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Progressive Symmetric Erythrokeratoderma (Progressive symmetric erythrokeratodermia, Symmetrical progressive erythrokeratodermia, Erythrokeratodermia figurata variabilis, Gottron’s syndrome, Darier-Gottron syndrome)

Are You Confident of the Diagnosis? What you should be alert for in the history The lesions usually appear soon after birth and progress during childhood. After puberty, the lesions may remain stable or regress partially. Characteristic findings on physical examination Progressive symmetric erythokeratoderm (PSEK) is characterized by well-demarcated hyperkeratotic plaques on erythematous bases symmetrically…


Are You Confident of the Diagnosis? Pellagra is classically described as the 4 D’s in order of symptoms starting: diarrhea (watery, but may contain pus or blood), dermatitis, dementia, death. Three 3 P’s also apply: photosensitive, painful, pruritic. Pellagra is the clinical manifestation of Vitamin B3 (niacin) deficiency. Early cutaneous findings, like many skin diseases,…


Are You Confident of the Diagnosis? Pruritus can be best defined as a sensation that leads to the desire to scratch. It is important to make a distinction between chronic and acute pruritus. All humans experience the acute form for a limited amount of time during the course of life, such as the itch related…
Hospital Medicine

Peripheral neuropathy

Peripheral neuropathies are syndromes, seen in association with a variety of anatomic or physical, metabolic, toxic, ischemic, nutritional, inflammatory (e.g., autoimmune, infectious), paraneoplastic, or inherited processes. They may be present as mononeuropathies, polyneuropathies, autonomic neuropathies, or polyneuropathies associated with autonomic neuropathies. Additionally, they may be further characterized by: Frequency of occurrence (common causes: diabetes, alcohol,…
Hospital Medicine

Mouth Ulcerations

Mouth Ulcerations I. Problem/Condition. Mouth ulcerations are common complaints in both hospitalized and non-hospitalized patients. Oral ulcers result from damage to the mucosa of the mouth, both the epithelium, and the lamina propria. When confronted by a patient with an oral ulcer, the key, besides treating any underlying discomfort, is to distinguish which represent underlying…
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