minkov M, Arico M, Braier J, Henter JI, Janka-Schaub G, Ladisch S, Ritter J, Steiner M, Unger E, Gadner H |title=Risk factors for diabetes insipidus in langerhans cell histiocytosis |journal=Pediatr Blood Cancer |volume=46 |issue=2 |pages=228–33 |year=2006 |pmid=16047354 |doi=10.1002/pbc.20425 |url=}}</ref>
** [[Diabetes insipidus]]<ref name="pmid16047354">{{cite journal |vauthors=Grois N, Pötschger U, Prosch H, Minkov M, Arico M, Braier J, Henter JI, Janka-Schaub G, Ladisch S, Ritter J, Steiner M, Unger E, Gadner H |title=Risk factors for diabetes insipidus in langerhans cell histiocytosis |journal=Pediatr Blood Cancer |volume=46 |issue=2 |pages=228–33 |year=2006 |pmid=16047354 |doi=10.1002/pbc.20425 |url=}}</ref>
** Pancytopenia
** [[Pancytopenia]]
|
|
[[Image:Langerhan_cell_histiocytosis.jpg|200px|courtesy http://www.regionalderm.com ]]
[[Image:Langerhan_cell_histiocytosis.jpg|200px|courtesy http://www.regionalderm.com ]]
|-
|-
|Tinea manuum/pedum/capitis<ref name="pmid15050029">{{cite journal |vauthors=Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G |title=Dermatology for the practicing allergist: Tinea pedis and its complications |journal=Clin Mol Allergy |volume=2 |issue=1 |pages=5 |year=2004 |pmid=15050029 |pmc=419368 |doi=10.1186/1476-7961-2-5 |url=}}</ref>
|[[Tinea manuum]]/pedum/capitis<ref name="pmid15050029">{{cite journal |vauthors=Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G |title=Dermatology for the practicing allergist: Tinea pedis and its complications |journal=Clin Mol Allergy |volume=2 |issue=1 |pages=5 |year=2004 |pmid=15050029 |pmc=419368 |doi=10.1186/1476-7961-2-5 |url=}}</ref>
|
|
* scaling, flaking, and sometimes blistering of the affected areas
* scaling, flaking, and sometimes blistering of the affected areas
* Hair loss with a black dot on scalp in case of tinea capitis
* Hair loss with a black dot on scalp in case of [[tinea capitis]]
|
|
* Pruritis
* [[Pruritis]]
* KOH preparation of the lesions confirms fungal infection
* KOH preparation of the lesions confirms fungal infection
|
|
* Associated with:
* Associated with:
** Diabetes
** [[Diabetes mellitus|Diabetes]]
** Immunosupression
** [[Immunosupression]]
** Intimate contact with infected person
** Intimate contact with infected person
** May lead to asthma exacerbation
** May lead to asthma exacerbation
Line 274: Line 274:
[[Image:Tinea_pedis.jpg|200px]]
[[Image:Tinea_pedis.jpg|200px]]
|-
|-
|Seborrheic dermatitis
|[[Seborrheic dermatitis]]
|
|
* Papulosquamous, scaly, flaky, itchy, and red rash found particularly at sebaceous gland-rich areas of the body
* [[Papulosquamous]], scaly, flaky, itchy, and red rash found particularly at [[sebaceous gland]]-rich areas of the body
|
|
|
|
* Associated with:<ref name="pmid16848386">{{cite journal |vauthors=Schwartz RA, Janusz CA, Janniger CK |title=Seborrheic dermatitis: an overview |journal=Am Fam Physician |volume=74 |issue=1 |pages=125–30 |year=2006 |pmid=16848386 |doi= |url=}}</ref>
* Associated with:<ref name="pmid16848386">{{cite journal |vauthors=Schwartz RA, Janusz CA, Janniger CK |title=Seborrheic dermatitis: an overview |journal=Am Fam Physician |volume=74 |issue=1 |pages=125–30 |year=2006 |pmid=16848386 |doi= |url=}}</ref>
** AIDS
** [[AIDS]]
** Stress<ref name="pmid18033062">{{cite journal |vauthors=Misery L, Touboul S, Vinçot C, Dutray S, Rolland-Jacob G, Consoli SG, Farcet Y, Feton-Danou N, Cardinaud F, Callot V, De La Chapelle C, Pomey-Rey D, Consoli SM |title=[Stress and seborrheic dermatitis] |language=French |journal=Ann Dermatol Venereol |volume=134 |issue=11 |pages=833–7 |year=2007 |pmid=18033062 |doi= |url=}}</ref>
** Stress<ref name="pmid18033062">{{cite journal |vauthors=Misery L, Touboul S, Vinçot C, Dutray S, Rolland-Jacob G, Consoli SG, Farcet Y, Feton-Danou N, Cardinaud F, Callot V, De La Chapelle C, Pomey-Rey D, Consoli SM |title=[Stress and seborrheic dermatitis] |language=French |journal=Ann Dermatol Venereol |volume=134 |issue=11 |pages=833–7 |year=2007 |pmid=18033062 |doi= |url=}}</ref>
** Fungal infection
** Fungal infection
** Fatigue
** [[Fatigue]]
** Sleep deprivation  
** Sleep deprivation  
** Change of season
** Change of season
** Parkinson's disease
** [[Parkinson's disease|Parkinson's]] disease
** Biotin deficiency
** [[Biotin]] deficiency
|
|
[[Image:Seborrhoeic_dermatitisnew.jpg|200px]]
[[Image:Seborrhoeic_dermatitisnew.jpg|200px]]

