TONGUE, RED

Blue rubber bleb nevus syndrome Cowden’s syndrome – scrotal tongue JAAD 11:1127-1141, 1984 Down’s syndrome – scrotal tongue Rook p.3123, 1998, Sixth Edition Epidermal nevus syndrome Focal epithelial hyperplasia (Heck’s disease) BJD 96:375-380, 1977 Gardner’s syndrome – multiple fibrous tumors Goltz’s syndrome LAMB syndrome – myxoma JAAD 10:72-82, 1984 Maffucci’s syndrome – multiple hemangiomas BJD 99 (Suppl 16):31-33, 1978; J Bone Jt Surg 55A:1465-1479, 1973 Melkersson-Rosenthal syndrome – scrotal tongue; orofacial edema; edema of cheeks, forehead, eyelids, scalp Oral Surg Oral Med Oral Pathol 75:220-224, 1993; Oral Surg Oral Med Oral Pathol 74:610-619, 1992; JAAD 21:1263-1270, 1989 Multicentric reticulohistiocytosis JAAD 20:530-532,535-536, 1989; Oral Surg Oral Med Oral Pathol 65:721-725, 1988 Multiple mucosal neuroma syndrome (MEN IIB) (Gorlin’s syndrome) – skin-colored papules and nodules of lips, tongue, oral mucosa AD 139:1647-1652, 2003; JAAD 36:296-300, 1997; Oral Surg 51:516-523, 1981; J Pediatr 86:77-83, 1975; Am J Med 31:163-166, 1961 Neurofibromatosis Syndromes of the Head and Neck, p.395, 1990 Nevus sebaceous syndrome (Schimmelpenning-FeuersteinMims syndrome) – papillomas of tongue, gingival hyperplasia, thickened mucosa, anodontia, dysodontia JAAD 52:S62-64, 2005; Ped Derm 13:22-24, 1996; Int J Oral Maxillofac Surg 12:437-443, 1983 Oral-facial-digital syndrome type I (Papillon-Leage syndrome) – X-linked dominant; short upper lip, hypoplastic alanasi, hooked pug nose, hypertrophied labial frenulae, bifid or multilobed tongue with small tumors within clefts, clefting of hard and soft palate, teeth widely spaced, trident hand or brachydactyly, syndactyly, or polydactyly; hair dry and brittle, alopecic, numerous milia of face, ears, backs of hands, mental retardation Ped Derm 9:52-56, 1992 Oral-facial-digital syndrome type II – autosomal recessive; lobulated, bifid tongue; poly-, syn-and brachydactyly, cleft palate, broad bifid nasal tip Clin Genet 2:261-266, 1971 Oral-facial-digital syndrome type III – lobulated hamartomatous tongue, mental retardation, eye abnormalities, dental abnormalities, bifid uvula, skeletal anomalies Clin Genet 2:248-254, 1971 Pachyonychia congenita – scrotal tongue Sjögren’s syndrome – scrotal tongue Werdnig-Hoffmann spinal muscular atrophy

Lymphangioma

Dermatomyositis Graft vs. host reaction Scleroderma

Antibiotics Anticholinergics Chemotherapy Drug rash Interleukin-2 JAMA 258:1624-1629, 1987

Mouthwash Reverse smoking

Candidiasis – acute atrophic oral candidiasis Am J Med 30:28-33, 1984 Herpes simplex – herpetic geometric glossitis HIV infection – acute retroviral syndrome – glossitis Scarlet fever – white or red strawberry tongue JAAD 39:383-398, 1998 Syphilis – secondary, tertiary (syphilitic glossitis) – red, smooth tongue with loss of papillae Rook p.1252, 1998, Sixth Edition Toxic shock syndrome, either staphylococcal or streptococcal JAAD 39:383-398, 1998

Amyloidosis, primary systemic – red nodule AD 126:235-240, 1990

Acrodermatitis continua Crohn’s disease – glossitis Rook p.3120, 1998, Sixth Edition Eruptive lingual papillitis – tongue papules composed of fungiform papillae of tip and side of tongue BJD 150:299-303, 2004 Erythema multiforme major (Stevens-Johnson syndrome) Foliate papillitis Rook p.3110, 1998, Sixth Edition Impetigo herpetiformis Median rhomboid glossitis – possibly related to candidiasis BJD 93:399-405, 1975

Acrodermatitis enteropathica Celiac disease Rook p.3120, 1998, Sixth Edition Deficiency states

Folic acid deficiency – glossitis JAAD 12:914-917, 1985 Iron deficiency anemia QJM 34:145, 1965 Kwashiorkor Cutis 51:445-446, 1993

Plummer-Vinson syndrome AD 105:720, 1972 Protein deficiency – kwashiorkor Cutis 67:321-327, 2001; Cutis 51:445-446, 1993 Sprue Tryptophan Vitamin B complex deficiencies Vitamin B1 deficiency (thiamine) – beriberi; edema, burning red tongue, vesicles of oral mucosa Ghatan p.294, 2002, Second Edition Vitamin B6 Ped Derm 16:95-102, 1999; Clinics in Derm 17:457-461, 1999 Vitamin B12 (pernicious anemia, sprue) – enlarged red tongue Cutis 71:127-130, 2003; AD 122:896-899, 1986 Niacin (pellagra) – glossitis and glossodynia Nicotinic acid Pantothenic acid Pyridoxine Riboflavin (vitamin B2) – magenta glossitis JAAD 21:1-30, 1989 Thiamine Zinc deficiency

Fucosidosis – autosomal recessive; angiokeratoma corporis diffusum with tongue lesions Rook p.2639, 1998, Sixth Edition; J R Soc Med 87:707, 1994 Liver disease Malabsorption Ghatan p.95, 2002, Second Edition Moeller’s glossitis Ghatan p.95, 2002, Second Edition Uremic glossitis Ghatan p.177, 2002, Second Edition

Erythroplasia, oral – underside of tongue, floor of mouth, soft palate J Oral Pathol 12:11-29, 1983 Kaposi’s sarcoma

Hypertrichosis lanuginosa AD 106:84, 1972

Acrodermatitis continua of Hallopeau Geographic tongue (migratory glossitis)

Atopic dermatitis BJD 101:159-162, 1979 Diabetes mellitus Oral Surg Oral Med Oral Pathol 63:68-70, 1987 Down’s syndrome Clin Genet 50:317-320, 1996 Fetal hydantoin syndrome Ped Derm 6:130-133, 1989 Hereditary Am J Hum Genet 24:124-133, 1972 Lichen planus J Oral Med 29:58-59, 1974 Lithium carbonate J Am Acad Child Adolesc Psychiatry 38:1069-1070, 1999; Int J Derm 31:368-369, 1992 Oral contraceptives Br Dent J 171:94-96, 1991 Pustular bacterid of Andrews Med Cutan Ibero Lat Am 3:453-458, 1975 Pustular psoriasis AD 107:240-244, 1973 Reiter’s syndrome AD 107:240-244, 1973

Lichen planus, including atrophic lichen planus Plasma cell glossitis

Brook’s disease Dyskeratosis congenita

Glucagonoma syndrome JAAD 12:1032-1039, 1985 Hartnup’s disease – red and inflamed tongue Hereditary mucoepithelial dysplasia Ped Derm 11:133-138, 1994 Ichthyosis follicularis with atrichia and photophobia (IFAP) – beefy red tongue; collodion membrane and erythema at birth; ichthyosis, spiny (keratotic) follicular papules (generalized follicular keratoses), non-scarring alopecia, keratotic papules of elbows, knees, fingers, extensor surfaces, xerosis; punctate keratitis, photophobia; nail dystrophy, psychomotor delay, short stature; enamel dysplasia, red gingiva, angular stomatitis, atopy, lamellar scales, psoriasiform plaques, palmoplantar erythema Curr Prob Derm 14:71-116, 2002; JAAD 46:S156-158, 2002; BJD 142:157-162, 2000; Am J Med Genet 85:365-368, 1999; Ped Derm 12:195, 1995;AD 125:103-106, 1989; Dermatologica 177:341-347, 1988 Kawasaki’s disease – strawberry tongue; macular, morbilliform, urticarial, scarlatiniform, erythema multiforme-like, pustular, erythema marginatum-like exanthems; non-suppurative conjunctivitis; cheilitis; edematous hands with lamellar desquamation; myocarditis and coronary artery thrombosis and aneurysms; arthralgia, arthritis JAAD 39:383-398, 1998; Jpn J Allergol 16:178-222, 1967 Progressive symmetric erythrokeratoderma Recalcitrant erythematous desquamating (RED) syndrome – diffuse macular erythema, ocular and mucosal erythema, strawberry tongue, delayed desquamation in the setting of AIDS JAAD 39:383-398, 1998 Reiter’s syndrome Rook p.2767, 1998, Sixth Edition; Semin Arthritis Rheum 3:253-286, 1974 Riley-Day syndrome – strawberry tongue Rook p.3104, 1998, Sixth Edition Sjögren’s syndrome – red, smooth, dry Rook p.2572, 1998, Sixth Edition Xerostomia (i.e. Sjögren’s)

