Squamous cell carcinoma of the skin differential diagnosis: Difference between revisions

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__NOTOC__
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[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Squamous_cell_carcinoma_of_the_skin]]
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Squamous_cell_carcinoma_of_the_skin]]
{{CMG}}; '''Associate Editor(s)-in-Chief:''' [[User:Aditya Govindavarjhulla|Aditya Govindavarjhulla, M.B.B.S.]] [mailto:agovi@wikidoc.org], [[User:Raviteja Reddy Guddeti|Raviteja Guddeti, M.B.B.S.]] [mailto:ravitheja.g@gmail.com]
{{CMG}}; {{AE}} {{RAK}}{{Homa}}
 
== Overview ==
== Overview ==
Squamous cell carcinoma should be differentiated from [[melanoma]] and [[basal cell carcinoma]]. It accounts for 20% of all non-melanomatous tumors, and is fairly invasive contrary to its counterpart, [[basal cell carcinoma]]. [[Squamous cell carcinoma]] typically presents as a non-healing ulcer or growth on a sun exposed area of the skin.
Squamous cell carcinoma should be differentiated from [[melanoma]] and [[basal cell carcinoma]]. It accounts for 20% of all non-melanomatous tumors and is fairly invasive contrary to its counterpart, [[basal cell carcinoma]]. [[Squamous cell carcinoma]] typically presents as a non-healing ulcer or growth on a sun-exposed area of the skin.


== Differentiating Squamous cell carcinoma from other Diseases ==
== Differentiating Squamous cell carcinoma from other Diseases ==
A few conditions that mimic [[Squamous cell carcinoma]] include the following;
A few conditions that mimic Squamous cell carcinoma of the skin include the following:
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! colspan="2" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="5" |'''Skin examination'''
! colspan="2" |Diagnosis
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Color
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Texture
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Size
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Distribution
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dermoscopic Findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-
| rowspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Cutaneous squamous cell carcinoma]]'''<ref name="pmid10848931">{{cite journal| author=Petter G, Haustein UF| title=Histologic subtyping and malignancy assessment of cutaneous squamous cell carcinoma. | journal=Dermatol Surg | year= 2000 | volume= 26 | issue= 6 | pages= 521-30 | pmid=10848931 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10848931  }}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Squamous cell carcinoma in situ of skin|'''SCC in situ (Bowen's disease''')]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Patched|Patch]]
*[[Plaque]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Erythematous]]
* Skin colored
| style="background: #F5F5F5; padding: 5px;" |
* Scaly
| style="background: #F5F5F5; padding: 5px;" |
* Variable
| style="background: #F5F5F5; padding: 5px;" |
* Fair-skinned individuals: sun-exposed areas


* [[Actinic keratosis]] (also called '''solar keratosis''', or '''AK''') is a [[premalignant condition]] consisting of one or multiple thick, scaly, or crusty patches on the skin. It is most common in fair-skinned people who are frequently exposed to the sun, due to lack of the protective pigment called melatonin. Actinic keratosis are pre-malignant lesions caused by solar damage that can progress to [[squamous cell carcinoma]], and should therefore be treated.It usually is accompanied by solar damage.
* In black individuals: [[Leg|legs]], [[anus]], and areas of [[chronic inflammation]]
* [[Atopic dermatitis]] (Atopic Eczema) is a hereditary, non-contagious skin disease characterized by chronic inflammation of the skin.
| style="background: #F5F5F5; padding: 5px;" |
* [[Atypical fibroxanthoma]] is a tumor that occurs primarily in older individuals when the skin of their head and neck area is exposed to sun and/or therapeutic radiation. Clinically, lesions usually are suggestive of malignancy because they arise rapidly in skin where other cancerous lesions have been found and treated. Clinical presentation is a red, beefy, sessile nodule. Solar telangiectasias can be found around the lesions.
* Presence of dotted and/or [[glomerular]] [[vessels]]
* [[Bowenoid papulosis]] presents as papules on the genitalia of both sexes and is induced by infection with [[HPV]]. Many of these lesions are benign, but there are case reports of malignant transformation (2.6%).
* White to yellowish [[Surface area|surface]] scales
* [[Contact dermatitis]]
* Red-yellowish [[background]]
* [[Erythroplasia of Queyrat]] is squamous cell carcinoma in situ of the penis.
| style="background: #F5F5F5; padding: 5px;" |
* [[Keratoacanthoma]] is a low-grade malignancy of the skin.  It originates in the [[sebaceous gland|pilo-sebaceous glands]], and is similar in its clinical presentation and microscopic analysis to squamous cell carcinoma, except that it contains a central [[keratin]] plug.  Statistically, it is less likely to become invasive than squamous cell carcinoma.
*[[Keratinocyte|Keratinocytic]] [[dysplasia]] of the [[epidermis]]
* [[Bowen's disease]] is a sunlight-induced skin disease, and is considered to be an early form of squamous cell carcinoma.
* No [[Infiltration (medical)|infiltration]] into [[dermis]]
* [[Marjolin's ulcer]] is a type of squamous cell carcinoma that arises from a non-healing [[ulcer]] or burn wound.
*[[Pleomorphism|Pleomorphic]] [[Keratinocyte|keratinocytes]]
* [[Melanoma]]
* Hyperchromatic [[nuclei]]
* [[Basal cell carcinoma]] is the most common skin tumor accounting for 80% of all non-melanomatous tumors of skin. It is a malignant epithelial cell tumor that begins as a papule (a small, circumscribed, solid elevation of the skin) and enlarges peripherally, developing into a crater that erodes, crusts, and bleeds
| style="background: #F5F5F5; padding: 5px;" |
* [[Pyoderma gangrenosum]] is an uncommon ulcerative condition associated with systemic disease in at least 50% of cases. This condition is a diagnosis of exclusion.
* Slow [[growth]] over the years
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Invasive squamous cell carcinoma'''
| style="background: #F5F5F5; padding: 5px;" |
* [[Papules|Papule]]
* [[Plaques|Plaque]]  
* [[Nodule]]
| style="background: #F5F5F5; padding: 5px;" |
* Skin colored
| style="background: #F5F5F5; padding: 5px;" |
* [[Induration|Indurated]] + [[Hyperkeratosis|hyperkeratotic]] (well [[Cellular differentiation|differentiated]])
* Soft + [[ulceration]] (poorly [[Cellular differentiation|differentiated]])
| style="background: #F5F5F5; padding: 5px;" |
* 0.5 to 1.5 cm
| style="background: #F5F5F5; padding: 5px;" |
* Fair-skinned individuals: sun-exposed areas


Squamous cell carcinoma of the mouth must be differentiated from other mouth lesions such as oral candidiasis and aphthous ulcer
* In black individuals: legs, anus, and areas of chronic inflammation
| style="background: #F5F5F5; padding: 5px;" |
* White circles
* White structureless areas
*[[Mass|Masses]] of [[keratin]]
*[[Hairpin]] and linear-irregular [[vessels]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Keratinocyte|Keratinocytic]] [[dysplasia]] of the [[epidermis]]
* No [[Infiltration (medical)|infiltration]] into [[dermis]]


<div style="width: 70%;">
* [[Pleomorphism|Pleomorphic]] [[Keratinocyte|keratinocytes]]
<small><small>
* Hyperchromatic [[nuclei]]
{| class="wikitable"
| style="background: #F5F5F5; padding: 5px;" |
!Disease
* May be [[painful]] or [[Itch|pruritic]]
!Presentation
!Risk Factors
!Diagnosis
!Affected Organ Systems
!Important features
!Picture
|-
|-
! colspan="3" |Diseases predominantly affecting the oral cavity
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Keratoacanthoma]]'''<ref name="pmid26853179">{{cite journal| author=Kwiek B, Schwartz RA| title=Keratoacanthoma (KA): An update and review. | journal=J Am Acad Dermatol | year= 2016 | volume= 74 | issue= 6 | pages= 1220-33 | pmid=26853179 | doi=10.1016/j.jaad.2015.11.033 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26853179  }}</ref>
!
| style="background: #F5F5F5; padding: 5px;" |
!
*[[Macule]]
*[[Papule]]
* May have [[telangiectasias]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]-colored
* Mildly [[erythematous]]
| style="background: #F5F5F5; padding: 5px;" |
* Prominent [[keratinous]] [[Core (anatomy)|core]] in the center of the [[nodule]]
| style="background: #F5F5F5; padding: 5px;" |
* 1 to 2.5 cm
| style="background: #F5F5F5; padding: 5px;" |
* Sun-exposed areas
*[[Face]], [[neck]], [[hands]], and [[Arm|arms]]
| style="background: #F5F5F5; padding: 5px;" |
* White circles
*[[Keratin]]
*[[Blood]] spots
* White structureless zones
| style="background: #F5F5F5; padding: 5px;" |
* Well-[[Cellular differentiation|differentiated]] [[squamous epithelium]]
* Central [[keratin]] core
*[[Epidermal]] [[hyperplasia]] + large [[eosinophilic]] [[Keratinocyte|keratinocytes]]
 
