Pityriasis rosea condition, treatments, and pictures for. A physical examination yielded twenty to thirty cm annular, uniformly hyperpigmented, slightly raisedpatches, some coalescing to form larger lesions, along bilateral anterior thighs, and across the upper back and upper abdomen. Numerous round and oval, hypopigmented, slightly scaling patches on the upper back. They are easier to see in darker skin and may be more obvious after tanning. Patients may occasionally provide selftaken digital images of skin lesions or.
Pityriasis versicolor is a disfiguring but otherwise harmless condition in which the organisms, usually malassezia globosa, develop filaments and cause damage in the stratum corneum through tissue invasion, dyspigmentation and minor inflammation. They occur when the body produces too little hypopigmentation or too much hyperpigmentation melanin. A previously healthy eightmonthold female chinese infant presented with hyperpigmented swirly patches over the abdomen and legs for the past two months. The lesions expand centrifugally and have central clearing leading to annular erythematous patches. Multiple oval to round polycyclic patches or thin plaques. Round or oval patches of hypopigmented lighter skin appear on the face, upper arms, neck, and upper middle of the body. Caused by fungi that are capable of colonizing cutaneous microbiome and superficially invading skin and mucosal sites. Tinea versicolor is characterized by a macule that may be hypopigmented or hyperpigmented and covered with brany scales, 2 predominantly on trunk and upper arms although other parts may be. Also known as tinea, this is a fungal skin infection that causes red or silver ringshaped patches of skin. Hypomelanosis of ito shows a familial tendency and is usually associated with systemic abnormalities. Hyperpigmented definition of hyperpigmented by the free.
In the right conditions, such as warm, oily, and moist skin, the yeast malassezia can overgrow and cause a rash consisting of tan, pink, brown, or. The most prominent symptom is round or oval patches on the childs skin, with mild scaling and itching, mostly found on the cheeks, arms, and upper trunk. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Jul 01, 2018 about half of cases will begin with a herald patch, a 2 to 4 cm lesion that occurs mainly on the trunk or neck. Nov 15, 2003 a localized hyperpigmented or irregularly pigmented lesion that is new in onset. Lichenoid and hyperpigmented patches with a welldemarcated border on the abdomen, the chest and the arms. It occurs primarily in pregnant women melasma gravidarum, or the mask of pregnancy and in women taking oral contraceptives. Treat same as atopic dermatitis, repigmentation can take months to years.
In many cases, the patient general may reveal a lesion or eruption of which the patient may be unaware. Racgp multiple hyperpigmented patches on a darkskinned. There appear to be two types of pityriasis rotunda. After puberty it often becomes darker and develops coarse dark hair. Racgp multiple hyperpigmented patches on a darkskinned patient.
Macular hyperpigmentation of cheeks, forehead, and upper lip. Two weeks before her visit, the infant developed a vesicular eruption within the hyperpigmented streaks, which the mother photographed figure 1. Tinea versicolor solitary 6mm dark brown round symmetric macule on upper back. Multiple 25mm hypopigmented, hyperpigmented, or tan round to oval macules on upper neck and back, upper chest, and arms with slight inducible scale on scraping macules. Mottling, or mottled skin, is another type of dyschromia in which changes in the blood vessels cause a patchy appearance. Disorders of hyperpigmentation and melanocytes clinical gate. Jan 20, 2012 the lesions most commonly affect the trunk, buttocks, thighs, and legs. Sometimes, the normal balances that keep fungi in check are upset, resulting in an infection. The second rash forms a christmas tree pattern on the back. Pv is found mainly on the seborrheic areas of the trunk, shoulders, upper aspects of the arms, and neck, but it may spread to the face, scalp, submammary areas, axillae, groin, skin folds, and. The lesions are usually 2 to 6 mm in size, but sometimes they are larger. Tinea versicolor, also known as pityriasis versicolor, is a common noncancerous benign skin condition caused by surface superficial infection with a yeast that commonly lives on the skin. Less common face more in kids, scalp, antecubital fossae, and groin. Pityriasis rotunda is a rare, chronic, asymptomatic dermatosis more common in darkercomplected individuals but occasionally encountered in caucasians that is characterized by strikingly circular or oval, widespread hypopigmented or hyperpigmented patches on the trunk, buttocks, and upper and lower extremities.
