Atopic dermatitis differential diagnosis: Difference between revisions

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{{Atopic dermatitis}}
{{Atopic dermatitis}}


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{{CMG}}; {{AE}} [[Ogechukwu Hannah Nnabude, MD]]; {{S.S}}
 
__NOTOC__
{{xyz}}
{{CMG}}; {{AE}}  
 
==Overview==
==Overview==
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
Atopic dermatitis is a chronic [[inflammatory]] [[skin disorder]], which is indistinguishable from other [[causes]] of dermatitis. Atopic dermatitis is usually associated with personal or [[family history]] of [[atopic diseases]] including [[asthma]], [[allergic rhinitis]] and [[food allergy]]. The most common clinically similar dermatitis in infancy is [[seborrheic dermatitis]] which includes [[hyperkeratosis]] of the [[Scalp rash|scalp]], also found in atopic dermatitis.  


==Differentiating [Disease name] from other Diseases==
==Atopic Dermatitis from other Diseases==
** Seborrhoeic dermatitis  
Atopic dermatitis should be differentiated from [[allergic contact dermatitis]], [[iirritant contact dermatitis]], [[seborrheic dermatitis]], [[psoriasis]], [[lichen simplex chronicus]], [[ichthyosis vulgaris]], [[nummular dermatitis (discoid eczema)]], [[netherton's syndrome]], and [[dermatitis herpetiformis]]
*** onset during the 1st days or weeks of life, absence of pruritus, and presence of greasy scaling on a yellow-red base
*** Involvement of the top of the scalp (cradle cap), axilla, and diaper area makes it more likely the patient has '''seborrheic dermatitis''', vs excoriated dermatitis involving the extensor surfaces, face, and trunk favour '''AE.'''
** Sarcoptes scabiei
*** highly pruritic, erythematous papular lesions. In most cases, the typical burrows can be found on the flexor wrists, finger webs and genitalia. Similar symptoms in other family members
{|
{|
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
Line 23: Line 14:
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquired
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquired
! colspan="13" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestations
! colspan="9" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestations
! colspan="9" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
! colspan="1" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
| colspan="2" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Associated factors'''
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
|-
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! colspan="5" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
! colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
! colspan="5" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
|-
|-
! colspan="7" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-
|-
! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Appearance
! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Appearance
! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Itching
! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Itching
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nail pitting
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Eosinophils
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |ESR/CRP
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum IgE
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Electrolytes
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |BUN/Cr
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |LFT
|-
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Single/
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Single/
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Involved areas
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Involved areas
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pustule
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pustule
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
|-
|-
! rowspan="10" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin disorders
! rowspan="10" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin disorders
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Contact dermatitis|Allergic contact dermatitis]]
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Atopic dermatitis]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Epidermal barrier dysfunction
| align="center" style="background:#F5F5F5;" |  
*[[Immune]] dysregulation
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*[[Incidence]] is highest during [[infancy]] and early childhood.
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*[[Erythema]], [[Exudate|exudates]], [[papules]],[[vesicles]], scales and crusts
| align="center" style="background:#F5F5F5;" |  
*Infiltrated [[erythema]], [[prurigo]], scales and crusts
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Young children -[[Scalp]], [[cheeks]] amd [[extensor]] surface
| align="center" style="background:#F5F5F5;" |  
*[[Adolescent|Adolescents]] -flexural areas and buttock-thigh creases
| align="center" style="background:#F5F5F5;" |  
*Adults - facial involvement and skin flexures
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Centrofacial pallor
| align="center" style="background:#F5F5F5;" |
*Delayed blanch response
| align="center" style="background:#F5F5F5;" |  
*[[Keratosis pilaris]]
| align="center" style="background:#F5F5F5;" |
*Palmar hyperlinearity
| align="center" style="background:#F5F5F5;" |
*[[Pityriasis alba]]
| align="center" style="background:#F5F5F5;" |
*[[Ichthyosis]]
| align="center" style="background:#F5F5F5;" |
 
*Infra-auricular and retro-auricular fissuring
*Nipple [[eczema]]
*White dermographism
*Perifollicular accentuation
| align="center" style="background:#F5F5F5;" |Nl to ↑
 
([[Eosinophilia|Eosinophilia)]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Epidermal psoriasiform [[hyperplasia]]
*Marked intercellular [[edema]] with spongiotic vesiculation
 
