Dermatology: Comprehensive Board Review and Practice Examinations

Authors v

Editors vii

Preface ix

Acknowledgements xi

1. 1. Science and Research 1

Structure and Function 1

Embryology 15

Genetics 15

Carcinogenesis 19

Photobiology 22

Immunology and Inflammation 25

Wound Healing 35

Pharmacology 36

Laboratory Techniques 38

Epidemiology and Statistics 41

2. 2. Nonneoplastic Disorders 49

Papulosquamous Disorders and Palmoplantar Keratodermas 49

Psoriasis: Group 1 49

Reactive Arthritis 54

Geographic Tongue: Group 2 55

Parapsoriasis: Group 2 55

Pityriasis Lichenoides 56

Pityriasis Rosea: Group 1 56

Pityriasis Rubra Pilaris: Group 2 58

Spotlight on Hereditary Palmoplantar Keratodermas 59

Granular Parakeratosis 62

Acanthosis Nigricans: Group 1 62

Confluent and Reticulated Papillomatosis 64

Eczematous Dermatoses and Related Disorders 64

Atopic dermatitis: Group 1 65

Asteatotic Dermatitis 67

Dyshidrotic Eczema 67

Nummular Dermatitis: Group 1 68

Seborrheic Dermatitis Group 1 68

Stasis Dermatitis: Group 1 69

Contact Dermatitis: Group 1 70

Ichthyosis Vulgaris: Group 2 78

Spotlight on Hereditary Ichthyoses and Erythrokeratodermas 79

Keratosis Pilaris 79

Pigmentary Disorders 83

Vitiligo: Group 1 84

Erythema Dyschromicum Perstans 85

Pigmentary Demarcation Lines 87

Prurigo Pigmentosa 88

Spotlight on Incontinentia Pigmenti 88

Vesiculobullous Disorders 93

Acute Generalized Exanthematous Pustulosis: Group 2 93

Pemphigus Foliaceus 96

Pemphigus Vulgaris: Group 2 96

Immunoglobulin A Pemphigus 98

Paraneoplastic Pemphigus 99

Spotlight on Hailey-Hailey Disease and Darier Disease 100

Grover Disease 102

Bullous Pemphigoid: Group 2 102

Linear Immunoglobulin A Bullous Dermatosis 105

Mucous Membrane Pemphigoid 106

Epidermolysis Bullosa Acquisita 107

Dermatitis Herpetiformis: Group 2 107

Interface Dermatoses and Other Connective Tissue Disorders 110

Lichen Planus: Group 1 111

Lichenoid Drug Eruption: Group 2 114

Lichen Striatus: Group 2 114

Lichen Nitidus 115

Erythema Multiforme: Group 1 116

Stevens- Johnson Syndrome/Toxic Epidermal Necrolysis: Group 1 117

Fixed Drug Eruption: Group 2 119

Toxic Erythema of Chemotherapy 120

Graft- V ersus- Host Disease 120

Lupus Erythematosus: Group 1 121

Dermatomyositis: Group 1 127

Lichen Sclerosus: Group 2 129

Morphea: Group 2 131

Systemic Sclerosis: Group 2 134

Eosinophilic Fasciitis 135

Nephrogenic Systemic Fibrosis 136

Relapsing Polychondritis 136

Rheumatoid Arthritis 136

Adult-Onset Still Disease 137

Acquired Perforating Dermatosis 137

Spotlight on Pseudoxanthoma Elasticum 141

Panniculitis and Lipodystrophy 144

Erythema Nodosum: Group 2 144

Lipodermatosclerosis: Group 2 147

Spotlight on Hereditary Lipodystrophies 149

Urticaria and Other Erythemas 150

Urticaria: Group 1 150

Spotlight on Hereditary Angioedema 153

Erythema Annulare Centrifugum 154

Morbilliform Drug Eruption: Group 1 154

Drug Reaction with Eosinophilia and Systemic Symptoms 155

Polymorphic Eruption of Pregnancy 157

Kawasaki Disease 158

