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[Dermatology] Atlas of Atopic Dermatitis, Eczema, and Noninfectious Immunodeficiency Disorders

These are pictures of Atopic Dermatitis, Eczema, and Noninfectious Immunodeficiency Disorders. This is a part of the Andrews' Diseases of the Skin Clinical Atlas 1st Edition 2018 book


Dermatitis can present with a variety of physical examination findings ranging from exuberant oozing to dry scale. These findings represent the acute and chronic inflammation that defines a variety of dermatitides and eczematous conditions. Intense itching that accompanies these conditions can lead to overlying excoriations and eventually thickening of the skin known as lichenification. Ultimately, constant itching and a poor epidermal barrier predispose patients with these eczematous conditions to repeated skin infections from bac- teria and viruses, which can present with pustules, vesicles, crusting, erosions, or painful nodules. Screening for signs of such infections is an important part of the physical examina- tion for all patients with dermatitis, especially those with any underlying immunodeficiency.


Although most cases will not require a skin biopsy for a diagnosis, the spongiosis of acute dermatitis or the acanthosis of the epidermis seen in chronic dermatitis can be confirma- tory in scenarios wherein other diagnoses that affect the epidermis are being considered, such as nutritional deficien- cies, graft-versus-host disease, or psoriasis.

The anatomic location of atopic dermatitis (AD) can vary depending on age. Infantile AD tends to affect the cheeks and can have impressive overlying exudation and crusting even in the absence of infection. In infants, AD can also be quite wide- spread with predilections for extensor surfaces and notable sparing of the diaper region and nose, the so-called headlight sign. Childhood AD may be more localized to the flexors and can begin to take on a more lichenified appearance. Many people with AD will outgrow a more widespread dermatitis, but may have chronic hand dermatitis or other more local- ized flares of their AD. Associated features of AD found on physical examination include Dennie-Morgan lines (accen- tuated folds of the lower eyelids), keratosis pilaris, general xerosis, follicular accentuation, and signs of atopy such as hyperpigmentation around the eyes known as allergic shiners. Other forms of eczema may take on different patterns on the body, including the coin-shaped, scaly, and exudative plaques of nummular eczema or the diffuse, dry, and cracked appearance of xerotic eczema (eczema craquele). Even in patients without a history of AD, localized forms of eczema may arise on the eyelids or nipples, or on the hands as vesicu- lobullous hand eczema (pompholyx). Finally, some forms of immunodeficiency disorders can present with relatively nonspecific exfoliative erythroderma, as in severe combined immunodeficiency (SCID), or an atopic dermatitis-like erup- tion, as in hyper–immunoglobulinemia E (IgE) syndrome, Wiskott-Aldrich syndrome (WAS), or DiGeorge syndrome. In these cases, the astute clinician will observe distinctive clini- cal findings such as the pustular eruption of hyper-IgE syn- drome, dysmorphisms of DiGeorge syndrome, or petechiae within the dermatitis of patients with WAS. This portion of the atlas will highlight the range of clinical findings seen in patients with atopic dermatitis and other forms of eczema, along with rarer findings seen in patients with immunodeficiency syndromes.

Fig. 5.1 Atopic dermatitis.
Fig. 5.1 Atopic dermatitis.

Fig. 5.2 Atopic dermatitis
Fig. 5.2 Atopic dermatitis


Fig. 5.3 Atopic dermatitis
Fig. 5.3 Atopic dermatitis

Fig. 5.4 Chronic atopic dermatitis
Fig. 5.4 Chronic atopic dermatitis

Fig. 5.5 Atopic dermatitis with excoriations
Fig. 5.5 Atopic dermatitis with excoriations

Fig. 5.6 Atopic dermatitis with secondary infection
Fig. 5.6 Atopic dermatitis with secondary infection

Fig. 5.7 Atopic dermatitis
Fig. 5.7 Atopic dermatitis

Fig. 5.8 Atopic dermatitis
Fig. 5.8 Atopic dermatitis

Fig. 5.9 Atopic dermatitis with secondary infection
Fig. 5.9 Atopic dermatitis with secondary infection

Fig. 5.10 Atopic dermatitis
Fig. 5.10 Atopic dermatitis

Fig. 5.11 Chronic atopic dermatitis
Fig. 5.11 Chronic atopic dermatitis

Fig. 5.12 Chronic atopic dermatitis
Fig. 5.12 Chronic atopic dermatitis

Fig. 5.13  Chronic atopic dermatitis with hyperpigmentation
Fig. 5.13 Chronic atopic dermatitis with hyperpigmentation

Fig. 5.14 Atopic dermatitis, lichenification
Fig. 5.14 Atopic dermatitis, lichenification

Fig. 5.15 Atopic dermatitis.
Fig. 5.15 Atopic dermatitis.

Fig. 5.16 Papular atopic dermatitis
Fig. 5.16 Papular atopic dermatitis

Fig. 5.17 Atopic dermatitis.
Fig. 5.17 Atopic dermatitis.

Fig. 5.18 Atopic dermatitis with Dennie-Morgan lines
Fig. 5.18 Atopic dermatitis with Dennie-Morgan lines

Fig. 5.19 White dermatographism.
Fig. 5.19 White dermatographism.

Fig. 5.20  Erythroderma from atopic dermatitis.
Fig. 5.20 Erythroderma from atopic dermatitis.

Fig. 5.21 Pityriasis alba
Fig. 5.21 Pityriasis alba

Fig. 5.22 Hyperlinear palms in a patient with active atopic dermatitis
Fig. 5.22 Hyperlinear palms in a patient with active atopic dermatitis
Fig. 5.23 Keratosis pilaris
Fig. 5.23 Keratosis pilaris

Fig. 5.24 Keratosis pilaris
Fig. 5.24 Keratosis pilaris

Fig. 5.25 Keratosis pilaris rubra faciei.
Fig. 5.25 Keratosis pilaris rubra faciei.

