Paget's disease of the breast differential diagnosis: Difference between revisions

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Generalized seborrheic [[erythroderma]] in immunodeficient patients
Generalized seborrheic [[erythroderma]] in immunodeficient patients
|-
|-
! 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;" |
* 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;" | Multiple
| align="center" style="background:#F5F5F5;" | [[Lichenification|Lichenified]] and [[erythematous]], [[Itch|pruritic]] [[exudative]] [[Plaques|plaque]], and excoriations
| 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;" |
* Color of [[Plaques|plaque]] varies from yellow to reddish brown
* [[Plaque]] size can vary between 3X6 cm 6X10 cm areas.
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" |
* Markedly [[Hyperplasia|hyperplastic]] [[epidermis]]
* Irregular [[hyperkeratosis]] and parakeratosis
* Thick granular zone
* [[Acanthosis]]
| colspan="2" align="center" style="background:#F5F5F5;" |Risk factors include
* [[Emotional stress]]
* Dry weather
* [[Sweating]]
* [[Sexual dysfunction]]
* [[Sleep disturbances]]
* [[Depression]]
|-
! 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;" |
* Loss of function [[mutations]] in the [[Filaggrin|filaggrin gene (''FLG'')]]
* [[Autosomal dominant inheritance]] with [[incomplete penetrance]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | Multiple
| align="center" style="background:#F5F5F5;" |
* [[Xerosis]] and gray [[Ichthyosis|scaling]]
* [[Palmar]] hyperlinearity
* [[Keratosis pilaris]]
| align="center" style="background:#F5F5F5;" |
* Extensor surfaces of the extremities
* Scalp
* 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;" |
* Scales can vary from mild scaling to large, plate (armor)-like scales and thickening of the skin.
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" |
* Reduced keratohyalin [[granules]]
* [[Perinuclear space|Perinuclear]] [[keratin]] retractions in [[Granule cell|granular]] cells
* 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|Nummular dermatitis (discoid eczema)]]
| align="center" style="background:#F5F5F5;" | Unknown
| align="center" style="background:#F5F5F5;" | –
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | Multiple
| align="center" style="background:#F5F5F5;" |
* Symmetrical  coin-shaped [[Erythematous rash|erythematous]] [[plaques]]
* Erosions and excoriations
* Chronic lesions- central clearing leading to annular lesions
| align="center" style="background:#F5F5F5;" |
* Upper and lower extremities
* 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;" |
* Chronically [[lesions]] result into central clearing leading to annular lesions.
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" |
* Spongiosis
* [[Perivascular cell|Perivascular]] [[lymphocytic]] infiltrates, with [[eosinophils]] and occasional [[neutrophils]]
| colspan="2" align="center" style="background:#F5F5F5;" |
* Risk factors include
** Temperature changes (particularly winter)
** [[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]]<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;" | [[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;" | Multiple
| align="center" style="background:#F5F5F5;" |
* Classic triad
** Congenital ichthyosiform erythroderma
** Trichorrhexis invaginata
** [[Atopy|Allergic diseases]] with ↑ serum [[IgE]] levels
* Ichthyosis linearis circumflexa (ILC) - [[serpiginous]] [[plaques]] with double scale at the margins
| align="center" style="background:#F5F5F5;" |
* Diffuse pattern
* Axillae,
* Hair
* Inguinal folds
* Gluteal cleft
* Groin
* 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;" |
* 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
| align="center" style="background:#F5F5F5;" |Nl to ↑