Vitamin A intoxication

Mouth breathing

Hemangioma Clin Nucl Med 11:113-114, 1986 Hereditary hemorrhagic telangiectasia Klippel-Trenaunay-Weber syndrome Temporal arteritis – glossitis; red tongue with blisters, desquamation, or necrosis BJD 76:299-308, 1964 Vascular malformation

TONGUE, SCROTAL Bazex-Dupre-Christol syndrome – congenital hypotrichosis, follicular atrophoderma, basal cell nevi and basal cell carcinomas, facial milia, hypohidrosis, pinched nose with hypoplastic alae, atopy with comedones, keratosis pilaris, joint hypermobility, scrotal tongue, hyperpigmentation of the forehead BJD 153:682-684, 2005; Dermatol Surg 26:152-154, 2000; Hautarzt 44:385-391, 1993 Cowden’s syndrome JAAD 11:1127-1141, 1984

Down’s syndrome Rook p.3123, 1998, Sixth Edition Tacrolimus, systemic HOPP syndrome – hypotrichosis, striate, reticulated pitted palmoplantar keratoderma, acro-osteolysis, psoriasiform plaques, lingua plicata, onychogryphosis, ventricular arrhythmias, periodontitis BJD 150:1032-1033, 2004; BJD 147:575-581, 2002 Melkersson-Rosenthal syndrome – scrotal tongue; orofacial edema; edema of cheeks, forehead, eyelids, scalp Oral Surg Oral Med Oral Pathol 75:220-224, 1993; Oral Surg Oral Med Oral Pathol 74:610-619, 1992; JAAD 21:1263-1270, 1989 Normal variant – 5% of general population Proc Finn Dent Soc 81:104-110, 1985 Pachyonychia congenita Psoriasis Rabson-Mendenhall syndrome – fissured tongue Ped Derm 19:267-270, 2002 Sjögren’s syndrome

JAAD 33:734-740, 1995

Allergic contact dermatitis Bullous pemphigoid Cicatricial pemphigoid (mucous membrane pemphigoid) – desquamative gingivitis AD 138:370-379, 2002; JAAD 43:571-591, 2000; J Periodontol 71:1620-1629, 2000 Dermatomyositis Ryumachi 39:836-840, 1999 Epidermolysis bullosa acquisita Graft vs. host disease Aust NZ J Med 16:239-240, 1986 Lichenoid reactions with antibodies to desmoplakins I and II – ulcers of hard palate and tongue JAAD 48:433-438, 2003 Linear IgA disease Lupus erythematosus – systemic lupus with antiphospholipid antibodies – tongue necrosis J Rheumatol 15:1281-1283, 1988; DLE, bullous LE Pemphigus vulgaris JAAD 38:860-861, 1998

Alendronate J Oral Pathol Med 29:514-518, 2000 Aspirin J Am Dent Assoc 91:130, 1975 Captopril AD 118:959, 1982 Ergotamine tartrate – tongue necrosis Schweiz Med Wochenschr 19:1152-1156, 2000; in temporal arteritis AD 130:261-262, 1994 Gold Inhalers for respiratory disease Br Dent J 182:350-352, 1997 Intra-arterial chemotherapy – 5-fluorouracil and cisplatin; tongue necrosis Otolaryngology 121:655-657, 1999 Methotrexate Nicorandil BJD 151:939-940, 2004; Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91:189-193, 2001 Stomatitis medicamentosa

Eugenol

AIDS – giant aphthous ulcers Aspergillosis Mycoses 37:209-215, 1994 Candida Chancriform pyoderma BJD 133:326-327, 1995 Coccidioidomycosis Cryptococcosis J Oral Maxillofac Surg 50:759-760, 1992 Cytomegalovirus Tyring p.187, 2002; Otolaryngol Head Neck Surg 110:463-464, 1994; CMV and HSV coinfected oral ulcers in HIV-positive patients Oral Surg Oral Med Oral Pathol Oral Radiol Endod 81:55-62, 1996 Exanthem subitum – human herpesvirus 6 – uvulopalatoglossal junctional ulcers J Clin Virol 17:83-90, 2000; Med J Malaysia 54:32-36, 1999 Geotrichosis (Geotrichum candidum) Oral Surg 73:726-728, 1992 Gonococcemia Br J Ven Dis 45:228-231, 1969 Hand, foot and mouth disease Oral Surg Oral Med Oral Pathol 41:333, 1976 Herpes simplex Tyring p.86, 2002; NEJM 329:1859-1860, 1993; in acute myelogenous leukemia JAAD 20:1125-1127, 1989; herpetic geometric glossitis Herpes zoster Tyring p.128, 2002; Rook p.3088-3089, 1998, Sixth Edition Histoplasmosis J Laryngol Otol 107:58-61, 1993; Oral Surg Oral Med Oral Pathol 70:631-636, 1990; Singapore Med J 31:286-288, 1990; Br J Oral Surg 16:234-240, 1979 HIV disease – major aphthae Oral Surg Oral Med Oral Pathol 71:68, 1991 Leishmaniasis Mycobacterium tuberculosis – primary lingual TB J Laryngol Otol 112:86-87, 1998; tuberculosis cutis orificialis (acute tuberculous ulcer) – tongue ulcer Rook p.1193, 1998, Sixth Edition; JAMA 235:2418, 1976; tongue ulcer as first clinical sign of asymptomatic pulmonary TB Gen Dent 48:458-461, 2000; J Infect 39:163-164, 1999; Cutis 60:201-202, 1997; Clin Inf Dis 19:200-202, 1994 Necrotizing bacterial infection Paracoccidioidomycosis J Clin Inf Dis 23:1026-1032, 1996 Parvovirus B19 Ann DV 123:735-738, 1996 Pyoderma gangrenosum Br J Oral Maxillofac surg 23:247-250, 1985 Streptococcal gingivostomatitis Syphilis – primary – chancre Rev Stomatol Chir Maxillofac 85:391-398, 1984; secondary, tertiary JAAD 49:749-751, 2003; Otolaryngol Head Neck Surg 119:399-402, 1998; tertiary Rook p.3091, 1998, Sixth Edition; Actas Dermatosifiliogr 69:145-148, 1978 Varicella Yaws Zygomycosis Lancet 336:282-284, 1991

Amyloidosis Langerhans cell histiocytosis

Crohn’s disease Eosinophilic ulcer of the lip, tongue, or buccal mucosa AD 137:815-820, 2001; Clin Exp Dermatol 22:154-156, 1997; Cutis 57:349-351, 1996; JAAD 33:734-740, 1995; Cutis 43:357-359, 1989 Erythema multiforme, including Stevens-Johnson syndrome Lethal midline granuloma Lymphocytoma Periadenitis mucosae necrotica recurrens (Sutton’s disease) AD 133:1161-1166, 1997 Pyoderma gangrenosum Br J Oral Maxillofac Surg 23:247-250, 1985 Sarcoid Rook p.2694, 1998, Sixth Edition Toxic epidermal necrolysis

Calciphylaxis – tongue necrosis J Oral Maxillofac Surg 55:193-196, 1997 Glycogen storage disease Neutropenia or agranulocytosis J Periodontol 58:51-55, 1987 Pellagra

Atypical histiocytic granuloma Foramen magnum meningioma – oral ulcers Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:609-611, 2000 Granular cell tumor Keratoacanthoma – multiple eruptive keratoacanthomas of Grzybowski Leukemia cutis Lymphoma – CD8 + cutaneous T-cell lymphoma Am J Dermatopathol 17:287-291, 1995; cutaneous T-cell lymphoma Oral Surg Oral Med Oral Pathol 57:267, 1984 Lymphomatoid papulosis Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:195-204, 2000 Metastases – small cell carcinoma; tongue necrosis Otolaryngology 1995:782-784 Monoclonal plasmacytic ulcerative stomatitis Oral Surg Oral Med Oral Pathol 75:483-487, 1993 Mucoepidermoid carcinoma Squamous cell carcinoma Rook p.3074-3076, 1998, Sixth Edition; JAAD 12:515, 1988

Paraneoplastic pemphigus AD 141:1285-1293, 2005

Aphthosis Dent Update 19:353, 1992 Hailey-Hailey disease Hydroa vacciniforme Ped Derm 21:555-557, 2004 Lichen planus JAAD 46:35-41, 2002; J Oral Maxillofac Surg 50:116-118, 1992 Median rhomboid glossitis BJD 93:399, 1975 Necrotizing sialometaplasia

Pityriasis rosea AD 121:14491451, 1985 Submucous fibrosis of tongue

Factitial JAAD 17:339-341, 1987

Behçet’s disease Tyring p.104, 2002 Hypereosinophilic syndrome AD 132:535-541, 1996; Ann Intern Med 121:648, 1994 Hyper-IgM syndrome (hypogammaglobulinemia with hyper-IgM) – X-linked with mutation in CD40 ligand gene; low IgA and IgG; sarcoid-like granulomas; multiple papulonodules of face, buttocks, arms Ped Derm 21:39-43, 2004; Bolognia p.845, 2003 Ped Derm 18:48-50, 2001 Lesch-Nyan syndrome Lipoid proteinosis JAAD 39:149-171, 1998 MAGIC syndrome AJM 79:65-71, 1985 Obstructive sleep apnea syndrome Br J Oral Maxillofac Surg 30:263-267, 1992 Reiter’s syndrome Rook p.2767-2768, 1998; Semin Arthritis Rheum 3:253-286, 1974 Xeroderma pigmentosum – squamous cell carcinoma JAAD 12:515-521, 1985