In lightskinned people the affected skin may appear darker than normal. A macule is a flat blemish or discoloration that measures less than 1 cm. Melanin is a pigment that creates hair, skin, and eye color and protects the skin by absorbing ultraviolet light. Manifestations hypopigmented, round oval, macular lesions to face, neck, upper trunk, upper arms, poorly defined borders, exacerbated by dry skin, absentmild itching. Healed hyperpigmented lesions often demonstrate pigmentary incontinence revealing dermal melanophages with little perivascular infiltration of inflammatory cells. Common superficial fungal infection of the skin, causing hypo or hyperpigmented versicolor, slightly scaly macules on the trunk, neck, and upper arms shortsleeved shirt distribution. The lesions are light pink in color but grow darker, turning a pale brown shade. The cause is unknown but is associated with eczema and a history of allergies. Multiple scaling hypo or hyperpigmented oval macules and patches on the upper trunk, proximal arms and occasionally neck and face. Oct 03, 2019 it starts with an acute eruption of bright red, flat to slightly raised oval spots usually on the trunk, thighs, and upper arms, but may also appear on the face, palms, soles of the feet, and. Recurring hyperpigmented patches page 2 dermatology. The herald patch is generally a singular, ovoid macule located on the trunk and can range from 2 to 10 cm in diameter. General dermatology site primary care dermatology society. Seborrheic areas and upper trunk and shoulderscommon.
Clinical assessment skin up to bates table 65 flashcards. Multiple pink, welldemarcated scaling macules becoming confluent on the neck, chest, flank, and arm. Differential diagnosis of round or discoid lesions. Pityriasis rotunda is a rare disease characterised by round or oval scaly, pigmented patches that mainly occur on the trunk, arms and legs. It starts with an acute eruption of bright red, flat to slightly raised oval spots usually on the trunk, thighs, and upper arms, but may also appear on the face, palms, soles of the feet, and. Hyperpigmentation dermatologic disorders merck manuals. Maculopapular rash is a compound word composed of the words macule and papule. Full text dermoscopic pattern of pityriasis versicolor ccid.
Melanin is a pigment that creates hair, skin, and eye color and protects the skin by. The typical initial skin lesion of pityriasis rosea pr, seen in more than 50% of patients, is a single pink macule or patch, which gradually expands over a few days to become an oval or round plaque that is 210 cm in diameter, generally with a central wrinkled salmoncolored area and a dark red peripheral zone. Pityriasis rosea causes, rash, herald patch, stages, treatment. Erythema chronicum migrans is the cutaneous hallmark of lyme disease. It is common among women taking birth control pills and exposure to sunlight can make the patches become darker and more prominent. There are many common skin disorders that require the clinical care of a physician or other health care professional. The scaly rash usually lasts between four to eight weeks and will often disappear without treatment. The second rash may form a christmas tree pattern on the back figure 2.
The lesions most commonly affect the trunk, buttocks, thighs, and legs. Hyperpigmentation of the face and neck primary care. Fnp ii midterm derm nurse practitioner fnp 2 with reyes. Pityriasis versicolor upper trunk the most common site oval shaped lesions but large confluent areas frequently develop fawn coloured in light skin, lighter colour in dark skin fine scale poikiloderma of civatte upper chest, neck and lateral cheeks, characteristically with sparing of the shaded area under the chin redbrown patches. Pediatric common skin disorders childrens national hospital. In patients with multiple suitable for macular nonpalpable lesions. Sep 09, 2012 a 55yearold ghanaian woman presented with a 1year history of worsening hyperpigmentation of the skin on the arms, chest, face and buttocks. Tinea versicolor tends to affect the trunk, neck, and upper arms. Extensive pityriasis alba is believed to be a primary, acquired hypopigmentation observed in females aged 1825 years of mixed ethnic origin.
Mar 16, 2020 the typical initial skin lesion of pityriasis rosea pr, seen in more than 50% of patients, is a single pink macule or patch, which gradually expands over a few days to become an oval or round plaque that is 210 cm in diameter, generally with a central wrinkled salmoncolored area and a dark red peripheral zone. Pityriasis rosea causes, rash, herald patch, stages. Tan hypopigmented and brown hyperpigmented patches. Dermatologic conditions flashcards by courtney kennison. It is characterized by large erythematous patches that may appear anywhere on the surface of the skin. Common superficial fungal infection of skin, causing hypo or hyperpigmented slightly scaly macules on trunk, neck, and upper arms shortsleeved shirt distribution easier to see in darker skin and may be more obvious after tanning. The main patch is usually followed after a few weeks by smaller pink or tan patches elsewhere on the body, usually the back, neck, arms and legs. Skin fungi live in the top layer of skin cells in moist areas of the body, such as between the toes or in the groin and diaper area. Common causes of hyperpigmentation include postinflammatory hyperpigmentation, melasma, solar lentigines, ephelides freckles, and cafeaulait macules. Melasma can often be seen in a butterfly pattern of dark patches on the nose, cheekbones, upper lip and sometimes on the forehead. Seborrheic areas upper trunk and shoulders are the most commonly affected locations.