*[[Hyperkeratosis]]
*Psoriasiform [[hyperplasia]]
*Dyskeratosis
| colspan="2" align="center" style="background:#F5F5F5;" |
*
*[[Family history]] of [[atopic dermatitis]] or other [[atopy]]
*Personal history of [[atopy]] ([[asthma]], [[allergic rhinitis]], [[food allergy]])
*Active and passive exposure to [[tobacco]]
|-
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Contact dermatitis|Irritant contact dermatitis]]
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Contact dermatitis|Allergic contact dermatitis]]<ref name="pmid19447733">{{cite journal |vauthors=Nosbaum A, Vocanson M, Rozieres A, Hennino A, Nicolas JF |title=Allergic and irritant contact dermatitis |journal=Eur J Dermatol |volume=19 |issue=4 |pages=325–32 |date=2009 |pmid=19447733 |doi=10.1684/ejd.2009.0686 |url=}}</ref>
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Delayed-type [[hypersensitivity]] response
| align="center" style="background:#F5F5F5;" |  
*Skin [[inflammation]] mediated by [[Haptens|hapten]]-specific T cells
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Any
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |May be multiple after 1-2 days of exposure
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Erythematous well-demarcated [[papules]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Surrounding the area in contact with the offending agent
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Stinging and burning
| align="center" style="background:#F5F5F5;" |  
*Localized [[swelling]]
| align="center" style="background:#F5F5F5;" |  
*[[Lichenification|Lichenified]] [[Itch|pruritic]] [[plaques]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl to ↑
| align="center" style="background:#F5F5F5;" |  
([[Eosinophilia]])
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*[[Eosinophilic]] spongiosis and [[microvesicles]]
| align="center" style="background:#F5F5F5;" |  
*[[Exocytosis]] of [[eosinophils]] and [[lymphocytes]]
| align="center" style="background:#F5F5F5;" |  
*Chronic - [[Hyperkeratosis]] and parakeratosis
| align="center" style="background:#F5F5F5;" |  
| colspan="2" align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Contact with [[allergens]] in the past 1-2 days
| align="center" style="background:#F5F5F5;" |  
*Positive [[family history]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Contact dermatitis|Irritant contact dermatitis]]<ref name="pmid30293200">{{cite journal |vauthors=Bains SN, Nash P, Fonacier L |title=Irritant Contact Dermatitis |journal=Clin Rev Allergy Immunol |volume= |issue= |pages= |date=October 2018 |pmid=30293200 |doi=10.1007/s12016-018-8713-0 |url=}}</ref>
| align="center" style="background:#F5F5F5;" |
*Activation of the [[innate immune system]] by the pro-[[inflammatory]] properties of chemicals
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |Any, more with occupational exposure
| align="center" style="background:#F5F5F5;" |Usually single immediately after the exposure
| align="center" style="background:#F5F5F5;" |Well-demarcated red patch with a glazed surface
| align="center" style="background:#F5F5F5;" |Any area in contact with the irritant
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
*[[Swelling]], [[Blister|blistering]] and scaling of the damaged area
*Dryness
*Thicker skin
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |
*Spongiosis
*Intraepidermal [[vesicles]] or bullae
*[[Necrosis]] of [[keratinocytes]]
| colspan="2" align="center" style="background:#F5F5F5;" |
*Cumulative exposure to [[irritants]]
*Negative hypersensitivity tests
|-
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Seborrheic dermatitis]]
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Seborrheic dermatitis]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Not known
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Any, onset during the infancy and peak during 3rd-4th decades
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*[[Cradle cap]] - yellowish scales on the [[Scalp rash|scalp]]
| align="center" style="background:#F5F5F5;" |  
*Patchy or diffuse greasy scaling with or without a yellow-red base
| align="center" style="background:#F5F5F5;" |  
*Crusts
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Scalp, face, trunk, postauricular, diaper area and axilla
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Infants:
| align="center" style="background:#F5F5F5;" |
**[[Cradle cap]] (Sclap) - non-inflammatory greasy scales on the scalp
| align="center" style="background:#F5F5F5;" |
**Asymptomatic
| align="center" style="background:#F5F5F5;" |  
**Self resolving
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Focal parakeratosis and spongiosis in epidermis
| align="center" style="background:#F5F5F5;" |
*Psoriasiform [[hyperplasia]]
| align="center" style="background:#F5F5F5;" |
*[[Neutrophils]] at the margins
| align="center" style="background:#F5F5F5;" |
| colspan="2" align="center" style="background:#F5F5F5;" |Risk factors include
 
*[[Stress]]
 
*Cold, dry weather can cause flare ups
*[[Superinfection]] with bacteria and [[candida]]
 
Generalized seborrheic [[erythroderma]] in immunodeficient patients
|-
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Psoriasis]]
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Psoriasis]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*[[Keratinocyte]] hyperproliferation
| align="center" style="background:#F5F5F5;" |  
*Dysregulation of the [[immune system]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Any, 2 peaks of onset 30-39 years and 50-59 years
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Well-circumscribed, pink [[papules]] and symmetrically distributed cutaneous [[plaques]] with silvery scales
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Scalp
| align="center" style="background:#F5F5F5;" |  
*Trunk
| align="center" style="background:#F5F5F5;" |  
*Gluteal cleft
| align="center" style="background:#F5F5F5;" |  
*Extensor surface of elbows and knees
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |_
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*[[Auspitz's sign]]  (pinpoint bleeding)
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*[[Epidermal]] [[hyperplasia]]
| align="center" style="background:#F5F5F5;" |
*Parakeratosis
| align="center" style="background:#F5F5F5;" |
*[[Neutrophils]] microabscesses (Munro microabscesses)
| align="center" style="background:#F5F5F5;" |
| colspan="2" align="center" style="background:#F5F5F5;" |Risk factors include
| align="center" style="background:#F5F5F5;" |
 