Chemical burn Congenital insensitivity to pain (analgesia congenita) Int J Paediatr Dent 6:117-122, 1996 Decubital lingual ulcers in myoclonus ASDC J Dent Child 65:474-477, 438, 1998 Electrical Embolization of cavernous hemangioma – tongue necrosis Epilepsy Intubation – pressure necrosis Anesthetis 24:136-137, 1975 Mechanical Neonatal sublingual traumatic ulceration (Riga-Fede disease) – natal or neonatal teeth with tongue ulceration Turk J Pediatr 41:113-116, 1999; Aust Dent J 42:225-227, 1997 Phenol burn Radiation glossitis Self-application of rubber band Br J Surg 62:956, 1975 Surgery Thermal Tongue biting Traumatic eosinophilic ulcer of the tongue

Arteriosclerosis – tongue necrosis Oral Surg Oral Med Oral Pathol 89:316-318, 2000 Necrotizing vasculitis in HIV Schweiz Monatsschr Zahnmed 105:54-62, 1995 Polyarteritis nodosa – tongue necrosis Acta Pediatr 84:1333-1336, 1995

Temporal arteritis (giant cell arteritis) – ulcer progressing to gangrene BJD 151:721-722, 2004; Oral Surg 74:582-586, 1992; Acta Med Scand 220:379-380, 1986; JAAD 6:1081-1088, 1982; BJD 76:299-308, 1964 Wegener’s granulomatosis Br J Clin Pract 46:268-269, 1992

TRANSIENT BLISTERS IN INFANTS Congenital self-healing mechanobullous dermatosis Perinatal trauma/iatrogenic injury Textbook of Neonatal Dermatology, p.148, 2001 Self-limited forms of epidermolysis bullosa (Bart’s syndrome) Sucking blisters Transient bullous dermolysis of the newborn Transient maternal autoimmune blistering dermatosis

TRICHOMEGALY Arch Ophthalmol 115:557-558, 1997; Principles and Practice of Ophthalmol, p.1852, 1994; AD 123:1599-1601, 1987 Acrodynia AIDS AIDS 17:1695-1696, 2003; J Eur Acad Dermatol Venereol 11:89-91, 1998; Arch Ophthalmol 115:557-558, 1997; JAAD 28:513, 1993; AD 123:1599-1601, 1987 AIDS and alopecia areata Dermatology 193:52-53, 1996 Allergic diseases – children Ped Derm 21:534-537, 2004 Anorexia nervosa Bimatoprost JAAD 51:S77-78, 2004 Cataract and spherocytosis Am J Ophthalmol 73:333-335, 1972 Coffin-Siris syndrome – autosomal recessive; hypertrichosis of eyelashes, eyebrows, and lumbosacral areas JAAD 48:161-179, 2003 Cone-rod congenital amaurosis associated with congenital hypertrichosis J Med Genet 26:504-510, 1989 Cornelia de Lange syndrome (Brachmann de Lange) – trichomegaly, synophrys, low hairline, low birth weight, mental deficiency, abnormal speech development, malformed upper limbs Am J Med Genet 47:940-946, 1993; J Pediatr Ophthalmol Strabismus 27:94-102, 1990; Syndromes of the Head and Neck; Gorlin; 1990;p.300-304 Cyclosporin A Am J Ophthalmol 109:293-294, 1990 Dermatomyositis Dermatology 205:305, 2002 Drug-induced – benoxaprofen, corticosteroids, cyclosporine Ann Ophthalmol 24:465-469, 1992; Nephrol Dial Transplant 11:1159-1161, 1996; diazoxide, interferon-α Lancet 359, 1107, March, 2002; J Interferon Cytokine Res 20:633-634, 2000; Eye 13:241-246, 1999; latanaprost Cutis 67:109-110, 2001; Clin and Exp Ophthalmol 29:272-273, 2001; minoxidil, penicillamine, phenytoin, psoralen, streptomycin, zidovudine Familial trichomegaly Arch Ophthalmol 115:1602-1603, 1997 Gefitinib (epidermal growth factor receptor inhibitor) BJD 151:1111-1112, 2004; Acta Oncol 42:345-346, 2003 Hermansky-Pudlak syndrome AD 135:774-780, 1999 Hypertrichosis lanuginose, congenital Rook p.2890-2891, 1998, Sixth Edition; J Genet Humaine 17:10-13, 1969 Hypothyroidism Interferon – interferon A NEJM 311:1259, 1984; interferon-α 2B Lancet 359:1107, 2002

Kabuki makeup syndrome J Pediatr 105:849-850, 1984 Liver disease, chronic Leishmaniasis – Kala-azar (Pitaluga’s sign) Rook p.2994, 1998, Sixth Edition Lupus erythematosus, systemic Clin Rheumatol 19:245-246, 2000 Malnutrition Metastatic adenocarcinoma Clin Exp Dermatol 20:237-239, 1995 Oliver-McFarlane syndrome – autosomal recessive; trichomegaly, pigmentatary degeneration of retina, mental and growth retardation, peripheral neuropathy, anterior pituitary deficiencies Br J Ophthalmol 87:119-120, 2003; Can J Ophthalmol 28:191-193, 1993; Genet Couns 2:115-118, 1991; Am J Med Genet 34:199-201, 1989; Am J Ophthalmol 101:490-491, 1986; Am J Dis Child 121:344-345, 1971; Arch Ophthalmol 74:169-171, 1965 Phenylketonuria Rook p.2812, 2994, 1998, Sixth Edition Porphyria Pregnancy Pretibial myxedema coma Vitreochorioretinal degeneration Ann Ophthalmol 8:811-815, 1976

TROPICAL FEVER AND RASH African trypanosomiasis African tick bite fever (Rickettsia africae) – hemorrhagic pustule, purpuric papules; transmitted by Amblyomma ticks – high fever, arthralgia, myalgia, fatigue, rash in 2-3 days, with eschar, maculopapules, vesicles, and pustules JAAD 48:S18-19, 2003 Alphavirus/flavivirus/bunyavirus American trypanosomiasis Arenaviruses (hemorrhagic fevers) – Lassa fever (rats and mice) (West Africa), Junin virus (Argentine pampas), Machupo virus (Bolivian savannas), Guanarito virus (Venezuela), Sabia virus (Southeast Brazil), Whitewater virus (California, New Mexico), Tacaribe virus complex (mice) – swelling of face and neck, oral hemorrhagic bullae, red eyes JAAD 49:979-1000, 2003 Argentinian hemorrhagic fever Tyring p.448, 2002 Boutonneuse fever – Rickettsia conorii; diffuse morbilliform eruption; petechiae; palms and soles involved JAAD 49:363-392, 2003; Marseilles fever, South African tick fever, Kenya tick typhus, Israeli tick typhus, and Indian tick typhus Brazilian purpuric fever – Haemophilus influenzae biogroup aegyptius strains J Infect Dis 171:209-212, 1995; Pediatr Infect Dis J 8:239-241, 1989 Brucellosis – morbilliform, scarlatiniform, disseminated papulonodular, bullous, hemorrhagic eruptions Cutis 63:25-27, 1999; AD 117:40-42, 1981 Bunyavirus hemorrhagic fever (Crimean Congo hemorrhagic fever, Rift Valley fever, Hantavirus) – ticks (Hyalomma genus) petechial eruption orally and on upper trunk JAAD 49:979-1000, 2003; Rook p.1083, 1998, Sixth Edition Chikungunya fever – morbilliform exanthem of trunk and limbs Chikungunya fever Tyring p.425,513, 2002 Congo Crimean hemorrhagic fever (Bunyavirus) – purpura Dengue fever (Flavivirus) – classic dengue fever; morbilliform or scarlatiniform eruption on day 3-4, then becomes petechial; joint and bone pain with severe backache JAAD 46:430-433, 2002; Tyring p.477, 2002; Dermatol Clinics 17:29-40, 1999; Inf Dis Clin NA 8:107, 1994; Bull Soc Pathol Exot 86:7-11, 1993;