Livedo Reticularis, Purpura, and Other Vascular Disorders 158

Livedo Reticularis: Group 1 161

Livedoid Vasculopathy: Group 2 162

Contents Spotlight on Neonatal Purpura Fulminans 164

Malignant Atrophic Papulosis 164

Cholesterol Emboli 164

Calciphylaxis: Group 2 165

Pigmented Purpura: Group 2 168

Small Vessel Vasculitis: Group 1 169

Serum Sickness-Like Eruption 170

Immunoglobulin A Vasculitis 171

Urticarial Vasculitis 171

Erythema Elevatum Diutinum 172

Cryoglobulinemia 172

Anti neutrophil Cytoplasmic Antibody Vasculitis 174

Polyarteritis Nodosa: Group 2 176

Giant Cell Arteritis 177

Edema Blister 177

Lymphedema 178

Venous Ulcer 178

Arterial Ulcer 180

Diffuse Dermal Angiomatosis 180

Erythromelalgia 181

Neurocutaneous and Psychocutaneous Disorders 181

Prurigo Nodularis: Group 1 181

Lichen Simplex Chronicus: Group 2 183

Complex Regional Pain Syndrome 184

Spotlight on Familial Dysautonomia 185

Delusions of Parasitosis 186

Excoriation Disorder 186

Factitial Dermatitis: Group 2 187

Disorders of Sebaceous, Apocrine, and Eccrine Glands 188

Acne Vulgaris: Group 1 188

Hidradenitis Suppurativa: Group 2 193

Rosacea: Group 1 194

Periorificial Dermatitis: Group 1 196

Lupus Miliaris Disseminatus Faciei 197

Hyperhidrosis 197

Spotlight on Ectodermal Dysplasias 198

Miliaria 200

Disorders of the Hair and Nails 200

Alopecia Areata: Group 1 200

Trichotillomania 203

Androgenetic Alopecia 204

Traction Alopecia 205

Anagen Effluvium 205

Telogen Effluvium 205

Frontal Fibrosing Alopecia/Lichen Planopilaris 206

Central Centrifugal Cicatricial Alopecia 208

Acne Keloidalis 208

Dissecting Cellulitis of the Scalp 209

Hypertrichosis 210

Beau Lines: Group 2 211

Spotlight on Pachyonychia Congenita 213

Neutrophilic and Eosinophilic Dermatoses 215

Sweet Syndrome: Group 2 215

Neutrophilic Eccrine Hidradenitis 217

Recurrent Aphthous Stomatitis 217

Behçet Disease 219

Pyoderma Gangrenosum: Group 1 219

Spotlight on Syndromic Pyoderma Gangrenosum 222

Bowel- Associated Der matosis- Arthritis Syndr ome 222

Granuloma Faciale 223

Eosinophilic Pustular Folliculitis 223

Wells Syndrome 224

Hypereosinophilic Syndrome 225

Noninfectious Granulomas, Histiocytoses, and Xanthomas 225

Sarcoidosis: Group 2 226

Spotlight on Blau syndrome 230

Granuloma Annulare: Group 1 230

Necrobiosis Lipoidica: Group 2 232

Langerhans Cell Histiocytosis 233

Necrobiotic Xanthogranuloma 234

nXanthoma 236

Depositional Disorders, Porphyrias, and Nutritional Deficiencies 237

nScleromyxedema 240

nScleredema 240

nAmyloidosis 243

nGout 245

Spotlight on Lipoid Proteinosis 248

Porphyria Cutanea Tarda: Group 2 248

Zinc Deficiency 252

3. 3. Infections, Infestations, and Other Animal

Kingdom Encounters 265

Viral Diseases 265

Herpes Simplex: Group 1 265

Eczema Herpeticum: Group 1 272

Varicella: Group 1 272

Herpes Zoster: Group 1 273

Infectious Mononucleosis 274

Cytomegalovirus Infection 275

Rubeola, Rubella, and Roseola 277

Wart: Group 1 278

Spotlight on Epidermodysplasia Verruciformis 280

Molluscum Contagiosum: Group 1 280