*[[Smoking]]
*Skin trauma
*[[Alcohol abuse]]
*[[Stress]]
*Cold weather
*Vitamin D deficiency
|-
|-
! align="center" style="background:#DCDCDC;" |[[Lichen simplex chronicus]]
! align="center" style="background:#DCDCDC;" |[[Lichen simplex chronicus|Lichen simplex]] <ref name="pmid28785363">{{cite journal |vauthors=Voicu C, Tebeica T, Zanardelli M, Mangarov H, Lotti T, Wollina U, Lotti J, França K, Batashki A, Tchernev G |title=Lichen Simplex Chronicus as an Essential Part of the Dermatologic Masquerade |journal=Open Access Maced J Med Sci |volume=5 |issue=4 |pages=556–557 |date=July 2017 |pmid=28785363 |pmc=5535688 |doi=10.3889/oamjms.2017.133 |url=}}</ref>[[Lichen simplex chronicus|chronicus]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Secondary to extensive [[pruritus]] due to other conditions such as [[Atopic dermatitis|atopic dermatitis,]] neuropathic pruritus, etc
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Any, peak at 30-50 years of age
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |[[Lichenification|Lichenified]] and [[erythematous]], [[Itch|pruritic]] [[exudative]] [[Plaques|plaque]], and excoriations
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Scalp, head, neck, hands, arms, and genitals areas
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Color of [[Plaques|plaque]] varies from yellow to reddish-brown
| align="center" style="background:#F5F5F5;" |  
*[[Plaque]] size can vary between 3X6 cm 6X10 cm areas.
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Markedly [[Hyperplasia|hyperplastic]] [[epidermis]]
| align="center" style="background:#F5F5F5;" |
*Irregular [[hyperkeratosis]] and parakeratosis
| align="center" style="background:#F5F5F5;" |  
*Thick granular zone
| align="center" style="background:#F5F5F5;" |  
*[[Acanthosis]]
| align="center" style="background:#F5F5F5;" |  
| colspan="2" align="center" style="background:#F5F5F5;" |Risk factors include
| align="center" style="background:#F5F5F5;" |
 
| align="center" style="background:#F5F5F5;" |
*[[Emotional stress]]
| align="center" style="background:#F5F5F5;" |  
*Dry weather
| align="center" style="background:#F5F5F5;" |
*[[Sweating]]
*[[Sexual dysfunction]]
*[[Sleep disturbances]]
*[[Depression]]
|-
|-
! align="center" style="background:#DCDCDC;" |[[Ichthyosis vulgaris]]
! align="center" style="background:#DCDCDC;" |[[Ichthyosis vulgaris]]<ref name="pmid23301728">{{cite journal |vauthors=Thyssen JP, Godoy-Gijon E, Elias PM |title=Ichthyosis vulgaris: the filaggrin mutation disease |journal=Br. J. Dermatol. |volume=168 |issue=6 |pages=1155–66 |date=June 2013 |pmid=23301728 |doi=10.1111/bjd.12219 |url=}}</ref>
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Loss of function [[mutations]] in the [[Filaggrin|filaggrin gene (''FLG'')]]
| align="center" style="background:#F5F5F5;" |  
*[[Autosomal dominant inheritance]] with [[incomplete penetrance]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Usually in infancy
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*[[Xerosis]] and gray [[Ichthyosis|scaling]]
| align="center" style="background:#F5F5F5;" |  
*[[Palmar]] hyperlinearity
| align="center" style="background:#F5F5F5;" |  
*[[Keratosis pilaris]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Extensor surfaces of the extremities
| align="center" style="background:#F5F5F5;" |  
*Scalp
| align="center" style="background:#F5F5F5;" |  
*Trunk
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Scales can vary from mild scaling to large, plate (armor)-like scales and thickening of the skin.
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Reduced keratohyalin [[granules]]
| align="center" style="background:#F5F5F5;" |  
*[[Perinuclear space|Perinuclear]] [[keratin]] retractions in [[Granule cell|granular]] cells
| align="center" style="background:#F5F5F5;" |
*Thick [[stratum corneum]]
*Basket-weave pattern of [[stratum corneum]]
| colspan="2" align="center" style="background:#F5F5F5;" |