([[Eosinophilia]])
| align="center" style="background:#F5F5F5;" | ↑
| align="center" style="background:#F5F5F5;" |
* Psoriasiform [[hyperplasia]]
* Reduced granular layer
* Dyskeratosis
* [[Dermal]] [[inflammatory]] infiltrate including [[neutrophils]] and [[eosinophils]]
| colspan="2" align="center" style="background:#F5F5F5;" |
* [[Atopic diseases]] including asthma, [[atopic dermatitis]] and [[allergic rhinitis]]
* Systemic and skin superinfections
* [[Failure to thrive]]
* Electrolyte imbalances, including [[hypernatremia]],[[dehydration]]
|-
! 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;" |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;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
! 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;" |Serum IgE
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated factors
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infection
! align="center" style="background:#DCDCDC;" |[[Molluscum contagiosum]]
| 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;" | Multiple
| align="center" style="background:#F5F5F5;" |
* Flesh-colored, dome-shaped [[papules]] with a central umbilication
* Lesions are 2-5mm in diameter
| 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;" | If [[molluscum contagiosum]] is acquired as [[sexually transmitted disease]], it involves, groin and genital region.
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" |
* [[Keratinocytes]] containing [[eosinophilic]] [[inclusion bodies]] (Henderson-Paterson bodies)
* [[H&E stain]] - inwards indentation of the [[epidermis]]
| colspan="2" align="center" style="background:#F5F5F5;" |
* Often [[asymptomatic]]
* Self resolve within 2 months
* Immunodeficient patients present with extensive and severe infections
* [[Molluscum contagiosum]]  lesions on the [[eyelid]] may lead to follicular or papillary [[conjunctivitis]]
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immunologic disorders
! 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;" | [[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;" | Multiple
| align="center" style="background:#F5F5F5;" |
* Excoriated [[papules]], [[plaques]] and [[vesicles]] arranged in a clustered fashion
* Symmetrical
* Erosions and excoriations
| align="center" style="background:#F5F5F5;" |
* Extensor surfaces including arms, knees, and buttocks.
| align="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;" | Nl
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" |
* [[Papillary]] micro-[[abscesses]]
* Sub-epidermal [[blisters]] containing [[neutrophils]], [[eosinophils]], and [[fibrin]]
* Sub-epidermal [[vacuolization]]
| colspan="2" align="center" style="background:#F5F5F5;" |
* Intermittent [[Itch|pruritic]] [[papules]] and [[vesicles]]
* [[Celiac disease]] with [[Villous folds|villous]] atrophy and [[Crypt (anatomy)|crypt]] [[hyperplasia]]
* Abdominal [[bloating]], pain, [[Diarrheal|diarrhea]], or [[constipation]]
|-
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immune deficiency
! 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;" |
* Mutation in the gene encoding for [[Wiskott-Aldrich syndrome]] protein (WASp) on the short arm of the [[X chromosome]]
* [[X linked inheritance|X-linked disorder]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | –
| align="center" style="background:#F5F5F5;" | Multiple
| align="center" style="background:#F5F5F5;" |
* Rash is clinically similar to [[atopic dermatitis]]
* [[Erythematous]] and [[Itch|pruritic]] lesions
* Lesions can bleed due to [[thrombocytopenia]]
* Cutaneous manifestations includes [[Petechia|petechiae]] and [[ecchymosis]]
| align="center" style="background:#F5F5F5;" | Rash can involve lesions located at the same areas of classical atopic dermatitis:


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;" | Infants can present with [[petechiae]], prolonged [[bleeding]] from [[umbilicus]] or circumcision,  [[purpura]],[[hematemesis]], [[melena]], [[epistaxis]], [[hematuria]]  or unusal bruising
| align="center" style="background:#F5F5F5;" |Nl to ↑
([[Eosinophilia]])
| 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]]
|-
! 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;" |
* 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;" | Multiple
| align="center" style="background:#F5F5F5;" |
* Papulopustular
* Severely [[Itch|pruritic]] eczematous rash
* [[Pustular rash|Pustular]] and may impetiginized
* [[Lichenification]] may occur
| align="center" style="background:#F5F5F5;" |
* Face and scalp
* Upper trunk and shoulders
* Buttocks
* 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;" |
* Characteristic coarse facies
* Increased alar width and broad [[nasal bridge]]
* High-arched oral palate
* Hyperextensible joints
| align="center" style="background:#F5F5F5;" |Nl to ↑
([[Eosinophilia]])
| align="center" style="background:#F5F5F5;" | ↑
| align="center" style="background:#F5F5F5;" |
* [[Eosinophil]]-rich infiltration around the hair follicles
| colspan="2" align="center" style="background:#F5F5F5;" |
* Cold [[abscesses]]
* [[Itch|Pruritic]] [[eczema]]
* [[Allergy|Allergic]] diseases
* Noneruption of permanent teeth
* Multiple bone [[Bone fracture|fractures]] and scoliosisis
* [[Peripheral T-cell lymphomas|Peripheral T-cell lymphoma]]
* [[Coronary artery]] [[aneurysms]]
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Malignancy
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mycosis fungoides]]
| 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;" | Multiple
| align="center" style="background:#F5F5F5;" |
* Non-pruritic patches and intensely [[Itch|pruritic]] [[plaques]]
* [[Comedones]], [[cysts]]
* [[Tumors]] of skin
* [[Erythematous]] [[macules]]
* [[Hypopigmented area|Hypopigmented]] patches
| align="center" style="background:#F5F5F5;" |
* Asymmetrical
* 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;" |
* [[Alopecia]]
* [[Acneiform eruption|Acneiform]] lesions
* [[Plaques]] size can vary between 2-20 cm
* [[Lymphadenopathy]]
* Children-  [[Hypopigmentation|hypopigmented]] patches most common
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" |
* Perifollicular infiltrates around the [[infundibulum]]
* [[Epidermis]] is spared or has minimal spongiosis
* Band-like [[Dermal|derma]]<nowiki/>l infiltrate of [[lymphocytes]] and and [[histiocytes]]
| colspan="2" align="center" style="background:#F5F5F5;" |
* Increased risk of :
** Severe viral and bacterial infections
** Secondary [[malignancies]], especially lymphomas
* Staging of [[Mycosis fungoides]] is based upon:
** Patches
** [[Plaques]]
** Skin tumors
** [[Lymphadenopathy]]
** [[Erythroderma]]
** [[Histology]]
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
! 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;" |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;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
! 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;" |Serum IgE
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated factors
|}
|}


Revision as of 21:01, 20 February 2019

Paget's disease of the breast Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]

Overview

Paget's disease of the breast must be differentiated from atopic dermatitis, eczema, psoriasis, malignant melanoma, Bowen's disease, basal cell carcinoma, and pagetoid dyskeratosis.[1][2]

Differential Diagnosis

Paget’s disease of the breast must be differentiated from other benign and malignant processes of nipple-areola complex such as:[1][2]

Category Diseases Etiology Inherited Acquired Clinical manifestations Para-clinical findings Associated factors
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[3] – + 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[4] – + 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
Psoriasis + + 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
Chronic eczema
– + Multiple Scalp, face, trunk, postauricular, diaper area and axilla + + – –
Nl Nl Risk factors include

Generalized seborrheic erythroderma in immunodeficient patients

References

  1. ↑ 1.0 1.1 Gaspari, Eleonora; Ricci, Aurora; Liberto, Valeria; Scarano, Angela Lia; Fornari, Maria; Simonetti, Giovanni (2013). "An Unusual Case of Mammary Paget's Disease Diagnosed Using Dynamic Contrast-Enhanced MRI". Case Reports in Radiology. 2013: 1–5. doi:10.1155/2013/206235. ISSN 2090-6862.
  2. ↑ 2.0 2.1 Lopes Filho, Lauro Lourival; Lopes, Ione Maria Ribeiro Soares; Lopes, Lauro Rodolpho Soares; Enokihara, Milvia M. S. S.; Michalany, Alexandre Osores; Matsunaga, Nobuo (2015). "Mammary and extramammary Paget's disease". Anais Brasileiros de Dermatologia. 90 (2): 225–231. doi:10.1590/abd1806-4841.20153189. ISSN 1806-4841.
  3. ↑ 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.
  4. ↑ Bains SN, Nash P, Fonacier L (October 2018). "Irritant Contact Dermatitis". Clin Rev Allergy Immunol. doi:10.1007/s12016-018-8713-0. PMID 30293200.
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