Revision as of 16:04, 21 June 2017

Psoriasis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

Psoriasis must be differentiated from other diseases that cause erythematous, scaly rash such as Cutaneous T cell lymphoma/mycosis fungoides, pityriasis rosea, pityriasis rubra pilaris, pityriasis lichenoides chronica, nummular dermatitis, secondary syphilis, bowen’s disease, exanthematous pustulosis, hypertrophic lichen planus, Sneddon–Wilkinson disease, small plaque parapsoriasis, intertrigo, langerhans cell histiocytosis, dyshidrotic dermatitis, tinea manuum/pedum/capitis and seborrheic dermatitis.

Differentiating Psoriasis from other Diseases

Disease Rash Characteristics Signs and Symptoms Associated Conditions Rash Appearance
Cutaneous T cell lymphoma/Mycosis fungoides[1]
    • Premycotic phase: A scaly, red rash in areas of the body that usually are not exposed to the sun. This rash does not cause symptoms and may last for months or years.
    • Patch phase: Thin, reddened, eczema -like rash.
    • Plaque phase: Small raised bumps (papules) or hardened lesions on the skin, which may be reddened.
    • Tumor phase: Tumors form on the skin. These tumors may develop ulcers and the skin may get infected.
  • Sezary syndrome

Pityriasis rosea[2]
  • Pink or salmon in colour, which may be scaly, termed as "herald patch"
  • Oval in shape
  • Long axis oriented along the clevage lines
  • Distributed on the trunk and proximal extremities
  • Squamous marginal collarette and a “fir-tree” or “Christmas tree” distribution on the posterior trunk
  • Develops after viral infection
  • Resolves spontaneously after 6-8 weeks
  • Preceded by a prodrome of:

Pityriasis lichenoides chronica
  • Recurrent lesions are usually less evenly scattered than psoriasis
  • Brownish red or orange-brown color
  • Lesions are capped by a single detachable opaque mica-like scale
  • Often leave hypopigmented macules

courtesy http://www.regionalderm.com

Nummular dermatitis[5]
  • Multiple coinshaped eczematous lesions
  • Commonly affecting the extremities (lower>upper) and trunk
  • May ooze fluid and become dry and crusty
  • Often appears after a skin injury, such as a burn, abrasion (from friction), or insect bite
  • Lesions commonly relapse after occasional remission or may persist for long periods
  • Pruritis

Secondary syphilis[6]
  • Round coppery red color lesions on palms and soles
  • Papules with collarette of scales

Bowen’s disease[7]
  • Erythematous little scaly plaque, which enlarges over time in an erratic manner
  • Scale is usually yellow or white and it is easily detachable without producing any bleeding
  • Well defined margins

Exanthematous pustulosis[9]
  • Numerous small, primarily non-follicular, sterile pustules, arising within large areas of edematous erythema