*Increased risk of [[atopic diseases]] including [[asthma]], alllergic rhinitis and [[atopic dermatitis]]
|-
|-
! align="center" style="background:#DCDCDC;" |[[Nummular dermatitis]]
! align="center" style="background:#DCDCDC;" |[[Nummular dermatitis|Nummular dermatitis (discoid eczema)]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Unknown
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Any,  two peaks, 6th-7th  decade of life in males and 2nd-3rd decade of life in females
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Symmetrical  coin-shaped [[Erythematous rash|erythematous]] [[plaques]]
| align="center" style="background:#F5F5F5;" |  
*Erosions and excoriations
| align="center" style="background:#F5F5F5;" |  
*Chronic lesions- central clearing leading to annular lesions
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Upper and lower extremities
| align="center" style="background:#F5F5F5;" |  
*Lower trunk
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Chronically [[lesions]] result into central clearing leading to annular lesions.
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Spongiosis
| align="center" style="background:#F5F5F5;" |
*[[Perivascular cell|Perivascular]] [[lymphocytic]] infiltrates, with [[eosinophils]] and occasional [[neutrophils]]
| align="center" style="background:#F5F5F5;" |
| colspan="2" align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Risk factors include
| align="center" style="background:#F5F5F5;" |
**Temperature changes (particularly winter)
| align="center" style="background:#F5F5F5;" |
**[[Emotional stress]]
**[[Dry skin]]
**Environmental irritants
**Recent [[surgery]]
**Medications like [[topical]] antibiotic creams and [[isotretinoin]]
*[[Superinfection]] with ''[[staphylococcus aureus]]''
|-
|-
! align="center" style="background:#DCDCDC;" |[[Netherton's syndrome]]
! align="center" style="background:#DCDCDC;" |[[Netherton's syndrome]]<ref name="pmid10835624">{{cite journal |vauthors=Chavanas S, Bodemer C, Rochat A, Hamel-Teillac D, Ali M, Irvine AD, Bonafé JL, Wilkinson J, Taïeb A, Barrandon Y, Harper JI, de Prost Y, Hovnanian A |title=Mutations in SPINK5, encoding a serine protease inhibitor, cause Netherton syndrome |journal=Nat. Genet. |volume=25 |issue=2 |pages=141–2 |date=June 2000 |pmid=10835624 |doi=10.1038/75977 |url=}}</ref>
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |[[Autosomal recessive]] [[mutations]] in the [[SPINK5|serine protease inhibitor of Kazal type 5 gene (''SPINK5)'']]'', encoding [[LEKTI]]''[[LEKTI|, a serine protease inhibitor]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Affects [[neonates]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Classic triad
| align="center" style="background:#F5F5F5;" |  
**Congenital ichthyosiform erythroderma
| align="center" style="background:#F5F5F5;" |  
**Trichorrhexis invaginata
| align="center" style="background:#F5F5F5;" |  
**[[Atopy|Allergic diseases]] with ↑ serum [[IgE]] levels
| align="center" style="background:#F5F5F5;" |  
*Ichthyosis linearis circumflexa (ILC) - [[serpiginous]] [[plaques]] with double scale at the margins
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Diffuse pattern
| align="center" style="background:#F5F5F5;" |
*Axillae,
| align="center" style="background:#F5F5F5;" |  
*Hair
| align="center" style="background:#F5F5F5;" |
*Inguinal folds
| align="center" style="background:#F5F5F5;" |  
*Gluteal cleft
| align="center" style="background:#F5F5F5;" |  
*Groin
| align="center" style="background:#F5F5F5;" |  
*Lower legs
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Trichorrhexis invaginata (hair involvement):
| align="center" style="background:#F5F5F5;" |
**Sparse, short, spike and brittle
| align="center" style="background:#F5F5F5;" |
**"Bamboo hair" or "ball and socket deformity" of hair and eyebrows
|-
**Nodes along the hair shaft
! align="center" style="background:#DCDCDC;" |[[Dubowitz syndrome]]
| align="center" style="background:#F5F5F5;" |Nl to ↑
| align="center" style="background:#F5F5F5;" |
 