Erythema Infectiosum 283

Coronavirus Disease 2019 283

nDengue 284

Hand-Foot-Mouth Disease: Group 2 284

Bacterial Diseases 285

Impetigo: Group 1 288

Staphylococcal Scalded Skin Syndrome 289

Scarlet Fever 290

Toxic Shock Syndrome 291

Cellulitis: Group 1 291

nErysipelas 292

Necrotizing Fasciitis 292

Bacterial Abscess 293

Spotlight on Chronic Granulomatous Disease 294

Bacterial Folliculitis 294

nParonychia 295

Pitted Keratolysis: Group 2 295

nErythrasma 296

nAnthrax 297

nActinomycosis 298

Septic Vasculitis and Infective

Endocarditis 298

Ecthyma Gangrenosum 300

nVibriosis 301

Cat Scratch Disease 303

Rocky Mountain Spotted Fever 303

Lyme Disease 304

nSyphilis 308

nTuberculosis 309

nLeprosy 313

Fungal Diseases 315

Tinea Versicolor: Group 1 315 n

Tinea Nigra 317

Piedra 318

Tinea: Group 1 318

Tinea Capitis 320

Onychomycosis: Group 1 321

Candidiasis: Group 1 322

Spotlight on Chronic Mucocutaneous Candidiasis 324

Blastomycosis, Chromoblastomycosis, and Paracoccidioidomycosis 325

Coccidioidomycosis 327

Histoplasmosis and Talaromycosis 327

Cryptococcosis 329

Lobomycosis 329

Sporotrichosis: Group 2 330

Angioinvasive Fungal Infection 331

Mycetoma 333

Protothecosis 333

Parasitic Diseases and Other Animal Kingdom Encounters 334

Leishmaniasis 334

Cutaneous Larva Migrans: Group 2 336

Spotlight on Hyper-Immunoglobulin E Syndromes 343

Scabies and Lice: Group 1 343

Arthropod Bites: Group 2 347

4. 4. Disorders Due to Physical Agents 353

Photodermatoses 353

Polymorphous Light Eruption: Group 2 353

Hydroa Vacciniforme 354

Chronic Actinic Dermatitis 355

Solar Urticaria 355

Spotlight on Xeroderma Pigmentosum 356

Photoallergic/Phototoxic Eruption: Group 2 358

Poikiloderma of Civatte: Group 2 359

Other Physical Agents 360

Erythema Ab Igne 363

Pernio 363

Spotlight on Sickle Cell Disease 364

Black Heel and Palm 364

Chondrodermatitis Nodularis Helicis: Group 2 365

5. 5. Neoplasms and Cysts 367

Epidermal Neoplasms 367

Seborrheic Keratosis: Group 1 367

Epidermal Nevus 369

Clear Cell Acanthoma 370

Basal Cell Carcinoma: Group 1 370

Spotlight on Basal Cell Nevus Syndrome 374

Porokeratosis: Group 2 375

Actinic Keratosis: Group 1 376

Squamous Cell Carcinoma: Group 1 377

Keratoacanthoma 381

Mammary Paget Disease and

Extramammary Paget Disease 381

Melanocytic Neoplasms 382

Lentigo Simplex: Group 1 382

Dermal Melanocytosis 385

Blue Nevus: Group 2 386

Nevocellular Nevus and Atypical Nevus: Group 1 387

Congenital Melanocytic Nevus 389

Nevus Spilus: Group 2 390

Halo Nevus 390

Spitz Nevus: Group 2 391

Melanoma: Group 1 393

Spotlight on Familial Atypical Multiple

Mole Melanoma Syndrome 398

Fibrous Neoplasms 399

Keloid: Group 1 399

Angiofibroma: Group 2 401

Spotlight on Tuberous Sclerosis 402

Dermatofibroma: Group 1 403

Dermatofibrosarcoma Protuberans 406

Atypical Fibroxanthoma 406

Epithelioid Sarcoma 406

Adipose Neoplasms 407

nHibernoma 409

nLipoma 409

Spotlight on Cowden Syndrome 411

Vascular Malformations and Neoplasms 412

