Skin Disorders Guide

Erylherna nodosurn commonly presents as a tender erythematous plaque simulating an area of cellulitis. A location on the “interior lower leg, stability in size, a chronic course, and a lack of rapid response to antibiotic therapy should suggest the possibility of erythema nodosum rather than cellulitis.Patients with severe acne frequently develop tender inflamed cystic lesions. These are dome-shaped or slope-shouldered modules 1 to 3 cm in diameter. The distribution of lesions on the face and upper trunk is characteristic. Pustules and comedones always occur in association with acne cysts. Clinical differentiation between inflamed epidermoid cysts and acne cysts can be problematic. Acne and its therapy are discussed .

Nodular hemangiomas of either the strawberry or the cavernous type may be present at birth or may develop during the first few months of life. These red, cool, non tender lesions are easily recognized. Small lesions are best left untreated. Large lesions and those occurring around the nose, eyes, and mouth may be troublesome enough to require therapy. If therapy is necessary, either intralesionally injected or systemically administered steroids can be used. Laser therapy can also be considered, and recent reports suggest that systemic administration of interferon alfa may be particularly effective. When lesions are large, physicians should watch carefully for the possibility of disseminated intravascular coagulation resulting from platelet consumption within the lesion (Kasabach-Memtt syndrome) and for the possibility of surface necrosis with subsequent infection.