*[[Dermal]] [[inflammatory]] [[Infiltration (medical)|infiltrate]]
| style="background: #F5F5F5; padding: 5px;" |
* Rapid [[growth]] (within weeks)
|-
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''Dermatofibroma'''<ref name="LeeLee2015">{{cite journal|last1=Lee|first1=MiWoo|last2=Lee|first2=WooJin|last3=Jung|first3=JoonMin|last4=Won|first4=ChongHyun|last5=Chang|first5=SungEun|last6=Choi|first6=JeeHo|last7=Moon|first7=KeeChan|title=Clinical and histological patterns of dermatofibroma without gross skin surface change: A comparative study with conventional dermatofibroma|journal=Indian Journal of Dermatology, Venereology, and Leprology|volume=81|issue=3|year=2015|pages=263|issn=0378-6323|doi=10.4103/0378-6323.154795}}</ref><ref name="MentzelWiesner2012">{{cite journal|last1=Mentzel|first1=Thomas|last2=Wiesner|first2=Thomas|last3=Cerroni|first3=Lorenzo|last4=Hantschke|first4=Markus|last5=Kutzner|first5=Heinz|last6=Rütten|first6=Arno|last7=Häberle|first7=Michael|last8=Bisceglia|first8=Michele|last9=Chibon|first9=Frederic|last10=Coindre|first10=Jean-Michel|title=Malignant dermatofibroma: clinicopathological, immunohistochemical, and molecular analysis of seven cases|journal=Modern Pathology|volume=26|issue=2|year=2012|pages=256–267|issn=0893-3952|doi=10.1038/modpathol.2012.157}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Nodule]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Hyperpigmentation|Hyperpigmented]]
| style="background: #F5F5F5; padding: 5px;" |
*Firm
| style="background: #F5F5F5; padding: 5px;" |
*0.3- 1 cm
| style="background: #F5F5F5; padding: 5px;" |
*Mostly seen in [[extremities]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
*Localized [[nodular]] [[proliferation]] of [[spindle]]-shaped [[fibrous]] [[Cells (biology)|cells]] in a [[mixture]] of [[Histiocyte|histocytoid]] [[Cells (biology)|cells]] inside the [[dermis]]
* Spiculated margin of cells
* “Storiform” [[pattern]]
*[[Collagen]] bundles
* "Grenz zone"
*[[Epidermal]] [[hyperplasia]]
| style="background: #F5F5F5; padding: 5px;" |
* Slow [[growth]] over the years
!
!
|-
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[dermatofibrosarcoma protuberans]]'''<ref name="BernardPoulalhon2013">{{cite journal|last1=Bernard|first1=J.|last2=Poulalhon|first2=N.|last3=Argenziano|first3=G.|last4=Debarbieux|first4=S.|last5=Dalle|first5=S.|last6=Thomas|first6=L.|title=Dermoscopy of dermatofibrosarcoma protuberans: a study of 15 cases|journal=British Journal of Dermatology|volume=169|issue=1|year=2013|pages=85–90|issn=00070963|doi=10.1111/bjd.12318}}</ref><ref name="AcostaVélez2017">{{cite journal|last1=Acosta|first1=Alvaro E.|last2=Vélez|first2=Catalina Santa|title=Dermatofibrosarcoma Protuberans|journal=Current Treatment Options in Oncology|volume=18|issue=9|year=2017|issn=1527-2729|doi=10.1007/s11864-017-0498-5}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Patched|Patch]]
*[[Plaque]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Skin]]-[[Color|colored]], [[Violet (plant)|violet]] or [[Red-Al|reddish]]-[[brown]]
| style="background: #F5F5F5; padding: 5px;" |
*Firm
| style="background: #F5F5F5; padding: 5px;" |
*1-5 cm
| style="background: #F5F5F5; padding: 5px;" |
*Mostly seen in [[trunk]]
| style="background: #F5F5F5; padding: 5px;" |
*Presence of [[vessels]]
*[[Pigmentation|pigmented]] network
*pinkish [[background]]
| style="background: #F5F5F5; padding: 5px;" |
*Highly [[cellular]] with [[Cells (biology)|cells]] having following [[Characteristic function (probability theory)|characteristics]]:
** Monomorphic
** Thin
** [[Spindle cells|Spindly]]
** Scant [[eosinophilic]] [[cytoplasm]]
** Hyperchromatic [[nuclei]] (resembling [[neurofibroma]])
| style="background: #F5F5F5; padding: 5px;" |
!
!
|-
|-
|[[Oral candidiasis|Oral Candidiasis]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Kaposi sarcoma]]'''<ref name="CesarmanDamania2019">{{cite journal|last1=Cesarman|first1=Ethel|last2=Damania|first2=Blossom|last3=Krown|first3=Susan E.|last4=Martin|first4=Jeffrey|last5=Bower|first5=Mark|last6=Whitby|first6=Denise|title=Kaposi sarcoma|journal=Nature Reviews Disease Primers|volume=5|issue=1|year=2019|issn=2056-676X|doi=10.1038/s41572-019-0060-9}}</ref><ref name="HuKe2009">{{cite journal|last1=Hu|first1=S C-S|last2=Ke|first2=C-L K|last3=Lee|first3=C-H|last4=Wu|first4=C-S|last5=Chen|first5=G-S|last6=Cheng|first6=S-T|title=Dermoscopy of Kaposi's sarcoma: Areas exhibiting the multicoloured ‘rainbow pattern’|journal=Journal of the European Academy of Dermatology and Venereology|volume=23|issue=10|year=2009|pages=1128–1132|issn=09269959|doi=10.1111/j.1468-3083.2009.03239.x}}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
* [[Dysphagia]] or [[odynophagia]]
*[[Macule]]
* White patches on the mouth and tongue
*[[Patched|Patch]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Newborn]] babies
* Red/violaceous
| style="background: #F5F5F5; padding: 5px;" |
*Smooth
| style="background: #F5F5F5; padding: 5px;" |
*[[Variable]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Mucus membrane]]
| style="background: #F5F5F5; padding: 5px;" |
* Rainbow pattern
* scaly [[Surface area|surface]]
* Small brown globules
| style="background: #F5F5F5; padding: 5px;" |
*[[Spindle cells]] with minimal [[nuclear]] [[atypia]]
* Excessive [[vascular]] [[proliferation]]
* Abundant [[Red blood cell|red blood cells]]
*[[RBC]] and [[hemosiderin]] [[extravasation]]
* Abundant [[Lymphocyte|lymphocytes]] and [[monocytes]]
* Premonitory sign
* Intracytoplasmic [[PAS stain|PAS]] +ve [[hyaline]] globules
| style="background: #F5F5F5; padding: 5px;" |
* Kaposi's sarcoma is commonly associated with [[AIDS|acquired immune deficiency syndrome]] ([[AIDS]])
|-


*Denture users
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Merkel cell carcinoma]]'''<ref name="pmid19638070">{{cite journal| author=Albores-Saavedra J, Batich K, Chable-Montero F, Sagy N, Schwartz AM, Henson DE| title=Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study. | journal=J Cutan Pathol | year= 2010 | volume= 37 | issue= 1 | pages= 20-7 | pmid=19638070 | doi=10.1111/j.1600-0560.2009.01370.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19638070  }}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* Intracutaneous [[nodule]]
| style="background: #F5F5F5; padding: 5px;" |
* Shiny
* Flesh-colored or bluish-red
| style="background: #F5F5F5; padding: 5px;" |
* Firm
| style="background: #F5F5F5; padding: 5px;" |
* < 1 cm
| style="background: #F5F5F5; padding: 5px;" |
* Sun-exposed areas


*Poorly controlled [[diabetes]]
* [[Head]] and [[neck]]
 
* [[Upper limbs]] and [[shoulder]]
*As a side effect of medication, most commonly having taken [[antibiotic]]s. Inhaled [[corticosteroids]] for the treatment of lung conditions (e.g, [[asthma]] or [[COPD]]) may also result in oral candidiasis which may be reduced by regularly rinsing the mouth with water after taking the medication.
* [[Lower limbs]] and [[hip]]
 
* [[Trunk]]
*People with poor [[nutrition]], specifically [[vitamin A]], [[Iron deficiency anemia|iron]] and [[Folate deficiency|folate deficiencies]].
| style="background: #F5F5F5; padding: 5px;" |
 
* Milky red areas
*People with an [[immune deficiency]] (e.g. as a result of [[AIDS]]/[[HIV]] or [[chemotherapy]] treatment).
* Linear
 
* Irregular [[vessels]]
*Women undergoing hormonal changes, like [[pregnancy]] or those on [[birth control pills]].
*[[Polymorphic|Polymorphous]] [[vessels]]
 
| style="background: #F5F5F5; padding: 5px;" |
*[[Organ transplantation]] patients
* Uniform [[cells]] with large [[basophilic]] [[nuclei]]
|
* Single-cell [[necrosis]]
* Clinical diagnosis
* Frequent [[mitoses]]
* Confirmatory tests rarely needed
* Lymphovascular [[Invasive (medical)|invasion]]
|'''Localized candidiasis'''
*[[Perineurium|Perineural]] [[invasion]]
* [[Oral candidiasis|Oral]] and [[Esophageal candidiasis|esophageal candidasis]]
* [[Epidermal]] involvement via [[pagetoid]] spread
* [[Candida vulvovaginitis]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Chronic mucocutaneous candidiasis]]
* Older individuals with light [[skin]] tones
 