Dyschromia refers to skin discolouration or patches of uneven colour resulting in temporary or permanent hyperpigmentation increase in pigment production and or hypopigmentation decrease in pigment production. The herald patch is followed weeks later by the development of a widespread rash, with smaller 0. These circular patches could get hyperpigmented when exposed to the sun. A localized hyperpigmented or irregularly pigmented lesion that is new in onset.
Segmental pigmentation disorder spd or mosaic hyperpigmentation, pigmentary mosaicism refers to a hyperpigmented or hypopigmented patch often with a sharp midline demarcation and a less distinct lateral border, commonly located on the trunk. Can appear as tan, flat, scaly plaques lighter skinmay look reddish or tan instead of white. What is pityriasis rotunda pityriasis rotunda is a rare disease characterised by round or oval scaly, pigmented patches that mainly occur on the trunk, arms and legs. Scaling annular plaques were also noted within her hairline.
Disorders of pigmentation present as skin that is discolored, blotchy, or darker or lighter than normal. Multiple scaling hypo or hyperpigmented oval macules and patches on the upper trunk, proximal arms and occasionally neck and face pityrisistinea versicolor what organism causes tinea versicolor. Shortterm dermoscopic monitoring is a safe and accepted approach to monitor. Closer examination of individual lesions reveals a fine white scale. It is clinically characterized by hyperpigmented or hypopigmented, round to oval lesions commonly found on the trunk, upper arms and face. Physical examination revealed oval and lichenoid patches with a well.
There are some topical creams that we use for patients with hyperpigmentation from a myriad of causes in the legs. This area, known as the herald patch, is usually located on the trunk, neck, or upper arms. A papule is as elevated lesion measuring less than 1 cm. Pityriasis versicolor pv or tinea versicolor is a fungal infection of the superficial layer of skin caused by malassezia yeasts. Sometimes, it takes up to 3 cycles of skin growth, 180 days each, for the hyperpigmentation to fade, if at all, without adjunctive therapy.
This rash usually appears on parts of the body that are exposed to sun, such as the arms. Adolescent female presents with discoloration on her back and. Congenital selfhealing reticulohistiocytosis presenting. Pityriasis tinea versicolor is a superficial mycosis that occurs as many oval or round patches with mild scales. Chloasma is a type of hyperpigmentation that can affect pregnant women, showing as.
Physical examination revealed a pebbly, hyperpigmented plaque with minimal scale on the extensor surfaces of both arms and smooth, hyperpigmented patches on her upper chest, face and buttocks. Combining the two terms, a maculopapular rash is as a smooth skin rash or redness covered by elevated bumps 1, 2, 3. Common pigmentation disorders american family physician. Adolescent female presents with discoloration on her back. In people with subacute cutaneous lupus scle, the rash looks like scaly red patches or ring shapes. Jan 15, 2009 common causes of hyperpigmentation include postinflammatory hyperpigmentation, melasma, solar lentigines, ephelides freckles, and cafeaulait macules. The characteristic lesions consist of patches of fine brown scaling that are found particularly on the upper trunk, neck, upper arms and abdomen. Maculopapular rash pictures, causes, diagnosis 2020. Type i is seen mainly in oriental and black patients older than 60 years and is often associated with internal disease or malignancy. Full text dermoscopic pattern of pityriasis versicolor. Fungal infections of the skin, hair, and nails introduction superficial fungal infections. The specific cause for this skin condition is not yet known and tends to get resolved on its own. Differential diagnosis of annular lesions american. In lighter skin, macules may look reddish or tan instead of pale.
Melasma consists of dark brown, sharply marginated, roughly symmetric patches of hyperpigmentation on the face usually on the forehead, temples, cheeks, upper lip, or nose. A 55yearold ghanaian woman presented with a 1year history of worsening hyperpigmentation of the skin on the arms, chest, face and buttocks. To identify the culprit of the fde, provocation tests can be done with the patch test being the most commonly used method as long as it is placed over a previously involved site and. General dermatology morphology primary care dermatology.