Angiokeratoma: Group 2 412

Capillary Malformation: Group 2 413

Venous Malformation 415

Lymphatic Malformation 417

Arteriovenous Malformation 418

Hemangioma: Group 1 419

Spotlight on PHACE(S) Syndrome and

LUMBAR Syndrome 422

Pyogenic Granuloma: Group 2 423

Cherry Angioma 424

Tufted Angioma and Kaposiform Hemangioendothelioma 424

Kaposi Sarcoma: Group 2 426

nAngiosarcoma 428

Glomus Tumor and Glomuvenous Malformation 429

Neural Malformations and Neoplasms 430

Aplasia Cutis Congenita 431

nNeurofibroma 432

nSchwannoma 432

Spotlight on Neurofibromatosis: Group 2 434

nNeuroma 435

Granular Cell Tumor 436

Merkel Cell Carcinoma 437

Neoplasms of Sebaceous, Apocrine, and Eccrine Glands 439

Nevus Sebaceous: Group 2 439

Sebaceous Gland Hyperplasia: Group 1 440

Sebaceous Adenoma and Sebaceoma 441

Sebaceous Carcinoma 442

Spotlight on Muir-Torre Syndrome 443

Cylindroma and Spiradenoma 443

Syringocystadenoma Papilliferum and Hidradenoma Papilliferum 444

nHidradenoma 446

nPoroma 446

Syringoma: Group 2 446

Microcystic Adnexal Carcinoma 448

Mucinous Carcinoma 450

Neoplasms of the Hair and Nails 450

Nevus Comedonicus 452

nTrichoepithelioma 453

Spotlight on Birt-Hogg-Dubé Syndrome 455

nTricholemmoma 455

nPilomatricoma 457

nOnychomatricoma 458

Other Malformations and Neoplasms 459

Accessory Tragus 459

Rudimentary Supernumerary Digit 460 n

Leiomyoma 461

Spotlight on Hereditary Leiomyomatosis and Renal Cell Cancer 462

Becker Nevus: Group 2 462

Cysts and Pseudocysts 464

Epidermoid Cyst 464

Spotlight on Gardner Syndrome 467

Hidrocystoma 467

Digital Mucous Cyst 468

Hematolymphoid Neoplasms and Solid Organ Metastases 470

Cutaneous T- Cell Lymphoma: Group 1 471

Lymphomatoid Papulosis 472

Cutaneous B- Cell Lymphoma 476

Cutaneous Lymphoid Hyperplasia 476

Leukemia Cutis 478

Spotlight on Mastocytosis 480

Solid Organ Metastasis 481

6. 6. Medical Treatments 487

Immunosuppressants and Immunomodulators 487

Antihistamines and Related Drugs 497

Retinoids 497

Hormonal Drugs 500

Antimicrobials 501

Antineoplastics 511

Miscellaneous Drugs 523

7. 7. Physical Treatments 529

Phototherapy 529

Photodynamic Therapy 529

Radiation Therapy 531

Cryosurgery 532

Electrocautery and Electrosurgery 533

8. 8. Surgery 537

Surgical Anatomy 537

Preoperative Considerations 545

Anesthetics and Antiseptics 546

Surgical Instruments and Materials 549

Basic Surgical Procedures 557

Mohs Micrographic Surgery 558

Flaps and Grafts 561

Surgical Emergencies and Complications 566

Nail Unit Surgery 569

9. 9. Cosmetics 573

Cosmetics and Cosmeceuticals 573

Chemical and Mechanical Skin Resurfacing 574

Lasers 576

Botulinum Neurotoxins 578

Soft- Tissue Dermal Fillers 580

Body Contouring 582

Sclerotherapy 583

Hair Restoration 583

Appendix 1: Mucosal and Adnexal Disorders 587

Appendix 2: Dermatologic Signs of Internal

Malignancy 605

Appendix 3: Dermatologic Signs of Metabolic

Disorders and Pregnancy 609

Appendix 4: Dermatology Diagnostics 613

Appendix 5: Billing 637

Abbreviations 641

Index 649