* Rapidly [[Growth|growing]]
'''Invasive candidasis'''
|-
* [[Candidiasis|Candidaemia]]
| rowspan="3" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Basal cell carcinoma]]'''<ref name="pmid22759209">{{cite journal| author=Wolberink EA, Pasch MC, Zeiler M, van Erp PE, Gerritsen MJ| title=High discordance between punch biopsy and excision in establishing basal cell carcinoma subtype: analysis of 500 cases. | journal=J Eur Acad Dermatol Venereol | year= 2013 | volume= 27 | issue= 8 | pages= 985-9 | pmid=22759209 | doi=10.1111/j.1468-3083.2012.04628.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22759209  }}</ref>
* [[Endocarditis|Candida endocarditis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Nodular basal cell carcinoma]]'''
* [[Osteoarthritis|Candida osteoarticular disease]]
| style="background: #F5F5F5; padding: 5px;" |
|
* [[Papule]]
* [[Osteoarthritis|Oral candidiaisis is]] a benign self limiting disease unless accompanied by [[immunosuppression]].
| style="background: #F5F5F5; padding: 5px;" |
|[[File:Human tongue infected with oral candidiasis--By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=11717223.jpg|thumb|Tongue infected with oral candidiasis - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=11717223.jpg|400x400px]]
* Flesh-colored
| style="background: #F5F5F5; padding: 5px;" |
* Small [[Bumps on skin|bump]]
| style="background: #F5F5F5; padding: 5px;" |
* Variable
| style="background: #F5F5F5; padding: 5px;" |
* [[Face]]
| style="background: #F5F5F5; padding: 5px;" |
* Focused, bright red, and branching arborizing [[vessels]]
* Loosely arranged blue-gray dots
| style="background: #F5F5F5; padding: 5px;" |
* Nest-like [[Infiltration (medical)|infiltration]] with [[Basal cell|basaloid]] [[cells]]
| style="background: #F5F5F5; padding: 5px;" |
* May have a "rolled" [[Borderline|border]]
|-
|-
|[[Herpes simplex|Herpes simplex oral lesions]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Superficial basal cell carcinoma '''
|
| style="background: #F5F5F5; padding: 5px;" |
* [[Fever]]
*[[Patched|Patch]]
* [[Sore throat]]
| style="background: #F5F5F5; padding: 5px;" |
* Painful [[ulcer]]s
* [[Erythematous]]
|
| style="background: #F5F5F5; padding: 5px;" |
* Stress
* Scaly
* Recent [[URTI]]
| style="background: #F5F5F5; padding: 5px;" |
* Female sex
* 1 to > 10 cm
|
| style="background: #F5F5F5; padding: 5px;" |
* Physical examination
* Sun-exposed areas
* [[Viral culture]]
* [[Head]] (cheek and nose)
* [[Tzanck smear]]
* [[Trunk]]
|
| style="background: #F5F5F5; padding: 5px;" |
* Orofacial Infection
*[[Superficial]] fine [[Telangiectasias|telangiectasia]]
* [[Herpes simplex anogenital infection|Anogenital Infection]]
* Shiny white to red, [[translucent]] or opaque structureless areas
* [[Herpes simplex ocular infection|Ocular Infection]]
* Multiple small erosions
* [[Herpes simplex encephalitis|Herpes Encephalitis]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Herpes simplex neonatorum|Neonatal Herpes]]
* Large, hyperchromatic, oval [[nuclei]]
* [[Herpetic whitlow|Herpetic Whitlow]]
* Minimal [[cytoplasm]]
* [[Herpes gladiatorum|Herpes Gladiatorum]]
* Small basaloid nodules
|
| style="background: #F5F5F5; padding: 5px;" |
* The symptoms of primary [[HSV]] infection generally resolve within two weeks
* Higher [[incidence]] in men
|[[File:Herpesinfection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|thumb|Oral herpes simplex infection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|400x400px]]
|-
|-
|[[Aphthous ulcer|Aphthous ulcers]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Sclerosing basal cell carcinoma (morpheaform)'''<ref name="pmid8959949">{{cite journal| author=Wrone DA, Swetter SM, Egbert BM, Smoller BR, Khavari PA| title=Increased proportion of aggressive-growth basal cell carcinoma in the Veterans Affairs population of Palo Alto, California. | journal=J Am Acad Dermatol | year= 1996 | volume= 35 | issue= 6 | pages= 907-10 | pmid=8959949 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8959949  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
* Painful, red spot or bump that develops into an open [[ulcer]]
*[[Papule]]
|
 
* Being a female
*[[Plaque]]
* Between the ages of 10-40
| style="background: #F5F5F5; padding: 5px;" |
* Family history of [[Aphthous ulcer|aphthous ulcers]]
* Flesh-colored
|
* [[Erythematous|Slightly erythematous]]
* Physical examination
| style="background: #F5F5F5; padding: 5px;" |
* Diagnosis of exclusion
* Firm
|
* [[Induration|Indurated]]
* Oral cavity
* Indistinct [[Borderline|borders]]
|
| style="background: #F5F5F5; padding: 5px;" |
* Self-limiting , [[Pain]] decreases in 7 to 10 days, with complete healing in 1 to 3 weeks
* Variable
|[[File:Afta foto - By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358.jpg|thumb|Apthous ulcer on the under surface of the tongue|By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358|400x400px]]
| style="background: #F5F5F5; padding: 5px;" |
* Sun-exposed areas
| style="background: #F5F5F5; padding: 5px;" |
* Whitish [[background]]
* Few fine arborizing [[vessels]]
* Multiple brown dots
* [[Ulceration]]
| style="background: #F5F5F5; padding: 5px;" |
* Thin columns + small nodules
* Highly [[Collagen|collagenized]] stroma
| style="background: #F5F5F5; padding: 5px;" |
* Expression of [[Alpha-actin|smooth muscle protein alpha-actin]] in tumor [[stroma]]
|-
|-
|[[Squamous cell carcinoma]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''Prurigo nodules'''<ref name="pmid25808786">{{cite journal| author=Errichetti E, Piccirillo A, Stinco G| title=Dermoscopy of prurigo nodularis. | journal=J Dermatol | year= 2015 | volume= 42 | issue= 6 | pages= 632-4 | pmid=25808786 | doi=10.1111/1346-8138.12844 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25808786  }}</ref><ref name="pmid20002240">{{cite journal| author=Weigelt N, Metze D, Ständer S| title=Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patients. | journal=J Cutan Pathol | year= 2010 | volume= 37 | issue= 5 | pages= 578-86 | pmid=20002240 | doi=10.1111/j.1600-0560.2009.01484.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20002240  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Non healing [[ulcer]], [[nodule]], indurated plaque or mass
* Dome-shaped [[nodule]]
*May involve [[skin]], [[lips]], inside the [[mouth]], [[throat]] or [[esophagus]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Flesh-colored
* Chronic sun or [[Ultraviolet|UV exposure]]
* [[Erythematous]]
* Fair [[skin]]
* Brown/black
* [[Elderly]] age (>45 yrs)
| style="background: #F5F5F5; padding: 5px;" |
* [[Male sex]]
* Firm
* [[Smoking]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Variable
*[[Physical exam]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
*[[Extensor]] [[Surface area|surfaces]] of the [[Arm|arms]] and [[Leg|legs]] and on the [[trunk]]
|
 