| align="center" style="background:#F5F5F5;" |
([[Eosinophilia]])
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Psoriasiform [[hyperplasia]]
| align="center" style="background:#F5F5F5;" |
*Reduced granular layer
| align="center" style="background:#F5F5F5;" |
*Dyskeratosis
| align="center" style="background:#F5F5F5;" |
*[[Dermal]] [[inflammatory]] infiltrate including [[neutrophils]] and [[eosinophils]]
| align="center" style="background:#F5F5F5;" |
| colspan="2" align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*[[Atopic diseases]] including asthma, [[atopic dermatitis]] and [[allergic rhinitis]]
| align="center" style="background:#F5F5F5;" |
*Systemic and skin superinfections
| align="center" style="background:#F5F5F5;" |
*[[Failure to thrive]]
| align="center" style="background:#F5F5F5;" |
*Electrolyte imbalances, including [[hypernatremia]],[[dehydration]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |Erythrokeratodermia variabilis
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! rowspan="8" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infection
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Dermatophyte|Dermatophytes]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Candidiasis|Candida]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Herpes simplex]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Staphylococcus aureus]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Molluscum contagiosum]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
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|-
! align="center" style="background:#DCDCDC;" |[[Scabies]]
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|-
! align="center" style="background:#DCDCDC;" |[[Human Immunodeficiency Virus (HIV)|HIV]]
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|-
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
Line 560: Line 363:
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquired
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquired
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Single/
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Single/
Multiple
Multiple
Line 567: Line 369:
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pustule
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pustule
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Itching
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Itching
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nail pitting
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum IgE
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |ESR/CRP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Electrolytes
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BUN/Cr
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |LFT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated factors
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
|-
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immunologic disorders
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infection
! align="center" style="background:#DCDCDC;" |[[Dermatitis herpetiformis]]
! align="center" style="background:#DCDCDC;" |[[Molluscum contagiosum]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |[[Molluscum contagiosum]] virus [[inoculation]] through direct skin contact
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Any, peak among children >5 years of age and young adults
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Flesh-colored, dome-shaped [[papules]] with a central umbilication
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*Lesions are 2-5mm in diameter
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| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Face, trunk, [[Antecubital fossa|antecubital]],  [[Popliteal fossa|popliteal fossae]] and groin
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |If [[molluscum contagiosum]] is acquired as [[sexually transmitted disease]], it involves, groin and genital region.
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*[[Keratinocytes]] containing [[eosinophilic]] [[inclusion bodies]] (Henderson-Paterson bodies)
| align="center" style="background:#F5F5F5;" |
*[[H&E stain]] - inwards indentation of the [[epidermis]]
| align="center" style="background:#F5F5F5;" |
| colspan="2" align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Often [[asymptomatic]]
| align="center" style="background:#F5F5F5;" |
*Self resolve within 2 months
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*Immunodeficient patients present with extensive and severe infections
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*[[Molluscum contagiosum]]  lesions on the [[eyelid]] may lead to follicular or papillary [[conjunctivitis]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
|-
! align="center" style="background:#DCDCDC;" |[[Pemphigus foliaceus]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immunologic disorders
| align="center" style="background:#F5F5F5;" |
! align="center" style="background:#DCDCDC;" |[[Dermatitis herpetiformis]]<ref name="pmid22137227">{{cite journal |vauthors=Kárpáti S |title=Dermatitis herpetiformis |journal=Clin. Dermatol. |volume=30 |issue=1 |pages=56–9 |date=2012 |pmid=22137227 |doi=10.1016/j.clindermatol.2011.03.010 |url=}}</ref>
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |[[Autoimmunity|Autoimmune]] disorder as a result of [[gluten sensitivity]] leading to the formation of [[IgA]] antibodies
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Any, mean age of disease onset is 2nd-4th decade
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Excoriated [[papules]], [[plaques]] and [[vesicles]] arranged in a clustered fashion
| align="center" style="background:#F5F5F5;" |  
*Symmetrical
| align="center" style="background:#F5F5F5;" |  
*Erosions and excoriations
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Extensor surfaces including arms, knees, and buttocks.
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| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Oral manifestation such as [[vesicles]] and erosion may be present
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*[[Papillary]] micro-[[abscesses]]
| align="center" style="background:#F5F5F5;" |
*Sub-epidermal [[blisters]] containing [[neutrophils]], [[eosinophils]], and [[fibrin]]
| align="center" style="background:#F5F5F5;" |  
*Sub-epidermal [[vacuolization]]
| align="center" style="background:#F5F5F5;" |
| colspan="2" align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Intermittent [[Itch|pruritic]] [[papules]] and [[vesicles]]
| align="center" style="background:#F5F5F5;" |
*[[Celiac disease]] with [[Villous folds|villous]] atrophy and [[Crypt (anatomy)|crypt]] [[hyperplasia]]
*Abdominal [[bloating]], pain, [[Diarrheal|diarrhea]], or [[constipation]]
|-
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! align="center" style="background:#DCDCDC;" |[[Graft-versus-host disease]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immune deficiency
| align="center" style="background:#F5F5F5;" |  
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Wiskott-Aldrich syndrome]]<ref name="pmid24817816">{{cite journal |vauthors=Buchbinder D, Nugent DJ, Fillipovich AH |title=Wiskott-Aldrich syndrome: diagnosis, current management, and emerging treatments |journal=Appl Clin Genet |volume=7 |issue= |pages=55–66 |date=2014 |pmid=24817816 |pmc=4012343 |doi=10.2147/TACG.S58444 |url=}}</ref>
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Mutation in the gene encoding for [[Wiskott-Aldrich syndrome]] protein (WASp) on the short arm of the [[X chromosome]]
| align="center" style="background:#F5F5F5;" |  
*[[X linked inheritance|X-linked disorder]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Seen almost exclusively in males in infancy
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Rash is clinically similar to [[atopic dermatitis]]
| align="center" style="background:#F5F5F5;" |  
*[[Erythematous]] and [[Itch|pruritic]] lesions
| align="center" style="background:#F5F5F5;" |  
*Lesions can bleed due to [[thrombocytopenia]]
| align="center" style="background:#F5F5F5;" |  
*Cutaneous manifestations includes [[Petechia|petechiae]] and [[ecchymosis]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Rash can involve lesions located at the same areas of classical atopic dermatitis:
| align="center" style="background:#F5F5F5;" |  
 
