Comdylomata acuminata, here localized in the perianal skin area. multiple previous operations already performed. due to the liocalization in the skin area a clinical aspect arises which rather reminds of a pigmented verruca seborrhoica than of typical condylomata acuminata.
Circumscribed scleroderma. Atrophy of the right leg muscles, atrophy of the gluteal muscles on the right, shortening of the right leg (difference 2.0 cm) with consecutive secondary pelvic obliquity and scoliosis in a 19-year-old female patient. The right knee joint is massively restricted in its movement (extension/flexion 0/25/100).
Keratosis palmoplantaris diffusa circumscripta. 2-year-old boy has a chronic, congenital, smooth, evenly distributed, waxy thickened and yellowish discolored plaque formation of both palms. No symptoms. It is an autosomal dominant inherited palmoplantar cornification disorder.
Granulomatosis disciformis chronica et progressiva. single, hardly infiltrated, hyperpigmented, bizarrely limited focus (only palpable as a spot) in the area of the lower leg.
Melanoma, malignant, amelanotic. sharply defined, largely amelanotic flat knot. on the right side still distinct melanotic pigmentation. also at the upper rim delicate pigmentation.
Scleroderma ligamentous: for years slowly progressive, only moderately indurated ligamentous morphea in a 42-year-old woman; no movement restrictions of the joints; follicular structures within the lesions no longer detectable (inlet: mutual area with distinct keratosis follicularis).
Acne keloidalis nuchae, detail magnification: In the center a wide scar plate with a linear course to the left and right side (condition after several excisions) with papules and nodules localized at the margins.
Cheilitis actinica. crusty, partly erosive, inflammatory reaction of the lower lip in a 67-year-old man. condition after blistering due to intensive sun exposure. Dg.: condition after acute cheilitis actinica.
Pemphigoid, bullous. general view: state of healing. Disseminated, sharply defined or confluent, brownish or livid, postinflammatory hyperpigmentation in a 55-year-old female patient.
DD: Nail hematoma - here Melanonychia longitudinalis: Typical finding of a melanocytic pigmentation of the nail. Melanon grows in stripes, starting at the site of pigment formation (here the nail root is not visible) to the front. This finding is not observed in a nail hematoma. Note: the nail matrix shows a dark discoloration at the front edge of the cut (pigment is embedded in the nail matrix).
Tuberculosis cutis luposa: In the 30-year-old Turkish woman there is a large, irregularly limited, symptom-free, reddish-brownish, smooth plaque with a partly verrucous surface behind the right ear.
Kaposi's sarcoma endemic: chronically stationary, flat, along the skin cleavage lines localized, sharply defined, violet colored, scaly, rough, consistency increased, flatly elevated, painful plaque in a 60 year old woman; partially disseminated, blue-black papules and nodules are found on the inner side of the thigh
Basal cell carcinoma, nodular: centrally ulcerated nodular tumor with clear wall at the edge, ulcer not painful, characteristic for the diagnosis "basal cell carcinoma" is the raised, reflecting wall at the edge of the ulcer.
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