*[[Oral Cavity]]
* Upper [[back]], [[abdomen]], and [[sacrum]]
**Floor of [[mouth]]
| style="background: #F5F5F5; padding: 5px;" |
**Lateral [[tongue]]
* White "starburst pattern" surrounding red/brown/yellow crusts
*[[Throat]]
*[[Erosion (dental)|Erosions]]
*[[Esophagus]]
*[[Hyperkeratosis]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Malignant]]
* Thick and compact orthohyperkeratosis
*Can spread to [[TMJ]]
* Irregular [[epidermal]] [[hyperplasia]]
*Some times associated with [[leukoplakia]]
* Focal parakeratosis with irregular [[Acanthosis nigricans|acanthosis]]
|[[File:PLoS oral cancer.png|thumb|400x400px| |Squamous cell carcinoma - By Luca Pastore, Maria Luisa Fiorella, Raffaele Fiorella, Lorenzo Lo Muzio - http://www.plosmedicine.org/article/showImageLarge.action?uri=info%3Adoi%2F10.1371%2Fjournal.pmed.0050212.g001, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=15252632]]  
* Nonspecific [[dermal]] [[Infiltration (medical)|infiltrate]] containing [[WBC|WBCs]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Nodule (medicine)|Nodules]] range in number from few to hundreds
* Worsened by [[heat]], [[sweating]], or [[irritation]] from clothing
|-
|-
|[[Leukoplakia]]
| rowspan="6" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Melanoma]]'''<ref name="pmid201377432">{{cite journal| author=Witt C, Krengel S| title=Clinical and epidemiological aspects of subtypes of melanocytic nevi (Flat nevi, Miescher nevi, Unna nevi). | journal=Dermatol Online J | year= 2010 | volume= 16 | issue= 1 | pages= 1 | pmid=20137743 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20137743  }}</ref>
|
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Melanoma in situ''' (Lentigo Maligna)<ref name="pmid30266559">{{cite journal| author=Connolly KL, Giordano C, Dusza S, Busam KJ, Nehal K| title=Follicular involvement is frequent in lentigo maligna: Implications for treatment. | journal=J Am Acad Dermatol | year= 2019 | volume= 80 | issue= 2 | pages= 532-537 | pmid=30266559 | doi=10.1016/j.jaad.2018.07.071 | pmc=6333487 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30266559  }}</ref>
*White leathery spots on the [[mucous membranes]] of the [[tongue]] and inside of the [[mouth]]
| style="background: #F5F5F5; padding: 5px;" |
*Lateral borders of [[tongue]]
* [[Macule]]
|
| style="background: #F5F5F5; padding: 5px;" |
*Atypical [[Tobacco]] use
* Variable (from light to dark brown, black, pink, red, or white)
*Chronic [[irritation]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Immunodeficiency]]
* Smooth
*[[Bloodroot]] ([[Sanguinarine|sanguinaria]])
| style="background: #F5F5F5; padding: 5px;" |
|
* Around 1 cm
*[[Physical exam]]
| style="background: #F5F5F5; padding: 5px;" |
*Diagnosis of exclusion
* Sun-damaged [[skin]] of the [[head]] or [[neck]]
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Asymmetric, [[Pigmented lesions|pigmented]] follicular openings
*[[Vulva|Vulvar]] lesions occur independent of oral lesions
* Gray angulated lines
|
* Gray areas, dots, and globules
*Associated with [[HIV]]
* Circle within a circle
*Persistant white spots
| style="background: #F5F5F5; padding: 5px;" |
*[[Benign]] but can progress to [[carcinoma]] after almost 10 years
* '''↑''' atypical [[spindle]] shaped [[melanocytes]]  
*Oral proliferative [[Leukoplakia|verrucous leukoplakia]] is an aggressive sub type with multiple lesions and higher conversion to [[warts]] or [[carcinoma]]<ref>{{Cite journal
* Arranged in single [[Cells (biology)|cells]] or in small nests along the [[Epidermal junctions|dermal-epidermal junction]]
| author = [[Ann M. Gillenwater]], [[Nadarajah Vigneswaran]], [[Hanadi Fatani]], [[Pierre Saintigny]] & [[Adel K. El-Naggar]]
| style="background: #F5F5F5; padding: 5px;" |
| title = Proliferative verrucous leukoplakia (PVL): a review of an elusive pathologic entity!
* Darkening of [[pigmentation]], sharpening of borders, or emergence of [[nodular]] areas are [[signs]] of progression to [[lentigo maligna melanoma]]
| journal = [[Advances in anatomic pathology]]
| volume = 20
| issue = 6
| pages = 416–423
| year = 2013
| month = November
| doi = 10.1097/PAP.0b013e3182a92df1
| pmid = 24113312
}}</ref>
|[[File:Oral hairy leukoplakia (EBV, in HIV)a.jpg|thumb|400x300px|Leukoplakia - By Aitor III - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=9873087]]
|-
|-
|[[Melanoma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Lentigo maligna melanoma]]'''<ref name="pmid302665592">{{cite journal| author=Connolly KL, Giordano C, Dusza S, Busam KJ, Nehal K| title=Follicular involvement is frequent in lentigo maligna: Implications for treatment. | journal=J Am Acad Dermatol | year= 2019 | volume= 80 | issue= 2 | pages= 532-537 | pmid=30266559 | doi=10.1016/j.jaad.2018.07.071 | pmc=6333487 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30266559  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*A lesion with [[ABCD]]
* [[Macule]]
**[[Asymmetry]]
| style="background: #F5F5F5; padding: 5px;" |
**Border irregularity
* Brown/tan
**Color variation
| style="background: #F5F5F5; padding: 5px;" |
**[[Diamete]]r changes
*[[Freckle]]-like
*[[Bleeding]] from the lesion
| style="background: #F5F5F5; padding: 5px;" |
|
* Variable
*[[Ultraviolet|UV radiations]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Genetic predisposition]]
*[[Chronic|Chronically]] sun-damaged [[Area|areas]]
*[[Old age]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Male gender]]
* Asymmetric, [[Pigmented lesions|pigmented]] follicular openings
*Family or personal history of [[melanoma]]
* Gray angulated lines
*Multiple benign or atypical [[Nevus|nevi]]
* Gray areas, dots, and globules
|
* Circle within a circle
*[[ABCD]] characteristics
| style="background: #F5F5F5; padding: 5px;" |
*[[Bleeding]] or [[ulceration]] may show [[malignancy]]
* "Star-burst giant cells" in [[epidermis]]
*Serum [[LDH]] may be elevated in case of [[malignancy]]
* "Swallow's nest" sign along the [[Epidermal junctions|dermal-epidermal junction]]
*[[Biopsy]]
* Minimal [[cytoplasm]]
|
* Pale nucleus with small nucleoli
*Can [[metastasize]]
| style="background: #F5F5F5; padding: 5px;" |
*All [[UV radiation]] or sun exposed areas can be effected independently
* Usually in older individuals
*1-2 to hundreds of [[granules]]
|
*[[Neural crest cell]] derivative
*Development begins with disruption of [[nevus]] growth control
*Progression involves [[MAPK/ERK pathway]]
*[[RAS|N-RAS]] or [[BRAF]] [[oncogene]] also involved
|[[File:Palate malign melanoma 01.jpg|thumb|400x400px|Oral melanoma - By Emmanouil K Symvoulakis, Dionysios E Kyrmizakis, Emmanouil I Drivas, Anastassios V Koutsopoulos, Stylianos G Malandrakis, Charalambos E Skoulakis and John G Bizakis - Symvoulakis et al. Head & Face Medicine 2006 2:7 doi:10.1186/1746-160X-2-7 (Open Access), [1], CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=9839811]]
|-
|-
|[[Fordyce spots]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Superficial spreading melanoma]]'''<ref name="pmid19782937">{{cite journal| author=Argenziano G, Ferrara G, Francione S, Di Nola K, Martino A, Zalaudek I| title=Dermoscopy--the ultimate tool for melanoma diagnosis. | journal=Semin Cutan Med Surg | year= 2009 | volume= 28 | issue= 3 | pages= 142-8 | pmid=19782937 | doi=10.1016/j.sder.2009.06.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19782937  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Rice-like [[granules]] or [[spots]]
* [[Macule]]
*Small, [[painless]], [[raised]], [[pale]], red or white
*[[Plaque]] with irregular [[Borderline|borders]]
*1 to 3 mm in [[diameter]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Variably [[Pigmented lesions|pigmented]] (red, blue, black, gray, and white)
*Greasy skin types
| style="background: #F5F5F5; padding: 5px;" |
*Some [[Rheumatic|rheumatic disorders]]
* Thin
*[[Hereditary nonpolyposis colorectal cancer]]
| style="background: #F5F5F5; padding: 5px;" |
**Lower [[gingiva]] (gums)
* 1 mm to > 1 cm
**[[Vestibular system|Vestibular mucosa]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Anywhere but usually:
*[[Physical exam]]
**[[Back]] ([[men]] and [[women]])
*Small [[keratin]]-filled [[pseudocysts]]
** Lower [[extremities]] ([[women]])
*May be seen on [[incidental]] [[mucosal]] [[biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
**[[Biopsy]] not done for them primarily
* Asymmetry of shape
|
* > 2 colors
*[[Oral cavity]]
* Asymmetry of structures
**[[Vermillion border|Vermilion border]] of the lips
| style="background: #F5F5F5; padding: 5px;" |
**[[Oral mucosa]] of the upper lip
* Asymmetric
*[[Buccal mucosa]] in the commissural region often bilaterally
* Poorly circumscribed
*[[Genitals]]
* Lack [[cellular]] [[maturation]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Benign neoplasms]] with [[sebaceous]] features
*[[Lateral]] (radial) [[growth]] before [[Vertical direction|vertical]] ([[invasive]]) [[growth]]
*Visible [[sebaceous glands]]
*No surrounding [[mucosal]] change
*Several adjacent [[glands]] may coalesce into a larger cauliflower-like cluster
|[[File:Fospot.jpg|thumb|400x400px|Fordyce spots - Por Perene - Obra do próprio, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19772899]]
|-
|-
|[[Burning mouth syndrome]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Nodular melanoma]]'''<ref name="pmid12734496">{{cite journal| author=Argenziano G, Soyer HP, Chimenti S, Talamini R, Corona R, Sera F et al.| title=Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet. | journal=J Am Acad Dermatol | year= 2003 | volume= 48 | issue= 5 | pages= 679-93 | pmid=12734496 | doi=10.1067/mjd.2003.281 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12734496  }}</ref><ref name="MenziesMoloney2013">{{cite journal|last1=Menzies|first1=Scott W.|last2=Moloney|first2=Fergal J.|last3=Byth|first3=Karen|last4=Avramidis|first4=Michelle|last5=Argenziano|first5=Giuseppe|last6=Zalaudek|first6=Iris|last7=Braun|first7=Ralph P.|last8=Malvehy|first8=Josep|last9=Puig|first9=Susana|last10=Rabinovitz|first10=Harold S.|last11=Oliviero|first11=Margaret|last12=Cabo|first12=Horacio|last13=Bono|first13=Riccardo|last14=Pizzichetta|first14=Maria A.|last15=Claeson|first15=Magdalena|last16=Gaffney|first16=Daniel C.|last17=Soyer|first17=H. Peter|last18=Stanganelli|first18=Ignazio|last19=Scolyer|first19=Richard A.|last20=Guitera|first20=Pascale|last21=Kelly|first21=John|last22=McCurdy|first22=Olivia|last23=Llambrich|first23=Alex|last24=Marghoob|first24=Ashfaq A.|last25=Zaballos|first25=Pedro|last26=Kirchesch|first26=Herbert M.|last27=Piccolo|first27=Domenico|last28=Bowling|first28=Jonathan|last29=Thomas|first29=Luc|last30=Terstappen|first30=Karin|last31=Tanaka|first31=Masaru|last32=Pellacani|first32=Giovanni|last33=Pagnanelli|first33=Gianluca|last34=Ghigliotti|first34=Giovanni|last35=Ortega|first35=Blanca Carlos|last36=Crafter|first36=Greg|last37=Ortiz|first37=Ana María Perusquía|last38=Tromme|first38=Isabelle|last39=Karaarslan|first39=Isil Kilinc|last40=Ozdemir|first40=Fezal|last41=Tam|first41=Anthony|last42=Landi|first42=Christian|last43=Norton|first43=Peter|last44=Kaçar|first44=Nida|last45=Rudnicka|first45=Lidia|last46=Slowinska|first46=Monika|last47=Simionescu|first47=Olga|last48=Di Stefani|first48=Alessandro|last49=Coates|first49=Elliot|last50=Kreusch|first50=Juergen|title=Dermoscopic Evaluation of Nodular Melanoma|journal=JAMA Dermatology|volume=149|issue=6|year=2013|pages=699|issn=2168-6068|doi=10.1001/jamadermatol.2013.2466}}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Burning or [[tingling]] on the [[lips]], [[tongue]], or entire [[mouth]]
*[[Polyploidy|Polypoid]] [[nodule]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Nutritional deficiencies]]
* Dark color
*Chronic [[anxiety]] or [[depression]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Diabetes type 2]]
*[[Lump]]
*[[Menopause]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Oral thrush]] or [[dry mouth]], or damaged [[nerves]] transmitting taste
* 6mm to > 1 cm
*[[Female gender ]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Menopause]]
*[[Trunk]]
|
*[[Head]]
*[[Presentation]]
*[[Neck]]
*[[Physical exam]]
| style="background: #F5F5F5; padding: 5px;" |
|
*[[Pigment]] network or pseudonetwork
*[[Oral cavity]]
* Aggregated brown or black globules
|
* Blue [[pigmentation]] within [[lesion]]
*Pain typically is low in the morning and builds up over the day
* Small dotted or comma [[vessels]]
*Low dosages of [[benzodiazepines]], [[tricyclic antidepressants]] or [[anticonvulsants]] may be effective
| style="background: #F5F5F5; padding: 5px;" |
|
*[[Cells (biology)|Cells]] [[proliferate]] downwards through the [[skin]]
 