Hypertrophic lichen planus[11]
  • Chronic pruritis
  • Scaling
  • May be asymptomatic

Sneddon–Wilkinson disease[13]
  • Flaccid pustules that are often generalized and have a tendency to involve the flexural areas
  • Have an annular configuration

Small plaque parapsoriasis[17]
  • Erythematous plaques which are covered with fine scale.
  • May present with elongated, finger-like patches symmetrically distributed on the flanks, also known as digitate dermatosis
  • Lesions may be asymptomatic
  • May be mildly pruritic
  • May fade or disappear after sun exposure during the summer season, but typically recur during the winter

courtesy http://www.regionalderm.com

Intertrigo[19]
  • Red and fleshy looking lesion in skin folds
  • Itching
  • oozing
  • May be sore

Langerhans cell histiocytosis[20]
  • Scaling and crusting of the scalp

courtesy http://www.regionalderm.com

Tinea manuum/pedum/capitis[24]
  • scaling, flaking, and sometimes blistering of the affected areas
  • Hair loss with a black dot on scalp in case of tinea capitis
  • Pruritis
  • KOH preparation of the lesions confirms fungal infection

Seborrheic dermatitis

References

  1. ↑ "Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute".
  2. ↑ Mahajan K, Relhan V, Relhan AK, Garg VK (2016). "Pityriasis Rosea: An Update on Etiopathogenesis and Management of Difficult Aspects". Indian J Dermatol. 61 (4): 375–84. doi:10.4103/0019-5154.185699. PMC 4966395. PMID 27512182.
  3. ↑ Prantsidis A, Rigopoulos D, Papatheodorou G, Menounos P, Gregoriou S, Alexiou-Mousatou I, Katsambas A (2009). "Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea". Acta Derm. Venereol. 89 (6): 604–6. doi:10.2340/00015555-0703. PMID 19997691.
  4. ↑ Smith KJ, Nelson A, Skelton H, Yeager J, Wagner KF (1997). "Pityriasis lichenoides et varioliformis acuta in HIV-1+ patients: a marker of early stage disease. The Military Medical Consortium for the Advancement of Retroviral Research (MMCARR)". Int. J. Dermatol. 36 (2): 104–9. PMID 9109005.
  5. ↑ Jiamton S, Tangjaturonrusamee C, Kulthanan K (2013). "Clinical features and aggravating factors in nummular eczema in Thais". Asian Pac. J. Allergy Immunol. 31 (1): 36–42. PMID 23517392.
  6. ↑ "STD Facts - Syphilis".
  7. ↑ Neagu TP, Ţigliş M, Botezatu D, Enache V, Cobilinschi CO, Vâlcea-Precup MS, GrinŢescu IM (2017). "Clinical, histological and therapeutic features of Bowen's disease". Rom J Morphol Embryol. 58 (1): 33–40. PMID 28523295.
  8. ↑ Murao K, Yoshioka R, Kubo Y (2014). "Human papillomavirus infection in Bowen disease: negative p53 expression, not p16(INK4a) overexpression, is correlated with human papillomavirus-associated Bowen disease". J. Dermatol. 41 (10): 878–84. doi:10.1111/1346-8138.12613. PMID 25201325.
  9. ↑ Szatkowski J, Schwartz RA (2015). "Acute generalized exanthematous pustulosis (AGEP): A review and update". J. Am. Acad. Dermatol. 73 (5): 843–8. doi:10.1016/j.jaad.2015.07.017. PMID 26354880.
  10. ↑ Schmid S, Kuechler PC, Britschgi M, Steiner UC, Yawalkar N, Limat A, Baltensperger K, Braathen L, Pichler WJ (2002). "Acute generalized exanthematous pustulosis: role of cytotoxic T cells in pustule formation". Am. J. Pathol. 161 (6): 2079–86. doi:10.1016/S0002-9440(10)64486-0. PMC 1850901. PMID 12466124.