| align="center" style="background:#F5F5F5;" |  
extensor surfaces of extremities and cheeks or scalp
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Infants can present with [[petechiae]], prolonged [[bleeding]] from [[umbilicus]] or circumcision,  [[purpura]],[[hematemesis]], [[melena]], [[epistaxis]], [[hematuria]]  or unusal bruising
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Nl to ↑
| align="center" style="background:#F5F5F5;" |  
 
| align="center" style="background:#F5F5F5;" |  
([[Eosinophilia]])
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*[[Hyperkeratosis]]
*Psoriasiform [[hyperplasia]]
*Dyskeratosis
 
*Epidermal psoriasiform [[hyperplasia]]
*Marked intercellular [[edema]] with spongiotic vesiculation
| colspan="2" align="center" style="background:#F5F5F5;" |
*↑ serum [[IgA]] levels
*↑ serum [[IgE]] levels
*Bleeding: severe [[thrombocytopenia]],
*[[Eczema]] - similar to [[atopic dermatitis]]
*Recurrent sino-pulmonary infections
*[[Opportunistic infection|Opportunistic infections.]]
*[[Autoimmune diseases]]
*[[Malignancies]]
|-
|-
! align="center" style="background:#DCDCDC;" |[[Polymyositis and dermatomyositis|Dermatomyositis]]
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hyper-IgE syndrome]]<ref name="pmid24058807">{{cite journal |vauthors=Mogensen TH |title=STAT3 and the Hyper-IgE syndrome: Clinical presentation, genetic origin, pathogenesis, novel findings and remaining uncertainties |journal=JAKSTAT |volume=2 |issue=2 |pages=e23435 |date=April 2013 |pmid=24058807 |pmc=3710320 |doi=10.4161/jkst.23435 |url=}}</ref>
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Defects in the [[JAK-STAT signaling pathway]] leading to dysfunctional [[T helper cell]] type 17 ([[T helper 17 cell|Th17]]) [[differentiation]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Rare, begin in infancy
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Papulopustular
| align="center" style="background:#F5F5F5;" |
*Severely [[Itch|pruritic]] eczematous rash
| align="center" style="background:#F5F5F5;" |
*[[Pustular rash|Pustular]] and may impetiginized
| align="center" style="background:#F5F5F5;" |
*[[Lichenification]] may occur
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Face and scalp
| align="center" style="background:#F5F5F5;" |
*Upper trunk and shoulders
| align="center" style="background:#F5F5F5;" |
*Buttocks
| align="center" style="background:#F5F5F5;" |
*Area behind the ears and around the hairline
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Characteristic coarse facies
| align="center" style="background:#F5F5F5;" |
*Increased alar width and broad [[nasal bridge]]
| align="center" style="background:#F5F5F5;" |
*High-arched oral palate
| align="center" style="background:#F5F5F5;" |
*Hyperextensible joints
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Nl to ↑
| align="center" style="background:#F5F5F5;" |
 
|-
([[Eosinophilia]])
! rowspan="6" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immune deficiency
| align="center" style="background:#F5F5F5;" |
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Wiskott-Aldrich syndrome]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*[[Eosinophil]]-rich infiltration around the hair follicles
| align="center" style="background:#F5F5F5;" |
| colspan="2" align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Cold [[abscesses]]
| align="center" style="background:#F5F5F5;" |  
 
| align="center" style="background:#F5F5F5;" |
*[[Itch|Pruritic]] [[eczema]]
| align="center" style="background:#F5F5F5;" |  
*[[Allergy|Allergic]] diseases
| align="center" style="background:#F5F5F5;" |  
*Noneruption of permanent teeth
| align="center" style="background:#F5F5F5;" |
*Multiple bone [[Bone fracture|fractures]] and scoliosisis
| align="center" style="background:#F5F5F5;" |  
*[[Peripheral T-cell lymphomas|Peripheral T-cell lymphoma]]
| align="center" style="background:#F5F5F5;" |
*[[Coronary artery]] [[aneurysms]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hyper-IgE syndrome]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
|-
! align="center" style="background:#DCDCDC;" |[[22q11.2 deletion syndrome|DiGeorge syndrome]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Malignancy
| align="center" style="background:#F5F5F5;" |  
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mycosis fungoides]]
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Clonal expansion of [[CD4+ cell|CD4]]<sup>+</sup> [[memory T cells]] (CD45RO<sup>+</sup>)
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Mean age is  55- 60 years
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |Multiple
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Non-pruritic patches and intensely [[Itch|pruritic]] [[plaques]]
| align="center" style="background:#F5F5F5;" |  
*[[Comedones]], [[cysts]]
| align="center" style="background:#F5F5F5;" |  
*[[Tumors]] of skin
| align="center" style="background:#F5F5F5;" |  
*[[Erythematous]] [[macules]]
| align="center" style="background:#F5F5F5;" |  
*[[Hypopigmented area|Hypopigmented]] patches
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*Asymmetrical
| align="center" style="background:#F5F5F5;" |  
*Hips, groin and trunk
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |  
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |  
*[[Alopecia]]
| align="center" style="background:#F5F5F5;" |
*[[Acneiform eruption|Acneiform]] lesions
| align="center" style="background:#F5F5F5;" |
*[[Plaques]] size can vary between 2-20 cm
| align="center" style="background:#F5F5F5;" |
*[[Lymphadenopathy]]
| align="center" style="background:#F5F5F5;" |
*Children-  [[Hypopigmentation|hypopigmented]] patches most common
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |Nl
|-
| align="center" style="background:#F5F5F5;" |
! align="center" style="background:#DCDCDC;" |[[Severe combined immunodeficiency]] ([[Severe combined immunodeficiency|SCID]])
*Perifollicular infiltrates around the [[infundibulum]]
| align="center" style="background:#F5F5F5;" |
*[[Epidermis]] is spared or has minimal spongiosis
| align="center" style="background:#F5F5F5;" |
*Band-like [[Dermal|derma]]<nowiki/>l infiltrate of [[lymphocytes]] and and [[histiocytes]]
| align="center" style="background:#F5F5F5;" |
| colspan="2" align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
*Increased risk of :
| align="center" style="background:#F5F5F5;" |
**Severe viral and bacterial infections
| align="center" style="background:#F5F5F5;" |
**Secondary [[malignancies]], especially lymphomas
| align="center" style="background:#F5F5F5;" |
*Staging of [[Mycosis fungoides]] is based upon:
| align="center" style="background:#F5F5F5;" |
**Patches
| align="center" style="background:#F5F5F5;" |
**[[Plaques]]
| align="center" style="background:#F5F5F5;" |
**Skin tumors
| align="center" style="background:#F5F5F5;" |
**[[Lymphadenopathy]]
| align="center" style="background:#F5F5F5;" |
**[[Erythroderma]]
| align="center" style="background:#F5F5F5;" |
**[[Histology]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Ataxia telangiectasia]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquired
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Single/
Multiple
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Involved areas
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pustule
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Itching
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nail pitting
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |ESR/CRP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Electrolytes
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BUN/Cr
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |LFT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Metabolic Diseases
! align="center" style="background:#DCDCDC;" |[[Phenylketonuria]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Tyrosinemia]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Histidinemia]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Multiple carboxylase deficiency]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nutritional deficiencies
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Zinc deficiency]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Pellagra|Niacin (B3) deficiency]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Pyridoxine deficiency|Pyridoxine (B6) deficiency]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
|-
! align="center" style="background:#DCDCDC;" |[[Biotin deficiency|Biotin (B7) deficiency]]
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
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! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cutaneous T cell lymphoma|Mycosis fungoides]]
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Latest revision as of 02:44, 16 October 2021