*[[Dermal]] [[growth]] in isolation or in association with an [[epidermal]] component
| style="background: #F5F5F5; padding: 5px;" |
* Two-thirds arise in normal [[skin]], the rest in existing [[moles]]
* Rapidly enlarging
|-
|-
|[[Torus palatinus]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Acral lentiginous melanoma]]'''<ref name="pmid19922528">{{cite journal| author=Phan A, Dalle S, Touzet S, Ronger-Savlé S, Balme B, Thomas L| title=Dermoscopic features of acral lentiginous melanoma in a large series of 110 cases in a white population. | journal=Br J Dermatol | year= 2010 | volume= 162 | issue= 4 | pages= 765-71 | pmid=19922528 | doi=10.1111/j.1365-2133.2009.09594.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19922528  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Bony growth on midline of the [[hard palate]]
* [[Macule]]
*[[Nodular]] mass covered with normal [[mucosa]]
*[[Patched|Patch]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Genetic predisposition]]
* Dark brown to black
**[[Autosomal dominant]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Raised [[Area|areas]]
*[[Physical exam]]
* [[Ulceration]]
*Types
* [[Bleeding]]
**[[Torus palatinus|Flat tori]]
| style="background: #F5F5F5; padding: 5px;" |
**[[Torus palatinus|Spindle tori]]
* Variable
**[[Torus palatinus|Nodular tori]]  
| style="background: #F5F5F5; padding: 5px;" |
**[[Torus palatinus|Lobular tori]]  
*[[Palmar]]
|
*[[Plantar]]
*[[Hard palate]]
* Subungual
|
*[[Mucosal]] surfaces
*More common in [[Asian]] and Inuit populations
| style="background: #F5F5F5; padding: 5px;" |
*Twice more common in [[females]]
* Parallel-ridge [[pattern]]
*Repeated [[trauma]] can cause [[bleeding]]
* Irregular [[diffuse]] [[pigmentation]]
*[[Surgery]] may be required in symptomatic
| style="background: #F5F5F5; padding: 5px;" |
|[[File:06-06-06palataltoria.jpg|thumb|Torus palatinus|400x400px|Torus palatinus - By Photo taken by dozenist, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=846591]]
* Asymmetric [[proliferation]] of single [[melanocytes]] at dermoepidermal junction
| style="background: #F5F5F5; padding: 5px;" |
* Most common among dark [[Skin|skinned]] individuals
|-
|-
| colspan="4" |'''Diseases involving oral cavity and other organ systems'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Amelanotic melanoma]]'''<ref name="pmid23197217">{{cite journal| author=Steglich RB, Meotti CD, Ferreira MS, Lovatto L, de Carvalho AV, de Castro CG| title=Dermoscopic clues in the diagnosis of amelanotic and hypomelanotic malignant melanoma. | journal=An Bras Dermatol | year= 2012 | volume= 87 | issue= 6 | pages= 920-3 | pmid=23197217 | doi= | pmc=3699915 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23197217  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
|
*[[Patched|Patch]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]] color
| style="background: #F5F5F5; padding: 5px;" |
* Slightly elevated [[Borderline|borders]]
| style="background: #F5F5F5; padding: 5px;" |
* Around 6 mm
| style="background: #F5F5F5; padding: 5px;" |
* Sun-exposed [[Area|areas]]
| style="background: #F5F5F5; padding: 5px;" |
* No [[melanin]] [[pigmentation]]
 
