Page 91 – Hematology Advisor

DiGeorge Syndrome (deletion 22q11.2; Velo-Cardio-Facial Syndrome; thymic hypoplasia; CATCH 22)

Are You Confident of the Diagnosis? Characteristic findings on physical examination Deletion 22q11.2 is associated with a wide range of clinical findings. Congenital heart disease occurs in 76% of patients and primarily involves conotruncal malformations, such as tetralogy of Fallot, interrupted aortic arch, and truncus arteriosus. Characteristic facial features include angular facies; small, posteriorly rotated…

Disseminated Intravascular Coagulation (DIC, consumptive coagulopathy, purpura fulminans)

Are You Confident of the Diagnosis? What you should be alert for in the history Skin findings are usually the trigger for a dermatologic consultation in a patient with suspected disseminated intravascular coagulation (DIC), consumptive coagulopathy, or purpura fulminans. but may precede the clinical recognition of the underlying coagulopathy. The dermatologist should be aware of…

Diaper dermatitis (diaper or napkin dermatitis, erythema)

Are You Confident of the Diagnosis? What you should be alert for in the patient’s history Diapers –Disposable diapers: cellulose-core diapers, absorbent gelling material (AGM) diapers (extra-absorbent)—prevent irritant-based diaper dermatitis by reducing wetness –Dye vs dye-free diapers: Patients may experience allergic contact dermatitis from the dyes within the diaper. –Cloth diapers consist of cotton weave…

Dermatophytosis

Are You Confident of the Diagnosis? Dermatophytoses are superficial fungal infections that are typically limited to the upper layer of the skin. Dermatophytes subsist on keratin debris. At any one time 1 in 5 Americans is affected by a dermatophyte infection. Dermatophytes are divided into three groups. Anthropophilic dermatophytes are restricted to human hosts and…

Dermatofibroma (Fibrous histiocytoma)

Are You Confident of the Diagnosis? The diagnosis of dermatofibroma (DF), also referred to as fibrous histiocytoma, is made clinically and confirmed histologically if warranted. A patient history of a solitary, slow-growing cutaneous nodule on the extremities of young to middle-aged adults, often female, is consistent with DF. Usually these lesions are asymptomatic. Characteristic findings…

Dermatitis Herpetiformis (Duhring disease)

Are You Confident of the Diagnosis? What you should be alert for in the history Patients with dermatitis herpetiformis (DH) usually complain of weeks to months of intense pruritus that has a stinging or burning quality. Only about 30% to 40% of patients admit to gastrointestinal symptoms of celiac disease. When patients do complain of…

Dermal melanocytosis (previously known as Mongolian spot)

Are You Confident of the Diagnosis? Characteristic findings on physical examination These lesions are usually present at birth as blue-black macular lesions found overlying the lumbosacral area (Figure 1). The lesions can range in size from 5mm to 10cm or more. The pigment will not accentuate when observed with a Wood’s lamp. The lesions can…

Demodicidosis (Other acariasis, including chiggers and Demodex folliculorum or Trombicula infestation)

Are You Confident of the Diagnosis? Demodex mites are the most common human ectoparasite. They are normally found in the pilosebaceous glands, and their role in causing human disease is controversial. High numbers of mites as well as the presence of mites free in the dermis has been implicated to cause various clinical manifestations in…

Degos Disease (Kohlmeier Disease, Degos-Kohlmeier Disease, Malignant atrophic papulosis, benign atrophic papulosis, Malignant atrophic papulosis)

Are You Confident of the Diagnosis? Atrophic papulosis or Degos disease (DD) has 2 variants: 1) a more common, limited, cutaneous type, which can be referred to as benign atrophic papulosis (BAP) and 2) a severe systemic, fatal variant, which can be referred to as malignant atrophic papulosis (MAP). Most cases of eruptions with clinical…

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