Urticarial vasculitis. 33-year-old female patient with distinct reduction of the az. 3 weeks of recurrent febrile attacks (CRP and SPA massively increased) and a distinct feeling of illness accompanied by a maculo-papular, moderately itchy exanthema. Histological: Evidence of a leukocytoclastic "small vessel vasculitis". The clinical differentiation from urticaria is possible by marking a persistent efflorescence for several days (marking test). Recurrent and changing arthritis.
Prurigo simplex subacuta:generalized, permanent clinical picture with disseminated, 0.2-0.5 cm large, severely itching, firm, red papules with central erosions or crusts; no disturbance of the general condition.
Acne, steroid acne. general view: For 4 months persistent, disseminated, 1-4 mm large, reddish papules in a 20-year-old patient who has been systemically treated with glucocorticoids for years because of an underlying vasculitic disease. dose at first manifestation of the skin changes: 40 mg prednisolone p.o.
Granuloma pyogenicum (pyogenic granuloma) Rapidly growing, bluish-black, soft, slightly bleeding tumour. Remark: the black colour was caused by thrombosis in the tumour parenchyma.
Syphilide, papular. multiple, acute, still increasing, generalized (trunk, extremities, palms, soles of feet affected), predominantly isolated, 0.1-0.3 cm in size, confluent in places (chest region), red or reddish-brownish, rough, slightly scaly papules or plaques. There is also fatigue, generalized, non-painful lymphadenopathy and positive syphilis serology. Typically, infestation of palms and soles of feet occurs.
Granuloma anulare disseminatum. 0.2-1.0 cm in size, distributed over the décolleté and arms, standing alone or confluent, bluish to brownish, often anular but also homogeneously filled, non-scaling or only slightly scaling, asymptomatic spots or flat papules and plaques with lupoid infiltrate.
Pityriasis rubra pilaris (adult type) Detail: chronic recurrent course for years with phases of marked improvement and extensive recurrence (fig. in a relapse period). Characteristic for the disease are the boundaries of the plaques drawn with a sharp pencil, resulting in the so-called "nappes claires", sharply recessed zones of unaffected skin in the case of extensive infestation.
scabies. severely itching, disseminated, pinhead to lentil-sized, centrally eroded papules on the trunk and extremities. granulomas appear periumbilical and inguinal.
Acne conglobata:symmetrically distributed, inflammatory papules and pustules with cystic transformation with a tendency to melt down, severe scarring and comedones. Mostly occurring in young people in the facial and upper body region. Chronic, often pressure-painful course.
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