* Dotted [[vessels]]
* Linear irregular [[vessels]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Lesion|Lesions]] not [[Pigmented lesions|pigmented]] since they don't produce [[melanin]]
*
|-
|-
|[[Behçet's disease|Behcet's disease]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Nevus|Common nevus]]<ref name="pmid20137743">{{cite journal| author=Witt C, Krengel S| title=Clinical and epidemiological aspects of subtypes of melanocytic nevi (Flat nevi, Miescher nevi, Unna nevi). | journal=Dermatol Online J | year= 2010 | volume= 16 | issue= 1 | pages= 1 | pmid=20137743 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20137743  }}</ref><ref name="pmid12753404">{{cite journal| author=Bauer J, Garbe C| title=Acquired melanocytic nevi as risk factor for melanoma development. A comprehensive review of epidemiological data. | journal=Pigment Cell Res | year= 2003 | volume= 16 | issue= 3 | pages= 297-306 | pmid=12753404 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12753404  }}</ref>'''
|
| style="background: #F5F5F5; padding: 5px;" |
*Painful [[mouth sores]]
* Dome-shaped  [[nodules]]
*[[Acne]] like skin lesions
| style="background: #F5F5F5; padding: 5px;" |
*Headache, [[fever]], poor [[balance]], [[disorientation]]
* [[Hypopigmentation|Hypopigmented]]
*[[Abdominal pain]], [[diarrhea]] or [[bleeding]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Uveitis]]
* Smooth [[Surface area|surface]]
*Joint [[swelling]] and joint [[pain]]
* Terminal [[hairs]] often present
*Genital [[sores]] wit [[pain]] and [[scaring]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Aneurysms]]
* 1 cm to > 20 cm
|
| style="background: #F5F5F5; padding: 5px;" |
*Over active [[immune system]]
* Sun-exposed [[Area|areas]] above the [[waist]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Physical examination]]
* Comma-shaped or curved [[vessels]]
|
* Structureless light brown [[background]]
*[[Mouth]]
* Residual brown thick circles around the [[hair follicles]]
*[[Genitals]]
| style="background: #F5F5F5; padding: 5px;" |
*[[GIT]]
*[[Multinucleated]] [[melanocytes]]
*[[Eye]]
* [[Melanocyte|Melanocytes]] diffusely [[Infiltration (medical)|infiltrate]] [[dermis]]
*[[Joints]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]
* Also called Miescher [[nevus]]
*[[Vascular system]]
*[[Brain]]
|
*[[Outbreaks]] of exaggerated [[inflammation]]
*Affects smaller [[blood vessels]]
|[[File:Behcets disease.jpg|thumb|400x400px|Behcet's disease - By Ahmet Altiner MD, Rajni Mandal MD - http://dermatology.cdlib.org/1611/articles/18_2009-10-20/2.jpg, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17863021]]
|-
|-
|[[Crohn's disease]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Blue nevus]]'''<ref name="pmid11224601">{{cite journal| author=Granter SR, McKee PH, Calonje E, Mihm  MC, Busam K| title=Melanoma associated with blue nevus and melanoma mimicking cellular blue nevus: a clinicopathologic study of 10 cases on the spectrum of so-called 'malignant blue nevus'. | journal=Am J Surg Pathol | year= 2001 | volume= 25 | issue= 3 | pages= 316-23 | pmid=11224601 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11224601  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*Chronic, episodic [[diarrhea]] or [[constipation]]
* [[Macules|Macule]]
*[[Abdominal pain]]
* [[Papule]]
*[[Vomiting]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Weight loss]] or [[weight gain]]
* Blue
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Smoking]]
* Smooth
*[[Whites]] and [[European]] [[Jews]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Hormonal contraception]]
* Variable
*Diets high in microparticles, sweet, fatty or refined foods
| style="background: #F5F5F5; padding: 5px;" |
*Industrialized country
*[[Head]] and [[neck]],
|
*[[Dorsal]] aspect of the [[distal]] [[extremities]]
*Typical [[history]] and [[symptoms]]
*[[Sacral]] [[area]]
*[[Skip lesions]] on [[biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Anti saccharomyces cerevisiae antibodies|Anti-Saccharomyces cerevisiae antibodies (ASCA)]]
* Structureless blue [[pigmentation]]
*[[Anti-neutrophil cytoplasmic antibodies]] ([[ANCA]])
* Structureless blue and white or blue and brown on some occasions
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Eyes]]
*[[Proliferation]] of [[Dendritic cell|dendritic]], [[dermal]], [[melanin]]-producing [[melanocytes]]
*[[Joints]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]
* Also called [[Mongolian spot|Mongolian spots]]
|
*May lead to
**[[Obstruction]]s
**[[Abscess]]es
**Free [[perforation]]
**[[Hemorrhage]]
|
|-
|-
|[[Agranulocytosis]]
| rowspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''Spitz nevus'''<ref name="pmid22082838">{{cite journal| author=Luo S, Sepehr A, Tsao H| title=Spitz nevi and other Spitzoid lesions part I. Background and diagnoses. | journal=J Am Acad Dermatol | year= 2011 | volume= 65 | issue= 6 | pages= 1073-84 | pmid=22082838 | doi=10.1016/j.jaad.2011.04.040 | pmc=3217183 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22082838  }}</ref><ref name="pmid21494025">{{cite journal| author=Argenziano G, Agozzino M, Bonifazi E, Broganelli P, Brunetti B, Ferrara G et al.| title=Natural evolution of Spitz nevi. | journal=Dermatology | year= 2011 | volume= 222 | issue= 3 | pages= 256-60 | pmid=21494025 | doi=10.1159/000326109 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21494025  }}</ref>
|
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Nonpigmented Spitz nevus'''
*[[Fever]] or [[chills]]
| style="background: #F5F5F5; padding: 5px;" |
*Frequent [[infections]]
* [[Nodule]]
*Unusual [[redness]], [[pain]], or [[swelling]] around a wound
| style="background: #F5F5F5; padding: 5px;" |
*Mouth [[ulcers]]
* Pink
*[[Abdominal pain]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Burning sensation when urinating]]
* Smooth
*[[Sore throat]]
| style="background: #F5F5F5; padding: 5px;" |
|
* < 1 cm
*[[Medications]]<ref name="PMID17142169">{{cite journal |author=Andrès E, Zimmer J, Affenberger S, Federici L, Alt M, Maloisel F. |title=Idiosyncratic drug-induced agranulocytosis: Update of an old disorder. |journal=Eur J Intern Med. |volume=17|issue=8 |pages=529-35 |year=2006|pmid 17142169|doi=|url=https://www.ncbi.nlm.nih.gov/pubmed/17142169}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[List of chemotherapeutic agents#Cytotoxic Chemotherapy|Cytotoxic chemotherapy]]
*[[Cheek]]
*[[Hematological malignancy|Hematologic malignancies]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Autoimmune disorders]]
* Coiled [[vessels]]
|
* White network over a pink to reddish [[background]]
*[[Neutropenia]] <100 cells per micro litre
| style="background: #F5F5F5; padding: 5px;" |
*[[Eosinopenia]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Basopenia]]
* In [[children]] and [[Adolescent|adolescents]]
|
*[[Oral cavity]]
*[[Skin]]
*[[GIT]]
*[[Urinary system]]
*[[Conjunctiva]]
|
*[[Immunocompromised|Immunocompromization]]
*Types
**[[Drug-induced]]
**[[Malignant]]
**[[Autoimmune]]
|
|-
|-
|[[Syphilis]]<ref> title="By Internet Archive Book Images [No restrictions], via Wikimedia Commons" href="https://commons.wikimedia.org/wiki/File:A_manual_of_syphilis_and_the_venereal_diseases%2C_(1900)_(14595882378).jpg"</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Reed-like Spitz'''<ref name="pmid27222770">{{cite journal| author=Pedrosa AF, Lopes JM, Azevedo F, Mota A| title=Spitz/Reed nevi: a review of clinical-dermatoscopic and histological correlation. | journal=Dermatol Pract Concept | year= 2016 | volume= 6 | issue= 2 | pages= 37-41 | pmid=27222770 | doi=10.5826/dpc.0602a07 | pmc=4866625 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27222770  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Chancre]]
*[[Papule]]
*Regional [[lymphadenopathy]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Heavily [[Pigmented lesions|pigmented]]
*[[Multiple sexual partners]]
| style="background: #F5F5F5; padding: 5px;" |
*Illicit [[drug use]]
* Smooth
*[[Unprotected sex]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Homosexual men|Men who have sex with men]]
* < 1 cm
*Residence in highly prevalent areas
| style="background: #F5F5F5; padding: 5px;" |
*[[Human Immunodeficiency Virus (HIV)|HIV]] infection
*[[Head]] and [[neck]]
*Presence of other [[STI]]s
* Upper and lower [[extremities]]
*Previous history of [[Sexually transmitted disease|STIs]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Intravenous drug use]]
* Structureless black to gray center
|
* [[Hypopigmented area|Hypopigmented]] follicular openings
*[[Darkfield microscope|Darkfield microscopy]]
* Peripheral streaks
*Non [[Treponema|treponemal]] tests like [[VDRL]] and [[RPR test]])
* [[Pseudopods]]
*[[Treponema|Treponemal]] tests[[FTA-ABS|FTA-ABS tests]], (TP-PA) assay, [[Enzyme linked immunosorbent assay (ELISA)|enzyme immunoassays]], and [[Chemiluminescence|chemiluminescence immunoassays]])
* Globules
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Oral cavity]]
* Enlarged [[spindle]] [[melanocytes]] with polyangular form
*[[Penis]]
* "Ground glass" [[cytoplasm]]
*[[Cervix]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Labia]]
* Most commonly develops in [[children]], [[Adolescent|adolescents]], and young [[Adult|adults]].
*[[Anal canal]]
*[[Rectum ]]
*[[CNS]]
*[[Cardiovascular|CVS]]
|
*[[Primary syphilis]]
**[[Chancre]]
*[[Secondary syphilis]]
**[[Condyloma latum|Condylomata lata]]
*[[Latent syphilis]]
**[[Asymptomatic]]
*[[Tertiary syphilis]]
**[[Gumma|Gummas]]
**[[Neurosyphilis]]
|[[File:Hutchinson teeth congenital syphilis PHIL 2385.rsh.jpg|thumb|400x400px|oral syphilis - By CDC/Susan Lindsley - http://phil.cdc.gov/phil_images/20021114/34/PHIL_2385_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2134349]]
|-
|-
|[[Coxsackie virus]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Solar lentigo]]'''<ref name="pmid21175756">{{cite journal| author=Tanaka M, Sawada M, Kobayashi K| title=Key points in dermoscopic differentiation between lentigo maligna and solar lentigo. | journal=J Dermatol | year= 2011 | volume= 38 | issue= 1 | pages= 53-8 | pmid=21175756 | doi=10.1111/j.1346-8138.2010.01132.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21175756  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Fever]]
* Multiple spots
*[[Sores]] in the [[mouth]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Rash]] with [[blisters]]
* Brown
*[[Aches]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Smooth
*[[Pregnancy]]
| style="background: #F5F5F5; padding: 5px;" |
*[[immunodeficiency]]
* Around 5mm
|
| style="background: #F5F5F5; padding: 5px;" |
*[[History]] and [[Physical exam]]
* Sun-exposed [[Area|areas]]
*[[Swabbing|Throat swabs]]
| style="background: #F5F5F5; padding: 5px;" |
*Swabs from the lesion
* Faint [[Pigment|pigmented]] [[fingerprint]] structures
*[[Tzanck test]]
* Structureless [[pattern]]
|
* Light brown pseudonetwork with well-defined [[Borderline|borders]] and a "moth-eaten" edge
*[[Oral cavity]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]
* '''↑''' [[melanin]] deposition in [[Keratinocyte|keratinocytes]]  
|
* '''↑''' linear arrangement of [[melanocytes]] at the [[Epidermal junctions|dermal-epidermal junction]]
*Symptomatic treatment
| style="background: #F5F5F5; padding: 5px;" |
|[[File:Hand foot mouth disease 07a.jpg|thumb|400x400px|Hand-foot-and-mouth disease - adapted from atlasdermatologico.com<ref name="urlDermatology
* Associated with UV exposure and skin aging
Atlas">{{cite web |url=http://www.atlasdermatologico.com.br/ |title=Dermatology Atlas |format= |work= |accessdate=}}</ref>]]
|-
|-
|[[Chickenpox|Chicken pox]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''[[Sebaceous hyperplasia]]'''<ref name="pmid24520522">{{cite journal| author=Sato T, Tanaka M| title=Linear sebaceous hyperplasia on the chest. | journal=Dermatol Pract Concept | year= 2014 | volume= 4 | issue= 1 | pages= 93-5 | pmid=24520522 | doi=10.5826/dpc.0401a16 | pmc=3919849 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24520522  }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Conjunctival]] symptoms
* [[Papule]]
*[[Catarrhal]] symptoms
| style="background: #F5F5F5; padding: 5px;" |
*Characteristic [[spots]] on the trunk appearing in two or three waves
*[[Skin]]-colored to brownish
*[[Itching]]
| style="background: #F5F5F5; padding: 5px;" |
|
*[[Umbilicated lesions|Umbilicated]]
*[[Pregnancy]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Premature infants]] born to susceptible mothers
* 2 - 6 mm
*All [[infants]] born at less than 28 weeks [[gestation]] or who weigh =1000 grams
| style="background: #F5F5F5; padding: 5px;" |
*[[Immunocompromised]]
* [[Forehead]]
|
* [[Nose]]
*[[History]] and [[physical exam]]
* [[Cheeks]]  
*[[PCR]] to detect [[VZV]] in [[skin lesions]] ([[vesicles]], [[scabs]], [[Maculopapular|maculopapular lesions]])
| style="background: #F5F5F5; padding: 5px;" |
|
* Structureless yellow to whitish center surrounded by short linear "crown [[vessels]]"
*[[Oral cavity]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Skin]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Usually in middle-aged or older [[patients]]
*[[Sodium bicarbonate]] in baths or [[antihistamines]] for [[itching]]
*[[Paracetamol]] ([[acetaminophen]]) for [[fever]]
*[[Prednisolone]] is [[contraindicated]]
|[[File:Herpangina2016.jpg|thumb|400x400px|Chickenpox - By James Heilman, MD - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=52872565]]
|-
|-
|[[Measles]]
| colspan="2" style="background: #C0C0C0; padding: 5px; text-align: center;" |'''Lichen planus-like keratosis'''<ref name="pmid16148406">{{cite journal| author=Morgan MB, Stevens GL, Switlyk S| title=Benign lichenoid keratosis: a clinical and pathologic reappraisal of 1040 cases. | journal=Am J Dermatopathol | year= 2005 | volume= 27 | issue= 5 | pages= 387-92 | pmid=16148406 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16148406 }}</ref>
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Fever]]
* [[Papule]]
*[[Rash]]
* [[Plaques|Plaque]]
*[[Cough]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Coryza]] (runny nose)
* Gray to brown
*[[Conjunctivitis]] (pink eye)
| style="background: #F5F5F5; padding: 5px;" |
*[[Malaise]]
* Prominent
*[[Koplick spots]] in mouth
| style="background: #F5F5F5; padding: 5px;" |
|
* Variable
*Unvaccinated individuals<ref name="pmid11135778">{{cite journal| author=Feikin DR, Lezotte DC, Hamman RF, Salmon DA, Chen RT, Hoffman RE| title=Individual and community risks of measles and pertussis associated with personal exemptions to immunization. | journal=JAMA | year= 2000 | volume= 284 | issue= 24 | pages= 3145-50 | pmid=11135778 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11135778  }} </ref><ref name="pmid9009400">{{cite journal| author=Ratnam S, West R, Gadag V, Williams B, Oates E| title=Immunity against measles in school-aged children: implications for measles revaccination strategies. | journal=Can J Public Health | year= 1996 | volume= 87 | issue= 6 | pages= 407-10 | pmid=9009400 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9009400 }} </ref>
| style="background: #F5F5F5; padding: 5px;" |
*Crowded and/or unsanitary conditions
* [[Upper trunk]]
*Traveling to less developed and developing countries
| style="background: #F5F5F5; padding: 5px;" |
*Immunocompromized
* Shows a coarse or fine, gray to blue, granular [[pigmentation]]
*Winter and [[spring]] seasons
*[[Diffuse]] brownish gray [[granules]]
*Born after 1956 and never fully vaccinated
| style="background: #F5F5F5; padding: 5px;" |
*Health care workers
* [[Hypergranulosis]]
|
* [[Epidermal]] [[hyperplasia]]
*[[History]] and [[examination]]
*[[Superficial]] bandlike  [[Infiltration (medical)|infiltrate]]
*[[PCR]] for [[Measles]]-specific [[IgM|IgM antibody]]
* Melanophages
*[[PCR]] for [[Measles]] [[RNA]]
| style="background: #F5F5F5; padding: 5px;" |
|
* Appearance depends on stage of evolution
*[[Oral cavity]]
|}
*[[Skin]]
*[[Respiratory tract]]
*[[Eyes]]
*[[Throat]]
|
*Caused by [[Morbillivirus]]
*Primary site of infection is the [[respiratory epithelium]] of the [[nasopharynx]]
*Transmitted in [[respiratory secretions]], via [[aerosol droplets]] containing [[Virus|virus particles]]
|[[File:Koplik spots, measles 6111 lores.jpg|thumb|400x400px|Koplick spots (Measles) - By CDC - http://phil.cdc.gov/PHIL_Images/20040908/4f54ee8f0e5f49f58aaa30c1bc6413ba/6111_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=824483]]
|}</small></small>
</div>
 