exanthem with islands of sparing (‘white islands in a sea of red’) Clin Inf Dis 36:1004-1005,1074-1075, 2003; clinical differential diagnosis includes typhoid fever, leptospirosis, meningococcal disease, streptococcal disease, staph, rickettsial disease, malaria, arbovirus (chikungunya, o’nyon nyong fevers), Kawasaki’s disease Drug eruptions Ebola viral hemorrhagic fever – morbilliform rash MMWR 44:468-469, 1995 Epidemic typhus (Rickettsia prowazeki ) (body louse) – pink macules on sides of trunk, spreads centrifugally; flushed face with injected conjunctivae; then rash becomes deeper red, then purpuric; gangrene of finger, toes, genitalia, nose JAAD 2:359-373, 1980; transient red rash of trunk and face Clin Inf Dis 32:979-982, 2001; Brill-Zinsser disease – recrudescence of epidemic typhus Filoviruses – Marburg and Ebola virus; transient morbilliform rashes, purpura, red eyes JAAD 49:979-1000, 2003 Hantavirus – infected rodent waste; flulike prodrome; nausea, vomiting, shock, extensive ecchymoses; oliguria, pulmonary edema, coagulopathy AD 140:656, 2004 Hemorrhagic fevers HTLV-1 infection – infective dermatitis of scalp, eyelid margins, perinasal skin, retro-auricular areas, axillae, groin; generalized papular dermatitis Lancet 336:1345-1347, 1990; BJD 79:229-236, 1967; BJD 78:93-100, 1966 Infectious mononucleosis Izumi fever Kaposi’s varicelliform eruption Kenya tick typhus – R. conorii Kyasanur Forest disease (Flavivirus) Lassa fever (arenavirus) – morbilliform or petechial rash with conjunctivitis J Infect Dis 155:445-455, 1985 Leptospirosis Leishmaniasis – disseminated leishmaniasis JAAD 50:461-465, 2004; post-kala-azar dermal leishmaniasis – papules of cheeks, chin, ears, extensor forearms, buttocks, lower legs; in India, hypopigmented macules; nodules develop after years; tongue, palate, genitalia Rook p.1419-1420, 1998, Sixth Edition; JAAD 34:257-272, 1996; E Afr Med J 63:365-371, 1986 Leprosy – including erythema nodosum leprosum AD 111:1575-1580, 1975 Leptospirosis – morbilliform J Clin Inf Dis 21:1-8, 1995; truncal red morbilliform, urticarial, pretibial, purpuric desquamative exanthem Tyring p.436, 2002; pretibial fever or canicola fever – blotchy erythema of legs Rook p.1162, 1998, Sixth Edition Malaria Marburg virus (filovirus) – maculopapular-vesicular Tyring p.423, 2002; S Afr Med J 60:751-753, 1981 Marseilles fever – Rickettsia conorii Mayaro – arbovirus; Brazil and Trinidad Tyring p.399, 2002 Measles Mediterranean spotted fever – Rickettsia conorii; petechiae JAAD 49:363-392, 2003 Melioidosis Meningococcemia Monkeypox – exanthem indistinguishable from smallpox (papulovesiculopustular) J Infect Dis 156:293-298, 1987 Murine typhus – Rickettsia typhi and ELB agent – blanching macular or morbilliform rash MMWR 52:1224-1226, 2003; J Clin Inf Dis 21:991, 1995

Mycobacterium tuberculosis – lichen scrofulosorum Ped Derm 17:373-376, 2000; AD 124:1421-1426, 1988; Clin Exp Dermatol 1:391-394, 1976 North Asian tick-borne typhus – Rickettsia siberica Omsk hemorrhagic fever (Flavivirus) AD 140:656, 2004 Onchocerciasis – acute papular onchodermatitis – non-specific papular rash Rook p.1381, 1998, Sixth Edition; BJD 121:187-198, 1989 ONN – arbovirus; morbilliform eruption, fever, arthritis Tyring p.399, 2002 Parvovirus B19 Penicillium marneffei – generalized papular eruption Lancet 344:110-113, 1994; Mycoses 34:245-249, 1991 Picornavirus Skin and Allergy News 30:38,1999 Plague (Yersinia pestis) – macular, red, petechial or purpuric eruption (black death) West J Med 142:641-646, 1985 Q fever – Coxiella burnetii; red macules, morbilliform, papular, urticarial, and purpuric eruptions JAAD 49:363-392, 2003; Pediatr Inf Dis J 19:358, 2000 Queensland tick typhus – Rickettsia australis Rat bite fever Roseola Rubella Scarlet fever Schistosomiasis – schistosomal dermatitis – identical to swimmer’s itch Dermatol Clin 7:291-300, 1989; Schistosoma japonicum – Katayama fever – purpura, arthralgia, systemic symptoms Dermatol Clin 7:291-300, 1989 Scrub typhus (Rickettsia tsutsugamuchi ) (mites) – headache and conjunctivitis; eschar with black crust; generalized macular or morbilliform rash Clin Inf Dis 18:624, 1994; JAAD 2:359-373, 1980 Sepsis Sindbis – arbovirus; fever, rash, arthritis; Europe, Asia, Africa, Australia Tyring p.399, 2002 Smallpox – morbilliform exanthem as initial cutaneous manifestation Cutis 71:319-321, 2003 South American Arenaviruses (Junin, Machupo, Sabia, Guanarito) Stevens-Johnson syndrome Stroke Syphilis Systemic lupus erythematosus Tacaribe viruses – Argentinian, Bolivian and Venezuelan hemorrhagic fevers – erythema of face, neck, and thorax with petechiae Lancet 338:1033-1036, 1991; JAMA 273:194-196, 1994 Togavirus – morbilliform, maculopapular-petechial (Sindbis) Rook p.998, 1998, Sixth Edition; BJD 135:320-323, 1996; BJD 80:67-74, 1968; chickungunya Trans R Soc Trop Med Hyg 49:28-32, 1955; and O’nyong-nyong fever Trans R Soc Med Hyg 55:361-373, 1961; bunyavirus fevers with joint pains; Ross River virus – morbilliform eruption and polyarthritis in Australia and Fiji Med J Aust 159:159-162, 1993; Barmah Forest virus – similar to Ross River virus Med J Aust 152:463-466, 1990 Tick typhus (Boutonneuse fever, Kenya tick typhus, African and Indian tick typhus) (ixodid ticks) – small ulcer at site of tick bite (tache noire) – black necrotic center with red halo; pink morbilliform eruption of forearms, then generalizes, involving face, palms, and soles; may be hemorrhagic; recovery uneventful JAAD 2:359-373, 1980

Trench fever – Bartonella quintana; body louse; truncal morbilliform Bull WHO 35:155-164, 1996 Toxic epidermal necrolysis Trypanosomiasis – African; edema of face, hands, feet with transient red macular, morbilliform, petechial or urticarial dermatitis; circinate, annular of trunk Rook p.1407-1408, 1998, Sixth Edition; AD 131:1178, 1995; American – cutaneous inoculation (inoculation chagoma); edema with exanthems Rook p.1409-1410, 1998, Sixth Edition Typhoid and paratyphoid fevers Typhus fevers – epidemic and murine Varicella Viral hemorrhagic fevers – including Argentine hemorrhagic fever, Bolivian hemorrhagic fever, Lassa fever, Venezuelan hemorrhagic fever, Kyasanur Forest disease, Omsk hemorrhagic fever, yellow fever Viral insect-borne and hemorrhagic fevers Dermatol Clinics 17:29-40, 1999

Togavirus Sindbis fever Chikungunya fever O’nyong nyong fever Ross river fever Barmah forest fever

Flavivirus Dengue fever West Nile fever Kunjin fever

Arena virus Lassa fever Junin fever Machupo fever

Filovirus Marburg fever Ebola fever

Bunyavirus Bwamba fever Rift valley fever Crimea/Congo fever Hanta virus (hemorrhagic fever with renal syndrome (Hanta virus))

West Nile virus – Culex salinarius; punctuate (1-2-mm) red macular, papular, or morbilliform eruption of neck, trunk, arms, or legs in 20% of patients JAAD 51:820-823, 2004; JAAD 49:979-1000, 2003; Ann Intern Med 137:173-179, 2002; Ann DV 128:656-658, 2001; Lancet 358:261-264, 2001

Dermoid cyst J Pediatr Orthop 6:486-488, 1986 Encephalocoele Fibrous hamartoma of infancy AD 125:88-91, 1989 Infantile myofibromatosis Curr Prob Derm 14:41-70, 2002 Meningocoele

Condyloma acuminatum Cutis 24:203-206,209, 1979 Echinococcosis – dog tapeworm; hydatid cyst Rook p.1401, 1998, Sixth Edition Leprosy – giant histoid tumor Int J Lepr Other Mycobact Dis 60:274-276, 1992

Lobomycosis Molluscum contagiosum with cyst formation Tyring p.64, 2002; Acta DV 76:247-248, 1996; Am J Dermatopathol 17:414-416, 1995; Int J Dermatol 33:266-267, 1994; JAAD 19:912-914, 1988 Rhinosporidiosis – vascular nodules of nose, extending to pharynx or lips Mycopathologica 73:79-82, 1981

Amyloidosis – primary systemic amyloid with large tumefactions Rook p.2633, 1998, Sixth Edition Juvenile xanthogranuloma AD 140:231-236, 2004; Ann DV 122:678-681, 1995; Ped Derm 11:227-230, 1994; AD 124:1723-1724, 1988; Arch Pathol Lab Med 110:911-915, 1986; exophytic and endophytic Ped Derm 7:185-188, 1990; congenital giant xanthogranuloma Ped Derm 21:121-123, 2004 Langerhans cell histiocytosis AD 127:1237-1238, 1991; AD 126:1617-1620, 1990 Regressing atypical histiocytosis AD 126:1609-1616, 1990 Verruciform xanthoma – of gluteal crease Ped Derm 21:432-439, 2004