Fig. 5.26 Eczema herpeticum
Fig. 5.26 Eczema herpeticum

Fig. 5.27 Ear eczema
Fig. 5.27 Ear eczema

Fig. 5.28 Eyelid eczema
Fig. 5.28 Eyelid eczema

Fig. 5.29 Nipple eczema in an atopic child
Fig. 5.29 Nipple eczema in an atopic child

Fig. 5.30 Hand dermatitis with secondary infection
Fig. 5.30 Hand dermatitis with secondary infection

Fig. 5.31 Finger dermatitis from primrose allergy
Fig. 5.31 Finger dermatitis from primrose allergy

Fig. 5.32 Pompholyx
Fig. 5.32 Pompholyx

Fig. 5.33 Pompholyx
Fig. 5.33 Pompholyx

Fig. 5.34 Irritant diaper dermatitis. Note sparing of folds
Fig. 5.34 Irritant diaper dermatitis. Note sparing of folds

Fig. 5.35 Id reaction
Fig. 5.35 Id reaction

Fig. 5.36 Xerotic eczema
Fig. 5.37 Nummular eczema
Fig. 5.37 Nummular eczema

Fig. 5.38 Nummular eczema
Fig. 5.38 Nummular eczema

Fig. 5.39 Job’s syndrome

Fig. 5.39 Job’s syndrome

Fig. 5.40 Job’s syndrome
Fig. 5.40 Job’s syndrome

Fig. 5.41 Job’s syndrome with secondary infection
Fig. 5.41 Job’s syndrome with secondary infection

Fig. 5.42 Eczema in Wiskott-Aldrich syndrome
Fig. 5.42 Eczema in Wiskott-Aldrich syndrome

Fig. 5.43  Ataxia telangiectasia
Fig. 5.43 Ataxia telangiectasia

Fig. 5.44 Granulomatous lesions in ataxia telangiectasia
Fig. 5.44 Granulomatous lesions in ataxia telangiectasia

Fig. 5.45 Common variable immunodeficiency with granulomas in vitiligo.
Fig. 5.45 Common variable immunodeficiency with granulomas in vitiligo.

Fig. 5.46 Common variable immunodeficiency with granulomas in vitiligo
Fig. 5.46 Common variable immunodeficiency 
with granulomas in vitiligo

Fig. 5.47 Common variable immunodeficiency with chronic candidiasis
Fig. 5.47 Common variable immunodeficiency with chronic candidiasis

Fig. 5.48 Warts in DOCK8 immunodeficiency

Fig. 5.48 Warts in DOCK8 immunodeficiency

Fig. 5.49 Warts in DOCK8 immunodeficiency
Fig. 5.49 Warts in DOCK8 immunodeficiency

Fig. 5.50 Warts in DOCK8 immunodeficiency
Fig. 5.50 Warts in DOCK8 immunodeficiency

Fig. 5.51 Subacute lupus erythematosus as can be seen in complement deficiency disorders
Fig. 5.51 Subacute lupus erythematosus as can be seen in 
complement deficiency disorders

Fig. 5.52 Acute graft-versus-host disease
Fig. 5.52 Acute graft-versus-host disease

Fig. 5.53 Acute graft-versus-host disease grade 2
Fig. 5.53 Acute graft-versus-host disease grade 2

Fig. 5.54 Acute graft-versus-host disease grade 2

Fig. 5.55 Acute graft-versus-host disease grade 4
Fig. 5.55 Acute graft-versus-host disease grade 4

Fig. 5.56 Acute graft-versus-host disease
Fig. 5.56 Acute graft-versus-host disease

Fig. 5.57 Lichenoid graft-versus-host disease
Fig. 5.57 Lichenoid graft-versus-host disease

Fig. 5.58 Chronic graft-versus-host disease
Fig. 5.58 Chronic graft-versus-host disease

Fig. 5.59 Chronic graft-versus-host disease, oral
Fig. 5.59 Chronic graft-versus-host disease, oral

Fig. 5.60 Chronic graft-versus-host disease, sclerodermoid type
Fig. 5.60 Chronic graft-versus-host disease, sclerodermoid type

Fig. 5.61 Chronic graft-versus-host disease
Fig. 5.61 Chronic graft-versus-host disease

Fig. 5.62  Sclerodermoid graft-versus-host disease
Fig. 5.62 Sclerodermoid graft-versus-host disease

Fig. 5.63 Sclerodermoid graft-versus-host disease
Fig. 5.63 Sclerodermoid graft-versus-host disease

Fig. 5.64 Fasciitis in graft-versus-host disease
Fig. 5.64 Fasciitis in graft-versus-host disease

REFERENCES

Andrews' Diseases of the Skin Clinical Atlas 1st Edition 2018

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CLINICAL ATLAS,118,DERMATOLOGY ATLAS,11,EMERGENCY ATLAS,44,HAEMATOLOGY ATLAS,23,HUMAN ANATOMY,1,MICROBIOLOGY ATLAS,66,PARASITOLOGY ATLAS,4,PATHOLOGY ATLAS,22,PEDIATRIC ATLAS,41,STDs,19,SUBCLINICAL ATLAS,116,
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Free Medical Atlas: [Dermatology] Atlas of Atopic Dermatitis, Eczema, and Noninfectious Immunodeficiency Disorders
[Dermatology] Atlas of Atopic Dermatitis, Eczema, and Noninfectious Immunodeficiency Disorders
These are pictures of Atopic Dermatitis, Eczema, and Noninfectious Immunodeficiency Disorders. This is a part of the Andrews' Diseases of the Skin Clinical Atlas 1st Edition 2018 book
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