porphyria cutanea tarda. shown here is a detailed picture of the hand with an overall generalized, chronically dynamic infection on the integument of a 55-year-old man. on the right hand, hemorrhagic blisters appear a few hours old next to older, crusty erosions and flat atrophic, somewhat depigmented scars. the blisters appear after banal everyday traumas. the blistering is combined with hyperpigmentation in the face and neck (melanodermic porphyria brugsch) and hypertrichosis lanuginosa of the zygomatic arch.
Acrodermatitis continua suppurativa, typical clinical picture. psoriasis known for many years. picture of acrodermatitis continua suppurativa continuously progressive for 1 year.
erythema multiforme: detailed picture: suddenly appeared, for 4 days existing, itchy, disseminated exanthema with cocard-like plaques. the skin changes appeared shortly after the beginning of antibiotic therapy for urinary tract infection. here the finding on the back of the hand. s. isomorphism (koebner phenomenon).
Dermatomyositis (V-sign): Characteristic cutaneous symptoms of the backs of hands and fingers, almost proving the diagnosis of "collagenosis", with reddish-livid papules arranged in stripes, which merge to form flat plaques in the area of the end phalanges. Painful nail fold keratoses with parungual erythema are sometimes seen. Such papules arranged on the stretching side are also found in SLE and mixed collagenosis, rarely once in lichen planus.
Calcinosis dystrophica disseminated: reddened nodules with painful central ulcerations and visible calcifications; the changes occurred bilaterally in the underlying progressive systemic scleroderma.
hand-foot-mouth disease: since about1 week, painful, blisters, pustules and papules on hands and feet. single aphthous lesions on palate and lip mucosa. about 2 weeks before, unspecific flu-like prodromas.
Dermatitis herpetiformis. disseminated, mostly eroded papules (vesicles not detectable here!) on the elbow and the extensor side of the forearm. recurrent course for months with tormenting, prickly itching.
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