Pseudomalignant granuloma JAAD 3:292-298, 1980 Sarcoid – giant nodular form Rook p.2694, 1998, Sixth Edition; tumoral sarcoidosis Ann DV 122:783-785, 1995; giant parotomegaly Cutis 68:199-200, 2001 Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) JAAD 50:159-161, 2004

Pretibial myxedema of shoulders AD 122:85-88, 1986

Acrochordon Adenoid cystic carcinoma Cancer 43:1463-1473, 1979 Alveolar soft part sarcoma – tumor of muscle or fascial planes Clin Exp Dermatol 10:523-539, 1985 Angiofibroma – in tuberous sclerosis J Dermatol 24:132-134, 1997; AD 114:1843-1844, 1978 Angiomyxoma Cutis 21:673-674, 1978 Apocrine cystadenoma J Oral Maxillofac Surg 59:463-467, 2001 Apocrine gland carcinoma BJD 371-373, 2004; Am J Med 115:677-679, 2003 Apocrine hidrocystoma J Surg Oncol 27:146-151, 1984; AD 104:515-521, 1971 Basal cell carcinoma JAAD 52:149-151, 2005; Cutis 67:73-76, 2001; Plast Reconstr Surg 106:653-656, 2000; Ann Plast Surg 41:444-447, 1998; J Dermatol 24:317-321, 1997; Int J Dermatol 35:222-223, 1996; Cutis 58:289-292, 1996; Neuroradiology 38:575-577, 1996; JAAD 30:856-859, 1994; BJD 127:164-167, 1992; J Derm Surg Oncol 12:459-464, 1986; AD 113:316-319, 1977; with cerebral invasion Eur J Surg Oncol 27:510-511, 2001; polypoid Cutis 58:289-292, 1996; linear Int J Dermatol 33:284, 1994; fatal giant basal cell carcinoma J Derm Surg Oncol 13:556-557, 1987; AD 113:316-319, 1977; ‘horrifying basal cell carcinomas’ J Surg Oncol 5:431-463, 1973 Blue nevus J Eur Acad DV 13:144-146, 1999; JAAD 28:653-654, 1993; cellular blue nevus J Surg Oncol

74:278-281, 2000; Br J Plast Surg 51:410-411, 1998; giant alopecic nodule (cellular blue nevus) BJD 126:375-377, 1992 Café au lait macule Acta DV 79:496, 1999 Cephalohematoma Chondroid syringoma J Cutan Med Surg 3:115-117, 1998 Clear cell acanthoma (exophytic) BJD 143:1114-1115, 2000; JAAD 21:313-315, 1989; JAAD 17:513-514, 1987 Cutaneous horns Ann Plast Surg 43:674, 1999; Ann Plast Surg 39:654-655, 1997; Cutis 77-78, 1982; JAMA 210:2285, 1969 Cylindroma NEJM 351:2530, 2004 Dermal dendrocytoma of the face AD 126:689-690, 1990 Dermatofibroma BJD 143:655-657, 2000; Cutis 58:282-285, 1996; JAAD 30:714-718, 1994; combined dermatofibroma BJD 143:655-657, 2000; xanthomatous dermatofibroma Dermatology 190:67-71, 1995 Dermatomyofibroma – up to 8 cm; oval nodule or firm plaque of shoulders, axillae, upper arms, neck, or abdomen Clin Exp Dermatol 21:307-309, 1996 Dermatofibrosarcoma protuberans JAAD 53:76-83, 2005 Desmoid tumors – in Gardner’s syndrome; subcutaneous mass in subumbilical paramedian region Rook p.2368-2369, 1998, Sixth Edition; arise in thoracotomy scar Thoracic Cardiovasc Surg 40:300-302, 1992 Eccrine acrospiroma JAAD 23:663-668, 1990 Eccrine spiradenoma Int J Dermatol 37:221-223, 1998; Ann DV 104:485-487, 1977 Embryonal rhabdomyosarcoma Ped Derm 22:218-221, 2005 Enchondroma of the forefinger Hautarzt 36:168-169, 1985 Epidermoid cyst – multiloculated epidermoid cyst BJD 151:943-945, 2004; BJD 144:217-218, 2001; of the skull Plast Reconstr Surg 97:1246-1248, 1996 Extramammary Paget’s disease of the genital areas Dermatology 202:249-251, 2001 Fibrokeratoma – acquired digital fibrokeratoma JAAD 48:S67-68, 2003; acquired fibrokeratoma of the nail bed Dermatology 190:169-171, 1995 Fibrosarcoma, neonatal Soc Ped Derm Annual Meeting, July 2005; JAAD 50:S23-25, 2004 Giant cell fibroblastoma (variant of dermatofibrosarcoma protuberans) Textbook of Neonatal Dermatology, p.439, 2001 Giant pore and hair-shaft acanthoma Hautarzt 34:209-216, 1983 Hidradenocarcinoma Pathol Int 48:818-823, 1998 Histiocytic lymphoma (reticulum cell sarcoma) – gigantic tumor G Ital Dermatol Venereol 115:143-145, 1980 Hypertrophic scar – plantar giant nodule BJD 145:1005-1007, 2001 Kaposi’s sarcoma BJD 145:847-849, 2001; Cutis 68:50-52, 2001 Keloid Rook p.3020,3247, 1998, Sixth Edition; keloid following BCG vaccination Ped Derm 20:460, 2003 Keratoacanthoma Dermatology 200:317-319, 2000; Otolaryngol Head Neck Surg 93:112-116, 1985; Ann Plast Surg 3:172-176, 1979; in epidermolysis bullosa, recessive dystrophic Ped Derm 19:436-438, 2002; keratoacanthoma centrifugum marginatum Cutis 73:257-262, 2004; JAAD 48:282-285, 2003; JAAD 30:1-19, 1994; AD 111:1024-1026, 1975; Hautarzt 13:348-352, 1962 Leukemia – HTLV-1 (acute T-cell leukemia) JAAD 49:979-1000, 2003 Lipomas JAAD 28:266-268, 1993; Zentralbl Chir 91:1608-1611, 1966; diffuse lipomatosis AD 122:1298-1302, 1986 Liposarcoma – diffuse nodular infiltration of leg or buttock Rook p.2369, 1998, Sixth Edition; JAAD 38:815-819, 1998

Lymphoma – cutaneous T-cell lymphoma JAAD 122:135-136, 1986; Woringer-Kolopp disease AD 128:526-529, 1992; granulomatous slack skin BJD 142:353-357, 2000; T-cell lymphoma presenting as giant ulcer Clin Exp Dermatol 17:379-381, 1992; HTLV-1 lymphoma BJD 144:1244-1248, 2001; CD30 + T-cell lymphoma JAAD 48:S28-30, 2003; BJD 146:1091-1095, 2002; large cell B-cell lymphoma of the leg JAAD 49:223-228, 2003; B-cell lymphoblastic lymphoma Ped Derm 21:525-533, 2004; pyogenic lymphoma – primary cutaneous neutrophil-rich CD30+ anaplastic large-cell lymphoma BJD 148:580-586, 2003 Malignant clear cell hidradenoma – giant axillary metastasis Ann Plast Surg 45:102, 2000 Malignant eccrine spiradenoma of the scalp Derm Surg 25:45-48, 1999 Malignant peripheral nerve sheath tumors (neurofibrosarcoma) BJD 153:79-82, 2005; AD 137:908-913, 2001 Malignant proliferating trichilemmal tumor BJD 148:180-182, 2003 Malignant sacrococcygeal teratoma Am Surg 57:425-430, 1991 Melanocytic nevi – congenital Clin Exp Dermatol 25:7-11, 2000; J Pediatr 120:906-911, 1992; congenital neuroid melanocytic nevus AD 116:318-320, 1980; giant cerebriform intradermal nevus Ann Plast Surg 19:84-88, 1987; giant congenital melanocytic nevi with proliferative nodules AD 140:83-88, 2004; congenital dermal melanocytic nevus JAAD 49:732-735, 2003; AD 134:245-246, 1998; AD 127:1702-1704, 1991; congenital lentiginous dermal nevus Ann Plast Surg 43:546-550, 1999 Melanoma Curr Prob Derm 14:41-70, 2002; Eur J Surg Oncol 26:189-190, 2000; metastatic melanoma J Dermatol 21:442-446, 1994; Ann Plast Surg 27:583-585, 1991; melanoma arising in a giant cerebriform nevus AD 96:536-539, 1967; amelanotic melanoma AD 138:1245-1250, 2002 Merkel cell carcinoma Derm Surg 27:493-494, 2001; JAAD 24:827-831, 1991; Surv Ophthalmol 35:171-187, 1990; Cancer 57:178-182, 1986; AD 123:653-658, 1987; exophytic Merkel cell carcinoma Cutis 44:295-299, 1989 Metastases – breast cancer Rook p.3160, 1998, Sixth Edition; others Microcystic adnexal carcinoma Derm Surg 27:678-680, 2001 Mixed tumor of the face J Dermatol 23:369-371, 1996 Mucinous carcinoma of skin JAAD 36:323-326, 1997; scalp Clin Exp Dermatol 18:375-377, 1993 Mucocutaneous papillomatoses, giant AD 99:499-502, 1969 Neurofibrosarcoma Nevus comedonicus Przegl Dermatol 75:305-307, 1988 (Polish) Nevus lipomatosis superficialis J Dermatol 27:16-19, 2000; J Dermatol 15:543-545, 1988; J Derm Surg Oncol 9:279-281, 1983 Nevus sebaceus Ann Chir Infant 11:243-253, 1970 Nevus spilus Acta DV 75:327, 1995; AD 125:1284-1285, 1989 Osteoma – platelike cutaneous osteoma JAAD 16:481-484, 1987 Pilar cyst Plast Reconstr Surg 92:1207-1208, 1993 Pilomatrix carcinoma – multiple of head and neck Otolaryngol Head Neck Surg 109:543-547, 1993; JAAD 23:985-988, 1990 Pilomatrixoma Australas J Dermatol 42:120-123, 2001; Arch Otolaryngol 102:753-755, 1976; Arch Surg 111:86-87, 1976; multiple giant pilomatrixomas J Dermatol 27:276-279, 2000; pedunculated giant pilomatrixoma Ann Plast Surg 41:337-338, 1998 Plexiform fibrohistiocytic tumor of the soft tissues and bone Cesk Patol 36:106-110, 2000; Ann Plast Surg 38:306-307, 1997; Am J Surg Pathol 21:235-241, 1997 Porocarcinoma BJD 152:1051-1055, 2005

