lupus erythematodes chronicus discoides: 13-year-old otherwise healthy patient. skin lesions since 6 months, gradually increasing, no photosensitivity. several, centrofacially localized, chronically stationary, touch-sensitive (slight pain when stroking with a wooden spatula), red, slightly scaly plaques. histology and DIF are typical for erythematodes. ANA and ENA negative.
Stage IIrosacea (rosacea papulopustulosa) Stage II rosacea with single, inflammatory papules and pustules on the forehead, nose, cheeks and chin in a 34-year-old female patient.
Basal cell carcinoma nodular: Irregularly configured, hardly painful, borderline red nodule (here the clinical suspicion of a basal cell carcinoma can be raised: nodular structure, shiny surface, telangiectasia); extensive decay of the tumor parenchyma in the center of the nodule.
acne conglobata. multiple comedones in the area of nose, cheeks and neck of a 53-year-old patient. irregular skin surface with pronounced scarring, predominantly deeply indented. approx. 2 cm large hyperpigmentation at the root of the nose.
DD: Rosacea erythematosa (in this case systemic lupus erythematosus): butterfly-like, symmetrical, variable redness and swelling of both cheek areas, excluding the perioral region.
Dermal melanocytic nevus: for 12 years persistent, 0.9 x 0.9 cm in diameter, soft, sharply defined, calotte-shaped skin-coloured lump on the forehead. 76 year old female patient: "In former times a brownish birthmark had been located at this site".
Anticonvulsant hypersensitivity syndrome. 4 weeks after the start of anticonvulsant therapy suddenly appeared, severe clinical picture with fever and exanthema, generalized lymphadenopathy, increase in liver values, leukocytosis with neutrophilia as well as eosinophilia. Uniform, scaling, painful facial redness.
sarcoidosis: anular or circine chronic sarcoidosis of the skin. existing for about 5 years. onset with papules the size of a pinhead (see middle of the cheek) with appositional growth and central healing. no detectable systemic involvement. findings: asymptomatic, brown to brown-red, borderline, centrally atrophic, little infiltrated, confluent lesions in the face in several places.
rosacea erythematosa: extensive and even redness of both cheeks. alternate course of redness. intensification with slight swelling due to cold/warm change or after alcohol consumption.
Elastoidosis cutanea nodularis et cystica. multiple, chronic inpatient, bds. periorbital localized, 0.2-0.4 cm large, blurred, soft, symptomless, black papules (comedones) and yellow papules (nodular elastosis). occurs in a 65-year-old man with chronic UV exposure over decades.
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