==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 16:52, 27 August 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Roukoz A. Karam, M.D.[2] Homa Najafi, M.D.[3]

Overview

Squamous cell carcinoma should be differentiated from melanoma and basal cell carcinoma. It accounts for 20% of all non-melanomatous tumors and is fairly invasive contrary to its counterpart, basal cell carcinoma. Squamous cell carcinoma typically presents as a non-healing ulcer or growth on a sun-exposed area of the skin.

Differentiating Squamous cell carcinoma from other Diseases

A few conditions that mimic Squamous cell carcinoma of the skin include the following:

Diseases Skin examination Diagnosis Additional findings
Type Color Texture Size Distribution Dermoscopic Findings Histopathology
Cutaneous squamous cell carcinoma[1] SCC in situ (Bowen's disease)
  • Scaly
  • Variable
  • Fair-skinned individuals: sun-exposed areas
Invasive squamous cell carcinoma
  • Skin colored
  • 0.5 to 1.5 cm
  • Fair-skinned individuals: sun-exposed areas
  • In black individuals: legs, anus, and areas of chronic inflammation
Keratoacanthoma[2]
  • 1 to 2.5 cm
Dermatofibroma[3][4]
  • Firm
  • 0.3- 1 cm
dermatofibrosarcoma protuberans[5][6]
  • Firm
  • 1-5 cm
Kaposi sarcoma[7][8]
  • Red/violaceous
  • Smooth
  • Rainbow pattern
  • scaly surface
  • Small brown globules
Merkel cell carcinoma[9]
  • Shiny
  • Flesh-colored or bluish-red
  • Firm
  • < 1 cm
  • Sun-exposed areas
  • Older individuals with light skin tones
  • Rapidly growing
Basal cell carcinoma[10] Nodular basal cell carcinoma
  • Flesh-colored
  • Variable
  • Focused, bright red, and branching arborizing vessels
  • Loosely arranged blue-gray dots
Superficial basal cell carcinoma
  • Scaly
  • 1 to > 10 cm
  • Sun-exposed areas
  • Head (cheek and nose)
  • Trunk
  • Large, hyperchromatic, oval nuclei
  • Minimal cytoplasm
  • Small basaloid nodules
Sclerosing basal cell carcinoma (morpheaform)[11]
  • Variable
  • Sun-exposed areas
Prurigo nodules[12][13]
  • Firm
  • Variable
Melanoma[14] Melanoma in situ (Lentigo Maligna)[15]
  • Variable (from light to dark brown, black, pink, red, or white)
  • Smooth
  • Around 1 cm
  • Asymmetric, pigmented follicular openings
  • Gray angulated lines
  • Gray areas, dots, and globules
  • Circle within a circle
Lentigo maligna melanoma[16]
  • Brown/tan
  • Variable
  • Asymmetric, pigmented follicular openings
  • Gray angulated lines
  • Gray areas, dots, and globules
  • Circle within a circle
  • Usually in older individuals
Superficial spreading melanoma[17]
  • Variably pigmented (red, blue, black, gray, and white)
  • Thin
  • 1 mm to > 1 cm
  • Asymmetry of shape
  • > 2 colors
  • Asymmetry of structures
Nodular melanoma[18][19]
  • Dark color
  • 6mm to > 1 cm
  • Two-thirds arise in normal skin, the rest in existing moles
  • Rapidly enlarging
Acral lentiginous melanoma[20]
  • Dark brown to black
  • Variable
  • Most common among dark skinned individuals
Amelanotic melanoma[21]
  • Around 6 mm
Common nevus[22][23]
  • 1 cm to > 20 cm
  • Also called Miescher nevus
Blue nevus[24]
  • Blue
  • Smooth
  • Variable
  • Structureless blue pigmentation
  • Structureless blue and white or blue and brown on some occasions
Spitz nevus[25][26] Nonpigmented Spitz nevus
  • Pink
  • Smooth
  • < 1 cm
Reed-like Spitz[27]
  • Smooth
  • < 1 cm
Solar lentigo[28]
  • Multiple spots
  • Brown
  • Smooth
  • Around 5mm
  • Associated with UV exposure and skin aging
Sebaceous hyperplasia[29]
  • Skin-colored to brownish
  • 2 - 6 mm
  • Structureless yellow to whitish center surrounded by short linear "crown vessels"
  • Usually in middle-aged or older patients
Lichen planus-like keratosis[30]
  • Gray to brown
  • Prominent
  • Variable
  • Appearance depends on stage of evolution