Porokeratosis BJD 141:936-938, 1999; Dermatology 189:78-80, 1994 Post-transplant lymphoproliferative disorder JAAD 52:S123-124, 2005 Proliferating trichilemmal tumor of the scalp J Dermatol 27:687-688, 2000; Ann Plast Surg 43:574-575, 1999; Mund Kiefer Gesechtschir 2:216-219, 1998; with malignant transformation Ann Plast Surg 41:314-316, 1998 Rhabdomyosarcoma Textbook of Neonatal Dermatology, p.441, 2001; Acta Oncol 35:494-495, 1996; Hautkr 53:887-892, 1978; congenital Ped Derm 20:335-338, 2003 Schwannoma Dur J Dermatol 9:493-495, 1999 Sebaceoma J Dermatol 21:367-369, 1994 Sebaceous gland carcinoma BJD 149:441-442, 2003; AD 137:1367-1372, 2001; Nippon Ganka Gakkai Zasshi 104:740-745, 2000 Seborrheic keratosis Plast Reconstr Surg 99:1466-1467, 1997; J Dermatol 12:341-343, 1985 Squamous cell carcinoma Derm Surg 28:268-273, 2002; JAAD 23:1174-1175, 1990; JAAD 10:372-378, 1984; vulvar Genital Skin Disorders, Fischer and Margesson, CV Mosby p.215, 1998; in epidermolysis bullosa, recessive dystrophic Ped Derm 19:436-438, 2002; of foot Caputo p.77, 2000 Syringocystadenoma papilliferum in a giant comedone Tokai J Exp Clin Med 11:47-50, 1986 Syringoma of the vulva BJD 141:374-375, 1999 Trichoblastoma – scalp Am J Dermatopathol 15:497-502, 1993 Trichoepithelioma Dermatology Online J 5:1, 1999; Am J Dermatopathol 14:155-160, 1992; perianal BJD 118:563-566, 1988; BJD 115:91-99, 1986; AD 120:797-798, 1984 Undifferentiated sarcoma – giant pendulous cystic lesion of cheek Soc Ped Derm Annual Meeting, July 2005 Verrucous carcinoma – Buschke-Lowenstein tumor Acta DV 79:253-254, 1999; Dermatol Monatsschr 175:247-250, 1989; Z Hautkr 58:1325-1327, 1983; epithelioma cuniculatum – of the foot NEJM 352:488, 2005; of the hand Ir J Med Sci 163:379-380, 1994; oral florid papillomatosis Cutis 21:207-211, 1978; of the lip BJD 151:727-729, 2004

Giant comedone BJD 133:662-663, 1995 Lipedema

Birt-Hogg-Dube syndrome – giant disfiguring lipomas JAAD 50:810-812, 2004 Blue rubber bleb nevus syndrome (Bean syndrome) – giant subcutaneous vascular malformations; blue lesions of skin and mucous membranes JAAD 50:S101-106, 2004; Cutis 62:97-98, 1998; Trans Pathol Soc 11:267, 1860 Congenital self-healing reticulohistiocytosis Ped Derm 6:28-32, 1989 Goltz’s syndrome (focal dermal hypoplasia) with giant papillomas BJD 133:997-999, 1995 Juvenile hyaline fibromatosis Caputo p.55, 2000 Maffucci’s syndrome Rook p.2295, 1998, Sixth Edition Neurofibromatosis – neurofibroma pendulans Zentralbl Chir 110:1193-1195, 1985; rugose and plexiform neurofibromas JAAD 52:191-195, 2005; Ann Plast Surg 45:442-445, 2000; elephantiasis neurofibromatosa – diffuse neurofibromatosis of

nerve trunks with overgrowth of skin and subcutaneous tissues yielding a wrinkled and pendulous appearance Rook p.380, 1998, Sixth Edition Olmsted syndrome – plantar squamous cell carcinoma BJD 145:685-686, 2001 Proteus syndrome – port wine stains, subcutaneous hemangiomas and lymphangiomas, lymphangioma circumscriptum, hemihypertrophy of the face, limbs, trunk; macrodactyly, cerebriform hypertrophy of palmar and/or plantar surfaces, macrocephaly; verrucous epidermal nevi, sebaceous nevi with hyper-or hypopigmentation Am J Med Genet 27:99-117, 1987; vascular nevi, soft subcutaneous masses; lipodystrophy, café au lait macules, linear and whorled macular pigmentation Pediatrics 76:984-989, 1985; Am J Med Genet 27:87-97, 1987; Eur J Pediatr 140:5-12, 198; Arch Fr Pediatr 47:441-444, 1990 (French) Rubinstein-Taybi syndrome – large keloids Cutis 57:346-348, 1996; broad thumb Ped Derm 11:21-25, 1994; mental deficiency, small head, broad thumbs and great toes, beaked nose, malformed low-set ears, capillary nevus of forehead, hypertrichosis of back and eyebrows, cardiac defects Am J Dis Child 105:588-608, 1963 Xeroderma pigmentosum – squamous cell carcinoma BJD 152:545-551, 2005

Angiosarcoma BJD 149:1273-1275, 2003; Caputo p.103, 2000 Glomus tumor JAAD 14:1083-1084, 1986; BJD 90:229-231, 1974; plaque type; patch-like JAAD 40:826-828, 1999 Hemangiomas, giant Textbook of Neonatal Dermatology, p.345, 2001; life-threatening AD 133:1567-1571, 1997; arising in port wine stain JAAD 31:675-676, 1994; multiple giant hemangiomas with heart failure Jpn Heart J 33:493-497, 1992; with diffuse neonatal hemangiomatosis J Dermatol 18:286-290, 1991; Clin Pediatr (Phila) 23:498-502, 1984; of scalp S Afr Med J 55:47-49, 1979 Hemangiopericytoma, congenital Ped Derm 10:267-270, 1993 Kassabach-Merritt syndrome Arch Dis Child 65:790-791, 1990 Lymphatic malformation Textbook of Neonatal Dermatology, p.328, 2001; lymphangiomatosis – fluctuant swellings Am J Surg Pathol 16:764-771, 1992 Pyogenic granuloma Rook p.2354-2355, 1998, Sixth Edition Retiform hemangioendothelioma – exophytic masses of scalp, arms, legs, and penis JAAD 38:143-175, 1998 Venous malformation – of scalp Zentralbl Neurochir 59:274-277, 1998

Allergic contact dermatitis – contact vulvitis NEJM 347:1412-1418, 2002 Anti-centromere antibodies – ulcers and gangrene of the extremities Br J Rheumatol 36:889-893, 1997 Antineutrophil cytoplasmic antibody syndrome – purpuric vasculitis, orogenital ulceration, fingertip necrosis, pyoderma gangrenosum-like ulcers BJD 134:924-928, 1996 Bowel-associated dermatitis arthritis syndrome (BADAS) Common variable immunodeficiency (Gottron-like papules) – granulomas presenting as acral red papules and plaques with