Atopic dermatitis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD; Shalinder Singh, M.B.B.S.[2]

Overview

Atopic dermatitis is a chronic inflammatory skin disorder, which is indistinguishable from other causes of dermatitis. Atopic dermatitis is usually associated with personal or family history of atopic diseases including asthma, allergic rhinitis and food allergy. The most common clinically similar dermatitis in infancy is seborrheic dermatitis which includes hyperkeratosis of the scalp, also found in atopic dermatitis.

Atopic Dermatitis from other Diseases

Atopic dermatitis should be differentiated from allergic contact dermatitis, iirritant contact dermatitis, seborrheic dermatitis, psoriasis, lichen simplex chronicus, ichthyosis vulgaris, nummular dermatitis (discoid eczema), netherton's syndrome, and dermatitis herpetiformis

Category Diseases Etiology Inherited Acquired Clinical manifestations Para-clinical findings Associated factors
Demography Symptoms Physical examination
Lab Findings Histopathology
Appearance Itching Fever Tenderness Other Eosinophils Serum IgE
Single/

Multiple

Rash Involved areas Pustule
Skin disorders Atopic dermatitis
  • Epidermal barrier dysfunction
  • Immune dysregulation
+ + Multiple
  • Young children -Scalp, cheeks amd extensor surface
  • Adolescents -flexural areas and buttock-thigh creases
  • Adults - facial involvement and skin flexures
+
  • Infra-auricular and retro-auricular fissuring
  • Nipple eczema
  • White dermographism
  • Perifollicular accentuation
Nl to ↑

(Eosinophilia)

  • Epidermal psoriasiform hyperplasia
  • Marked intercellular edema with spongiotic vesiculation
Allergic contact dermatitis[1] + Any May be multiple after 1-2 days of exposure Erythematous well-demarcated papules Surrounding the area in contact with the offending agent + + Nl to ↑

(Eosinophilia)

Nl
Irritant contact dermatitis[2] + Any, more with occupational exposure Usually single immediately after the exposure Well-demarcated red patch with a glazed surface Any area in contact with the irritant + + Nl Nl
  • Cumulative exposure to irritants
  • Negative hypersensitivity tests
Seborrheic dermatitis
  • Not known
+ Any, onset during the infancy and peak during 3rd-4th decades Multiple
  • Cradle cap - yellowish scales on the scalp
  • Patchy or diffuse greasy scaling with or without a yellow-red base
  • Crusts
Scalp, face, trunk, postauricular, diaper area and axilla + +
  • Infants:
    • Cradle cap (Sclap) - non-inflammatory greasy scales on the scalp
    • Asymptomatic
    • Self resolving
Nl Nl Risk factors include

Generalized seborrheic erythroderma in immunodeficient patients

Psoriasis + + Any, 2 peaks of onset 30-39 years and 50-59 years Multiple Well-circumscribed, pink papules and symmetrically distributed cutaneous plaques with silvery scales
  • Scalp
  • Trunk
  • Gluteal cleft
  • Extensor surface of elbows and knees
+ + _ + Nl Nl Risk factors include
Lichen simplex [3]chronicus + Any, peak at 30-50 years of age Multiple Lichenified and erythematous, pruritic exudative plaque, and excoriations Scalp, head, neck, hands, arms, and genitals areas +
  • Color of plaque varies from yellow to reddish-brown
  • Plaque size can vary between 3X6 cm 6X10 cm areas.
Nl Nl Risk factors include
Ichthyosis vulgaris[4] + + Usually in infancy Multiple
  • Extensor surfaces of the extremities
  • Scalp
  • Trunk
  • Scales can vary from mild scaling to large, plate (armor)-like scales and thickening of the skin.
Nl Nl
Nummular dermatitis (discoid eczema) Unknown + Any, two peaks, 6th-7th decade of life in males and 2nd-3rd decade of life in females Multiple
  • Symmetrical coin-shaped erythematous plaques
  • Erosions and excoriations
  • Chronic lesions- central clearing leading to annular lesions
  • Upper and lower extremities
  • Lower trunk
+
  • Chronically lesions result into central clearing leading to annular lesions.
Nl Nl
Netherton's syndrome[5] Autosomal recessive mutations in the serine protease inhibitor of Kazal type 5 gene (SPINK5), encoding LEKTI, a serine protease inhibitor + Affects neonates Multiple
  • Classic triad
    • Congenital ichthyosiform erythroderma
    • Trichorrhexis invaginata
    • Allergic diseases with ↑ serum IgE levels
  • Ichthyosis linearis circumflexa (ILC) - serpiginous plaques with double scale at the margins
  • Diffuse pattern
  • Axillae,
  • Hair
  • Inguinal folds
  • Gluteal cleft
  • Groin
  • Lower legs
+ +
  • Trichorrhexis invaginata (hair involvement):
    • Sparse, short, spike and brittle
    • "Bamboo hair" or "ball and socket deformity" of hair and eyebrows
    • Nodes along the hair shaft
Nl to ↑