References

  1. ↑ Petter G, Haustein UF (2000). "Histologic subtyping and malignancy assessment of cutaneous squamous cell carcinoma". Dermatol Surg. 26 (6): 521–30. PMID 10848931.
  2. ↑ Kwiek B, Schwartz RA (2016). "Keratoacanthoma (KA): An update and review". J Am Acad Dermatol. 74 (6): 1220–33. doi:10.1016/j.jaad.2015.11.033. PMID 26853179.
  3. ↑ Lee, MiWoo; Lee, WooJin; Jung, JoonMin; Won, ChongHyun; Chang, SungEun; Choi, JeeHo; Moon, KeeChan (2015). "Clinical and histological patterns of dermatofibroma without gross skin surface change: A comparative study with conventional dermatofibroma". Indian Journal of Dermatology, Venereology, and Leprology. 81 (3): 263. doi:10.4103/0378-6323.154795. ISSN 0378-6323.
  4. ↑ Mentzel, Thomas; Wiesner, Thomas; Cerroni, Lorenzo; Hantschke, Markus; Kutzner, Heinz; Rütten, Arno; Häberle, Michael; Bisceglia, Michele; Chibon, Frederic; Coindre, Jean-Michel (2012). "Malignant dermatofibroma: clinicopathological, immunohistochemical, and molecular analysis of seven cases". Modern Pathology. 26 (2): 256–267. doi:10.1038/modpathol.2012.157. ISSN 0893-3952.
  5. ↑ Bernard, J.; Poulalhon, N.; Argenziano, G.; Debarbieux, S.; Dalle, S.; Thomas, L. (2013). "Dermoscopy of dermatofibrosarcoma protuberans: a study of 15 cases". British Journal of Dermatology. 169 (1): 85–90. doi:10.1111/bjd.12318. ISSN 0007-0963.
  6. ↑ Acosta, Alvaro E.; Vélez, Catalina Santa (2017). "Dermatofibrosarcoma Protuberans". Current Treatment Options in Oncology. 18 (9). doi:10.1007/s11864-017-0498-5. ISSN 1527-2729.
  7. ↑ Cesarman, Ethel; Damania, Blossom; Krown, Susan E.; Martin, Jeffrey; Bower, Mark; Whitby, Denise (2019). "Kaposi sarcoma". Nature Reviews Disease Primers. 5 (1). doi:10.1038/s41572-019-0060-9. ISSN 2056-676X.
  8. ↑ Hu, S C-S; Ke, C-L K; Lee, C-H; Wu, C-S; Chen, G-S; Cheng, S-T (2009). "Dermoscopy of Kaposi's sarcoma: Areas exhibiting the multicoloured 'rainbow pattern'". Journal of the European Academy of Dermatology and Venereology. 23 (10): 1128–1132. doi:10.1111/j.1468-3083.2009.03239.x. ISSN 0926-9959.
  9. ↑ Albores-Saavedra J, Batich K, Chable-Montero F, Sagy N, Schwartz AM, Henson DE (2010). "Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study". J Cutan Pathol. 37 (1): 20–7. doi:10.1111/j.1600-0560.2009.01370.x. PMID 19638070.
  10. ↑ Wolberink EA, Pasch MC, Zeiler M, van Erp PE, Gerritsen MJ (2013). "High discordance between punch biopsy and excision in establishing basal cell carcinoma subtype: analysis of 500 cases". J Eur Acad Dermatol Venereol. 27 (8): 985–9. doi:10.1111/j.1468-3083.2012.04628.x. PMID 22759209.
  11. ↑ Wrone DA, Swetter SM, Egbert BM, Smoller BR, Khavari PA (1996). "Increased proportion of aggressive-growth basal cell carcinoma in the Veterans Affairs population of Palo Alto, California". J Am Acad Dermatol. 35 (6): 907–10. PMID 8959949.
  12. ↑ Errichetti E, Piccirillo A, Stinco G (2015). "Dermoscopy of prurigo nodularis". J Dermatol. 42 (6): 632–4. doi:10.1111/1346-8138.12844. PMID 25808786.
  13. ↑ Weigelt N, Metze D, Ständer S (2010). "Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patients". J Cutan Pathol. 37 (5): 578–86. doi:10.1111/j.1600-0560.2009.01484.x. PMID 20002240.
  14. ↑ Witt C, Krengel S (2010). "Clinical and epidemiological aspects of subtypes of melanocytic nevi (Flat nevi, Miescher nevi, Unna nevi)". Dermatol Online J. 16 (1): 1. PMID 20137743.
  15. ↑ Connolly KL, Giordano C, Dusza S, Busam KJ, Nehal K (2019). "Follicular involvement is frequent in lentigo maligna: Implications for treatment". J Am Acad Dermatol. 80 (2): 532–537. doi:10.1016/j.jaad.2018.07.071. PMC 6333487. PMID 30266559.
  16. ↑ Connolly KL, Giordano C, Dusza S, Busam KJ, Nehal K (2019). "Follicular involvement is frequent in lentigo maligna: Implications for treatment". J Am Acad Dermatol. 80 (2): 532–537. doi:10.1016/j.jaad.2018.07.071. PMC 6333487. PMID 30266559.
  17. ↑ Argenziano G, Ferrara G, Francione S, Di Nola K, Martino A, Zalaudek I (2009). "Dermoscopy--the ultimate tool for melanoma diagnosis". Semin Cutan Med Surg. 28 (3): 142–8. doi:10.1016/j.sder.2009.06.001. PMID 19782937.
  18. ↑ Argenziano G, Soyer HP, Chimenti S, Talamini R, Corona R, Sera F; et al. (2003). "Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet". J Am Acad Dermatol. 48 (5): 679–93. doi:10.1067/mjd.2003.281. PMID 12734496.
  19. ↑ Menzies, Scott W.; Moloney, Fergal J.; Byth, Karen; Avramidis, Michelle; Argenziano, Giuseppe; Zalaudek, Iris; Braun, Ralph P.; Malvehy, Josep; Puig, Susana; Rabinovitz, Harold S.; Oliviero, Margaret; Cabo, Horacio; Bono, Riccardo; Pizzichetta, Maria A.; Claeson, Magdalena; Gaffney, Daniel C.; Soyer, H. Peter; Stanganelli, Ignazio; Scolyer, Richard A.; Guitera, Pascale; Kelly, John; McCurdy, Olivia; Llambrich, Alex; Marghoob, Ashfaq A.; Zaballos, Pedro; Kirchesch, Herbert M.; Piccolo, Domenico; Bowling, Jonathan; Thomas, Luc; Terstappen, Karin; Tanaka, Masaru; Pellacani, Giovanni; Pagnanelli, Gianluca; Ghigliotti, Giovanni; Ortega, Blanca Carlos; Crafter, Greg; Ortiz, Ana María Perusquía; Tromme, Isabelle; Karaarslan, Isil Kilinc; Ozdemir, Fezal; Tam, Anthony; Landi, Christian; Norton, Peter; Kaçar, Nida; Rudnicka, Lidia; Slowinska, Monika; Simionescu, Olga; Di Stefani, Alessandro; Coates, Elliot; Kreusch, Juergen (2013). "Dermoscopic Evaluation of Nodular Melanoma". JAMA Dermatology. 149 (6): 699. doi:10.1001/jamadermatol.2013.2466. ISSN 2168-6068.
  20. ↑ Phan A, Dalle S, Touzet S, Ronger-Savlé S, Balme B, Thomas L (2010). "Dermoscopic features of acral lentiginous melanoma in a large series of 110 cases in a white population". Br J Dermatol. 162 (4): 765–71. doi:10.1111/j.1365-2133.2009.09594.x. PMID 19922528.
  21. ↑ Steglich RB, Meotti CD, Ferreira MS, Lovatto L, de Carvalho AV, de Castro CG (2012). "Dermoscopic clues in the diagnosis of amelanotic and hypomelanotic malignant melanoma". An Bras Dermatol. 87 (6): 920–3. PMC 3699915. PMID 23197217.
  22. ↑ Witt C, Krengel S (2010). "Clinical and epidemiological aspects of subtypes of melanocytic nevi (Flat nevi, Miescher nevi, Unna nevi)". Dermatol Online J. 16 (1): 1. PMID 20137743.
  23. ↑ Bauer J, Garbe C (2003). "Acquired melanocytic nevi as risk factor for melanoma development. A comprehensive review of epidemiological data". Pigment Cell Res. 16 (3): 297–306. PMID 12753404.
  24. ↑ Granter SR, McKee PH, Calonje E, Mihm MC, Busam K (2001). "Melanoma associated with blue nevus and melanoma mimicking cellular blue nevus: a clinicopathologic study of 10 cases on the spectrum of so-called 'malignant blue nevus'". Am J Surg Pathol. 25 (3): 316–23. PMID 11224601.
  25. ↑ Luo S, Sepehr A, Tsao H (2011). "Spitz nevi and other Spitzoid lesions part I. Background and diagnoses". J Am Acad Dermatol. 65 (6): 1073–84. doi:10.1016/j.jaad.2011.04.040. PMC 3217183. PMID 22082838.
  26. ↑ Argenziano G, Agozzino M, Bonifazi E, Broganelli P, Brunetti B, Ferrara G; et al. (2011). "Natural evolution of Spitz nevi". Dermatology. 222 (3): 256–60. doi:10.1159/000326109. PMID 21494025.
  27. ↑ Pedrosa AF, Lopes JM, Azevedo F, Mota A (2016). "Spitz/Reed nevi: a review of clinical-dermatoscopic and histological correlation". Dermatol Pract Concept. 6 (2): 37–41. doi:10.5826/dpc.0602a07. PMC 4866625. PMID 27222770.
  28. ↑ Tanaka M, Sawada M, Kobayashi K (2011). "Key points in dermoscopic differentiation between lentigo maligna and solar lentigo". J Dermatol. 38 (1): 53–8. doi:10.1111/j.1346-8138.2010.01132.x. PMID 21175756.
  29. ↑ Sato T, Tanaka M (2014). "Linear sebaceous hyperplasia on the chest". Dermatol Pract Concept. 4 (1): 93–5. doi:10.5826/dpc.0401a16. PMC 3919849. PMID 24520522.
  30. ↑ Morgan MB, Stevens GL, Switlyk S (2005). "Benign lichenoid keratosis: a clinical and pathologic reappraisal of 1040 cases". Am J Dermatopathol. 27 (5): 387–92. PMID 16148406.
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