central scaling, scarring, atrophy, ulceration Cutis 52:221-222, 1993 Chronic granulomatous disease – necrotic ulcers; bacterial abscesses, perianal abscesses JAAD 36:899-907, 1997; AD 130:105-110, 1994; NEJM 317:687-694, 1987; AD 103:351-357, 1971 Dermatitis herpetiformis Dermatomyositis Cutis 62:89-93, 1998; AD 126:633-637, 1990; livedo reticularis and multiple ulcers J Eur Acad DV 11:48-50, 1998; calcinosis cutis with ulcers due to extrusion of calcium Rook p.2560, 1998, Sixth Edition Graft vs. host disease, chronic – deep ulcers of the buttocks and legs AD 138:924-934, 2002; Rook p.1920,2517, 1998, Sixth Edition; Arch Neurol 39:188-190, 1982 Leukocyte adhesion deficiency (beta 2 integrin deficiency) (congenital deficiency of leukocyte-adherence glycoproteins (CD11a (LFA-1), CD11b, CD11c, CD18)) – necrotic cutaneous abscesses, cellulitis, skin ulcerations (pyoderma gangrenosum-like ulcer), psoriasiform dermatitis, ulcerative stomatitis; gingivitis, periodontitis, septicemia, ulcerative stomatitis, pharyngitis, otitis, pneumonia, peritonitis BJD 139:1064-1067, 1998; J Pediatr 119:343-354, 1991; BJD 123:395-401, 1990; Annu Rev Med 38:175-194, 1987; J Infect Dis 152:668-689, 1985 Lupus erythematosus, systemic – malleolar, foot ulcers in areas of livedo or vasculitis Rook p.2474, 1998, Sixth Edition; J Rheumatol 6:204-209, 1979; generalized discoid lupus erythematosus; vasculitis – punched-out ulcers JAAD 48:311-340, 2003; Lupus 235-242, 1997; chronic pyoderma gangrenosum in hydralazine-induced LE NEJM 347:1412-1418, 2002; JAAD 10:379-384, 1984; DLE; palmar ulcer in SLE AD 135:845-850, 1999; lupus profundus Lupus 10:514-516, 2001 Pemphigus vulgaris – bilateral foot ulcers Clin Exp Dermatol 25:224-226, 2000 Rheumatoid arthritis – rheumatoid vasculitis Rheum Dis Clin North Am 16:445-461, 1990; JAAD 18:140-141, 1988; Semin Arthritis Rheum 14:280-286, 1985; ulcers JAAD 48:311-340, 2003; ulceration of sacrum; ulcerated rheumatoid nodule Br Med J iv:92-93, 1975; neutrophilic dermatitis Cutis 60:203-205, 1997 Scleroderma, systemic J Rheumatol 25:1540-1543, 1998; Semin Cutan Med Surg 17:48-54, 1998; ulcers over knuckles Rook p.2529, 1998, Sixth Edition; ulcers overlying calcinosis cutis Rook p.2530, 1998, Sixth Edition

Aplasia cutis congenita – without associated anomalies Textbook of Neonatal Dermatology, p.129, 2001; extensive scalp ulcer AD 141:554-556, 2005 Aplasia cutis congenita in surviving co-twins Ped Derm 18:511-515, 2001 Bart’s syndrome – congenital localized absence of skin with epidermolysis bullosa AD 93:293-304, 1966 Congenital absence of skin JAAD 2:203-206, 1980 Epidermal necrosis, intrauterine Textbook of Neonatal Dermatology, p.149, 2001; JAAD 38:712-715, 1998 Noma neonatorum – deep ulcers with bone loss, mutilation of nose, lips, intraorally, anus, genitalia; Pseudomonas, malnutrition, immunodeficiency Textbook of Neonatal Dermatology, p.149, 2001 Porokeratosis – congenital linear porokeratosis Ped Derm 12:318-322, 1995

Occult spinal dysraphism – aplasia cutis congenita-like lesion J Pediatr 96:687-689, 1980

Digital mucous cyst Hereditary sensory neuropathy – plantar ulcers Int J Dermatol 23:664-668, 1984 Hypesthesia following encephalitis Neurotrophic ulcers (mal perforans) (Charcot foot); including those associated with neuropathies – on metatarsal heads and heels with underlying sinsus tract to joint or subfascial abscess Rook p.2775, 1998, Sixth Edition Peripheral neuropathy – painless acral cutaneous ulcers with deformity Rook p.2775, 1998, Sixth Edition Reflex sympathetic dystrophy JAAD 35:843-845, 1996; AD 127:1541-1544, 1991 Syringomyelia – painless ulcer Ghatan p.26, 2002, Second Edition Trophic ulcers

Acrodystrophic neuropathy of Bureau and Barriere Alcoholism Amantadine-induced peripheral neuropathy Autonomic trophic disorder of the cerebral hemispheres Beta thalassemia major and intermedia Carpal tunnel syndrome Cauda equina syndrome Charcot-Marie-Tooth syndrome, type 2A Chronic obliterating arteriopathies Compression syndrome Congenital acro-osteolysis Congenital dyserythropoietic anemia type II Cutaneous-mucous trophic disorder Diabetes mellitus Distal hyperirrigation syndrome Familial amyloid polyneuropathy type I Giaccai syndrome Gilbert’s syndrome Hereditary sensory and autonomic neuropathies (HSAN), four types Hereditary spastic paraplegia with sensory neuropathy Klinefelter’s syndrome Klippel-Trenaunay syndrome Leprosy Lipomeningocoele Multiple sclerosis Multiple symmetric lipomatosis Neuroacropathy Peripheral arterial occlusive disease (Fontaine stage III, IV) Peripheral neuropathy Poliomyelitis Post-external fixation in quadriplegia Post-femoropopliteal shunt Post-keratoplasty Post-retroperitoneoscopic lumbar sympathectomy Post-spinal anesthesia Post-surgery of trigeminal nerve Post-varicose vein surgery Reflex sympathetic dystrophy Rheumatoid arthritis Spina bifida Split cord malformation with meningomyelocele (complex spina bifida) Syringomyelia Tabes dorsalis Trigeminal trophic syndrome (Wallenberg’s syndrome) Ulcerative-mutilating acropathy – inherited (Thavenard’s syndrome) or acquired (Bureau-Barriere syndrome) Venous insufficiency Werner’s syndrome with torpid trophic ulcera cruris

ULCERS

Coumarin necrosis – eschar and ulceration JAAD 47:766-769, 2002 Etretinate – ulcerated atrophic striae Cutis 65:327-328, 2000 Halogenoderma – iododerma JAAD 36:1014-1016, 1997 Heparin necrosis – eschar and ulceration JAAD 47:766-769, 2002 Hydralazine-induced SLE (pyoderma gangrenosum-like ulcers) JAAD 10:379-384, 1984; acute vasculitis after urography with iopamidol BJD 129:82-85, 1993 Hydroxyurea – ulcers of the lower legs and feet; atrophic, scaling, poikilodermatous patches with erosions on the backs of the hands, sides of the feet NEJM 347:1412-1418, 2002; JAAD 45:321-322, 2001; AD 135:818-820, 1999; Leuk Lymphoma 35:109-118, 1999 Ibuprofen vasculitis Interferon-α – necrotic ulcerations at injection site JAAD 46:611-616, 2002; J Eur Acad DV 13:141-143, 1999; JAAD 35:788-789, 1996; interferon-β-1b injection sites JAAD 37:553-558, 1997; JAAD 37:488-489, 1997; JAAD 34:365-367, 1996 Lotrisone atrophy with ulceration and extrusion of fat Methimazole, carbimazole – congenital skin defects Ann Intern Med 106:60-61, 1987 Methotrexate – ulcers in psoriatic plaques or normal skin JAAD 11:59-65, 1984 Pentazocine AD 132:1365-1370, 1996; JAAD 2:47-55, 1980 Vasculitis, drug-induced

Bromoderma NEJM 347:1412-1418, 2002 Calcium – exogenous calcinosis cutis – ulcerated plaque Ped Derm 15:27-30, 1998 Caustics Chemical burns

Acids and alkalis Cement (lime) (calcium hydroxide) Br Med J i:1250, 1978 Chromic acid Hydrofluoric acid Lime dust – necrosis with ulcers Contact Dermatitis 1:59, 1981 Phosphorus Phenol

Chrome ulcers of skin and nasal mucosae – tanners, electroplaters Rook p.770, 1998, Sixth Edition Sodium silicate – ulcerative contact dermatitis due to primary irritant contact dermatitis with contact urticaria AD 118:518-520, 1982

Abscess – bacterial, fungal, parasitic Actinomycosis Aeromonas hydrophila African histoplasmosis (Histoplasma duboisii) BJD 82:435-444, 1970 African trypanosomiasis AD 131:1178, 1995 AIDS – acute HIV infection; genital ulcers AD 134:1279-1284, 1998 Alternaria alternata (phaeohyphomycosis) Cutis 56:145-150, 1995; Clin Exp Dermatol 18:156-158, 1993; cellulitis with