(Eosinophilia)

Diseases Etiology Inherited Acquired Demography Single/

Multiple

Rash Involved areas Pustule Itching Fever Tenderness Other WBC Serum IgE Histopathology Associated factors
Infection Molluscum contagiosum Molluscum contagiosum virus inoculation through direct skin contact + Any, peak among children >5 years of age and young adults Multiple
  • Flesh-colored, dome-shaped papules with a central umbilication
  • Lesions are 2-5mm in diameter
+ If molluscum contagiosum is acquired as sexually transmitted disease, it involves, groin and genital region. Nl Nl
Immunologic disorders Dermatitis herpetiformis[6] Autoimmune disorder as a result of gluten sensitivity leading to the formation of IgA antibodies + Any, mean age of disease onset is 2nd-4th decade Multiple
  • Excoriated papules, plaques and vesicles arranged in a clustered fashion
  • Symmetrical
  • Erosions and excoriations
  • Extensor surfaces including arms, knees, and buttocks.
+
  • Oral manifestation such as vesicles and erosion may be present
Nl Nl
Immune deficiency Wiskott-Aldrich syndrome[7] + Seen almost exclusively in males in infancy Multiple Rash can involve lesions located at the same areas of classical atopic dermatitis:

extensor surfaces of extremities and cheeks or scalp

+ Infants can present with petechiae, prolonged bleeding from umbilicus or circumcision, purpura,hematemesis, melena, epistaxis, hematuria or unusal bruising Nl to ↑

(Eosinophilia)

  • Epidermal psoriasiform hyperplasia
  • Marked intercellular edema with spongiotic vesiculation
Hyper-IgE syndrome[8] + Rare, begin in infancy Multiple
  • Face and scalp
  • Upper trunk and shoulders
  • Buttocks
  • Area behind the ears and around the hairline
+ +
  • Characteristic coarse facies
  • Increased alar width and broad nasal bridge
  • High-arched oral palate
  • Hyperextensible joints
Nl to ↑

(Eosinophilia)

  • Eosinophil-rich infiltration around the hair follicles
Malignancy Mycosis fungoides Clonal expansion of CD4+ memory T cells (CD45RO+) + Mean age is 55- 60 years Multiple
  • Asymmetrical
  • Hips, groin and trunk
+ Nl Nl

References

  1. Nosbaum A, Vocanson M, Rozieres A, Hennino A, Nicolas JF (2009). "Allergic and irritant contact dermatitis". Eur J Dermatol. 19 (4): 325–32. doi:10.1684/ejd.2009.0686. PMID 19447733.
  2. Bains SN, Nash P, Fonacier L (October 2018). "Irritant Contact Dermatitis". Clin Rev Allergy Immunol. doi:10.1007/s12016-018-8713-0. PMID 30293200.
  3. Voicu C, Tebeica T, Zanardelli M, Mangarov H, Lotti T, Wollina U, Lotti J, França K, Batashki A, Tchernev G (July 2017). "Lichen Simplex Chronicus as an Essential Part of the Dermatologic Masquerade". Open Access Maced J Med Sci. 5 (4): 556–557. doi:10.3889/oamjms.2017.133. PMC 5535688. PMID 28785363.
  4. Thyssen JP, Godoy-Gijon E, Elias PM (June 2013). "Ichthyosis vulgaris: the filaggrin mutation disease". Br. J. Dermatol. 168 (6): 1155–66. doi:10.1111/bjd.12219. PMID 23301728.
  5. Chavanas S, Bodemer C, Rochat A, Hamel-Teillac D, Ali M, Irvine AD, Bonafé JL, Wilkinson J, Taïeb A, Barrandon Y, Harper JI, de Prost Y, Hovnanian A (June 2000). "Mutations in SPINK5, encoding a serine protease inhibitor, cause Netherton syndrome". Nat. Genet. 25 (2): 141–2. doi:10.1038/75977. PMID 10835624.
  6. Kárpáti S (2012). "Dermatitis herpetiformis". Clin. Dermatol. 30 (1): 56–9. doi:10.1016/j.clindermatol.2011.03.010. PMID 22137227.
  7. Buchbinder D, Nugent DJ, Fillipovich AH (2014). "Wiskott-Aldrich syndrome: diagnosis, current management, and emerging treatments". Appl Clin Genet. 7: 55–66. doi:10.2147/TACG.S58444. PMC 4012343. PMID 24817816.
  8. Mogensen TH (April 2013). "STAT3 and the Hyper-IgE syndrome: Clinical presentation, genetic origin, pathogenesis, novel findings and remaining uncertainties". JAKSTAT. 2 (2): e23435. doi:10.4161/jkst.23435. PMC 3710320. PMID 24058807.