  11. ↑ Ankad BS, Beergouder SL (2016). "Hypertrophic lichen planus versus prurigo nodularis: a dermoscopic perspective". Dermatol Pract Concept. 6 (2): 9–15. doi:10.5826/dpc.0602a03. PMC 4866621. PMID 27222766.
  12. ↑ Shengyuan L, Songpo Y, Wen W, Wenjing T, Haitao Z, Binyou W (2009). "Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis". Arch Dermatol. 145 (9): 1040–7. doi:10.1001/archdermatol.2009.200. PMID 19770446.
  13. ↑ Lutz ME, Daoud MS, McEvoy MT, Gibson LE (1998). "Subcorneal pustular dermatosis: a clinical study of ten patients". Cutis. 61 (4): 203–8. PMID 9564592.
  14. ↑ Kasha EE, Epinette WW (1988). "Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) in association with a monoclonal IgA gammopathy: a report and review of the literature". J. Am. Acad. Dermatol. 19 (5 Pt 1): 854–8. PMID 3056995.
  15. ↑ Delaporte E, Colombel JF, Nguyen-Mailfer C, Piette F, Cortot A, Bergoend H (1992). "Subcorneal pustular dermatosis in a patient with Crohn's disease". Acta Derm. Venereol. 72 (4): 301–2. PMID 1357895.
  16. ↑ Sauder MB, Glassman SJ (2013). "Palmoplantar subcorneal pustular dermatosis following adalimumab therapy for rheumatoid arthritis". Int. J. Dermatol. 52 (5): 624–8. doi:10.1111/j.1365-4632.2012.05707.x. PMID 23489057.
  17. ↑ Lambert WC, Everett MA (1981). "The nosology of parapsoriasis". J. Am. Acad. Dermatol. 5 (4): 373–95. PMID 7026622.
  18. ↑ Väkevä L, Sarna S, Vaalasti A, Pukkala E, Kariniemi AL, Ranki A (2005). "A retrospective study of the probability of the evolution of parapsoriasis en plaques into mycosis fungoides". Acta Derm. Venereol. 85 (4): 318–23. doi:10.1080/00015550510030087. PMID 16191852.
  19. ↑ Janniger CK, Schwartz RA, Szepietowski JC, Reich A (2005). "Intertrigo and common secondary skin infections". Am Fam Physician. 72 (5): 833–8. PMID 16156342.
  20. ↑ Satter EK, High WA (2008). "Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society". Pediatr Dermatol. 25 (3): 291–5. doi:10.1111/j.1525-1470.2008.00669.x. PMID 18577030.
  21. ↑ Stull MA, Kransdorf MJ, Devaney KO (1992). "Langerhans cell histiocytosis of bone". Radiographics. 12 (4): 801–23. doi:10.1148/radiographics.12.4.1636041. PMID 1636041.
  22. ↑ Sholl LM, Hornick JL, Pinkus JL, Pinkus GS, Padera RF (2007). "Immunohistochemical analysis of langerin in langerhans cell histiocytosis and pulmonary inflammatory and infectious diseases". Am. J. Surg. Pathol. 31 (6): 947–52. doi:10.1097/01.pas.0000249443.82971.bb. PMID 17527085.
  23. ↑ Grois N, Pötschger U, Prosch H, Minkov M, Arico M, Braier J, Henter JI, Janka-Schaub G, Ladisch S, Ritter J, Steiner M, Unger E, Gadner H (2006). "Risk factors for diabetes insipidus in langerhans cell histiocytosis". Pediatr Blood Cancer. 46 (2): 228–33. doi:10.1002/pbc.20425. PMID 16047354.
  24. ↑ Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G (2004). "Dermatology for the practicing allergist: Tinea pedis and its complications". Clin Mol Allergy. 2 (1): 5. doi:10.1186/1476-7961-2-5. PMC 419368. PMID 15050029.
  25. ↑ Schwartz RA, Janusz CA, Janniger CK (2006). "Seborrheic dermatitis: an overview". Am Fam Physician. 74 (1): 125–30. PMID 16848386.
  26. ↑ Misery L, Touboul S, Vinçot C, Dutray S, Rolland-Jacob G, Consoli SG, Farcet Y, Feton-Danou N, Cardinaud F, Callot V, De La Chapelle C, Pomey-Rey D, Consoli SM (2007). "[Stress and seborrheic dermatitis]". Ann Dermatol Venereol (in French). 134 (11): 833–7. PMID 18033062.

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