Dermatoses due to Physical Agents

Cornu cutaneum

History

           A 67-year-old man presented with an about 2.5 cm long cutaneous horn arise from a hyperkeratotic base situated in the middle part of the auricle of many years duration. Excisional biopsy has showed actinic keratosis at the base of the horn.
Hair Disorders

Trichotillomania

History

          A teenager girl presented with diffuse non-cicatricial alopecia involved the vertex and crown areas of the scalp with preservation of the frontal hair line. The condition started one year ago and the patient didn’t deny the habit of hair pulling under stressful conditions. The involved areas were not completely bald but the hairs were cut at different levels above the scalp surface.
Genodermatoses

Adenoma sebaceum

Adenoma sebaceum2

History

          A young adult female presented with skin-colored to brownish firm papules involved the cheeks and dorsal surface of the nose since early childhood without other manifestations of tuberous sclerosis.  The lesions on the left cheek had been treated with dermabrasion by a plastic surgeon with bad cosmetic outcome (atrophic scar).
Genodermatoses

Cutis Marmorata Telangiectatica Congenita

History

       A few-months-old female baby presented with unilateral lower limb hypoplasia, a network-like telengiectasia and focal atrophic scars since birth. The vascular anomaly is exaggerated on crying and cold exposure.

           Cutis Marmorata Telangiectatica Congenita (Congenital Phlebectasia, Van Lohuizen Syndrome) is characterized by the presence of a purplish, reticulated vascular network with a segmental distribution, usually involving the extremities. The mottling is pronounced and is made more distinct by crying, vigorous activity, and cold. Lesions usually improve by 2 years of age, but may remain stable. The condition occurs sporadically, and there is a female preponderance. Associated anomalies occur in more than half of patients. Common anomalies include varicosities, nevus flammeus, ulceration, macrocephaly, and hypoplasia and hypertrophy of soft tissue and bone.

Pigmentary Disorders

Vitiligo

History

         A 25-year-old male presented with depigmented patches with some repigmentation induced by treatment with topical psoralen solution associated with white hair in the involved area (lower half of the face) of 5 months duration.
Dermatoses due to Physical Agents

Perniosis of the ear

History

           A 25-year-old male after an exposure to severe bout of cold weather a painful dull red plaque developed on the ear’s rim. Within two days it was complicated by a superficial ulcer of the ear. On examination, the lesion was cold and tender. There was no other perniotic lesions elsewhere.
Pigmentary Disorders

Vitiligo of the lip

History

         Vitiligo may affect the vermilion zone of the lips as in the presented case of 17-year-old male patient who had linear depigmentation involved the entire length of the upper lip of one year duration. Other body areas were not involved. Vitiligo of the lips rarely responds to any therapeutic agent or procedure as the lips are devoid of hair follicles from where repigmentation usually starts.

Common, interesting and rare dermatoses presented in simple way by Dr. Nameer Al-Sudany