ulceration JAAD 52:653-659, 2005; multiple ulcers BJD 145:484-486, 2001 Amebiasis NEJM 347:1412-1418, 2002; foot ulcer, perianal ulcer; Acanthamoeba Cutis 73:241-248, 2004; JAAD 42:351-354, 2000; J Clin Inf Dis 20:1207-1216, 1995; Entamoeba histolytica in neonate Textbook of Neonatal Dermatology, p.234, 2001 Animal bite Anthrax – eschar and ulceration; ulceroglandular disease JAAD 47:766-769, 2002 Arcanobacterium haemolyticum – trophic ulcer Clin Inf Dis 18:835-836, 1994 Aspergillosis NEJM 347:1412-1418, 2002; ulcers with satellite abscesses Ped Derm 19:439-444, 2002; eschar and ulceration JAAD 47:766-769, 2002; Aspergillus flavus, primary cutaneous – necrotic ulcer AD 141:1035-1040, 2005; primary cutaneous in neonate Ped Derm 8:253-255, 1991; Clin Exp Dermatol 15:446-450, 1990 Basidiobolomycosis Ped Derm 8:325-328, 1991 BCG vaccination site in Kawasaki’s disease – ulcerated plaque JAAD 37:303-304, 1997 Bilophila wadsworthia – cellulitis J Clin Inf Dis (Suppl 2):S88-93, 1997 Botryomycosis JAAD 24:393-396, 1991 Boutonneuse spotted fever – Rickettsia conorii ; black eschar (tache noir) JAAD 49:363-392, 2003 Brown recluse spider bite NEJM 347:1412-1418, 2002 Brucellosis (Brucella melitensis) Med Clin (Barc) 100:417-419, 1993 Calymmatobacterium granulomatis (Donovanosis) – buttock ulcer J Clin Inf Dis 25:24-32, 1997 Candida albicans Clin Exp Dermatol 14:295-297, 1989; granulomatous panniculitis with multiple leg ulcers JAAD 28:315-317, 1993 Carbuncle Rook p.1120, 1998, Sixth Edition Cat scratch disease – ulceroglandular disease JAAD 47:766-769, 2002 Chagas’ disease Chancriform pyoderma (Staphylococcus aureus) – ulcer with indurated base; eyelid, near mouth, genital AD 87:736-739, 1963 Chancroid – resembling granuloma inguinale; ulceroglandular disease JAAD 47:766-769, 2002; phagedenic chancroid Chromomycosis – feet, legs, arms, face, and neck AD 133:1027-1032, 1997; BJD 96:454-458, 1977; AD 104:476-485, 1971 Clostridium welchii Rook p.2188, 1998, Sixth Edition Clostridial gas gangrene – acute ulcer Rook p.2265, 1998, Sixth Edition Coccidioidomycosis JAAD 46:743-747, 2002; Rook p.1368, 1998, Sixth Edition; primary cutaneous coccidioidomycosis JAAD 49:944-949, 2003 Corynebacterium pseudodiphtheriticum – hand ulcer Clin Infect Dis 29:938-939, 1999 Corynebacterium pyogenes – epidemic leg ulcers in Thailand Int J Dermatol 21:407-409, 1987 Corynebacterium ulcerans – ulcer mimicking diphtheria with gray membrane and sweet smell Clin Inf Dis 33:1598-1600, 2001 Cowpox – papule progresses to vesicle to hemorrhagic vesicle to umbilicated pustule, then eschar with ulcer JAAD 44:1-14, 2001; BJD 133:598-607, 1994

Cryptococcosis – punched out ulcers with rolled edge NEJM 347:1412-1418, 2002; AD 124:429-434, 1988; AD 112:1734-1740, 1976; BJD 74:43-49, 1962; AD 77:210-215, 1958; verrucous ulcer Cutis 51:377-380, 1993; herpetiform ulcers JAAD 10:387-390, 1984; mimicking pyoderma gangrenosum JAAD 5:32-36, 1981 Curvularia lunata – sternal wound infection with chest ulcer J Clin Inf Dis 19:735-740, 1994; Arch Int Med 139:940-941, 1979 Cytomegalovirus Dermatology 200:189-195, 2000; JAAD 38:349-351, 1998; J Rheumatol 20:155-157, 1993; AD 127:396-398, 1991 Dematiacious fungal infections in organ transplant recipients – all lesions on extremities

Alternaria Bipolaris hawaiiensis Exophiala jeanselmei, E. spinifera, E. pisciphera, E. castellani Exserohilum rostratum Fonsacaea pedrosoi Phialophora parasitica

Diphtheria – superficial round ulcer with overhanging edge; gray adherent membrane; later edge thickens and becomes raised and rolled; umbilicus, post-auricular, groin, finger or toe web; heals with scarring; crusts around nose and mouth with faucial diphtheria Schweiz Rundsch Med Prax 87:1188-1190, 1998; Postgrad Med J 72:619-620, 1996; Am J Epidemiol 102:179-184, 1975 Dracunculosis – small papule or vesicle which ruptures; ulcer forms from which worm can be removed Dermatol Clinic 7:323-330, 1989 Escherichia coli Ecthyma – streptococcal or staphylococcal; ulcer with thick hard crust Rook p.1112, 1998, Sixth Edition; eschar and ulceration JAAD 47:766-769, 2002 Ecthyma gangrenosum – Pseudomonas aeruginosa, Candida, Aspergillus, Escherichia coli, Aeromonas hydrophila Filariasis – elephantiasis of the dorsum of the foot with ulceration Caputo p.162, 2000 Fusarium solanae Rev Soc Bras Med Trop 30:323-328, 1997 (Spanish); Sabouradis 17:219-223, 1979 Glanders – Pseudomonas mallei – cellulitis which ulcerates with purulent foul-smelling discharge, regional lymphatics become abscesses; nasal and palatal necrosis and destruction; metastatic papules, pustules, bullae over joints and face, then ulcerate; deep abscesses with sinus tracts occur; polyarthritis, meningitis, pneumonia; eschar and ulceration; ulceroglandular JAAD 47:766-769, 2002; Rook p.1146-1147, 1998, Sixth Edition Gram-negative web space infection Granuloma inguinale – papule or nodule breaks down to form ulcer with overhanging edge; deep extension may occur; or serpiginous extension with vegetative hyperplasia; pubis, genitalia, perineum; extragenital lesions of nose and lips, or extremities JAAD 11:433-437, 1984 Herpes simplex NEJM 347:1412-1418, 2002; Tyring p.86-87, 2002; AD 132:1157-1158, 1996; JAMA 241:592-594, 1979; neonatal HSV – widespread erosions Tyring p.89, 2002; J Pediatr 101:958-960, 1982; congenital absence of skin J Pediatr 101:958-960, 1982; ulceroglandular disease JAAD 47:766-769, 2002 Herpes zoster – chronic ulcerating acyclovir-resistant varicella zoster Scand J Infect Dis 27:623-625, 1995 Histoplasmosis AD 132:341-346, 1996; JAAD 29:311-313, 1993; Medicine 60:361-373, 1990; Cutis 43:535-538, 1989; punched out ulcers Arch Derm Syphilol 56:715-739, 1947

Impetigo Insect bites – eschar and ulceration JAAD 47:766-769, 2002 Kerion Leishmaniasis JAAD 51:S125-128, 2004; Clin Inf Dis 33:815,897-898, 2001; Clin Inf Dis 32:1304-1312, 2001; Trans R Soc Trop Med Hyg 81:606, 1987; Cutis 38:198-199, 1986; mucocutaneous leishmaniasis J Emerg Med 20:353-356, 2001; AD 134:193-198, 1998; J Clin Inf Dis 22:1-13, 1996; kala-azar – Leishmania donovani – pedal edema; primary ulcer; hyperpigmented skin of face, hands, feet abdomen Rook p.1419, 1998, Sixth Edition; leishmaniasis recidivans – crusted ulcer Clin Inf Dis 33:1076-1079, 2001; eschar and ulceration JAAD 47:766-769, 2002 Leprosy (Mycobacterium leprae) – lepromatous leprosy Int J Dermatol 29:156-157, 1990; plantar ulcers due to involvement of common peroneal and posterior tibial nerve leading to foot drop Indian J Lepr 71:437-450, 1999; neurotrophic ulcers Rook p.2265, 1998, Sixth Edition; Lucio’s phenomenon – generalized ulcers AD 135:983-988, 1999; Rook p.1227, 1998, Sixth Edition; eschar and ulceration JAAD 47:766-769, 2002; painless ulcers JAAD 48:958-961, 2003; immune reconstitution inflammatory syndrome (IRIS) in HIV disease – ulcerated plaque AD 140:997-1000, 2004; tender ulcerations of buttocks and legs AD 116:201-204, 1980 Lobomycosis Lymphogranuloma venereum – ulceroglandular disease JAAD 47:766-769, 2002 Meleney’s synergistic gangrene Rook p.2265,2266, 1998, Sixth Edition Melioidosis – Burkholderia pseudomallei ; septic arthritis, abscesses, ulcers Clin Inf Dis 31:981-986, 2000; ulceroglandular disease JAAD 47:766-769, 2002; ulcerative vegetative plaque Cutis 72:310-312, 2003 Meningococcemia – necrotic purpura with ulcerations Pediatrics 60:104-106, 1977 Milker’s nodule – eschar and ulceration JAAD 47:766-769, 2002 Mosquito bite hypersensitivity syndrome in Epstein-Barr virus-associated natural killer cell leukemia/lymphoma – clear or hemorrhagic bullae with necrosis, ulceration and scar formation JAAD 45:569-578, 2001 Mucormycosis Clin Inf Dis 19:67-76, 1994; JAAD 21:1232-1234, 1989; eschar and ulceration JAAD 47:766-769, 2002 Mycetoma Mycobacterium avium-intracellulare BJD 142:789-793, 2000; BJD 136:260-263, 1997; Clin Inf Dis 19:263-273, 1994; JAAD 19:492-495, 1988; ecthyma-like ulcer AD 126:1108-1110, 1990 Mycobacterium chelonae Clin Inf Dis 19:263-273, 1994; AD 129:1190-1191, 1193, 1993; post-surgical wound infection J Infect Dis 143:533-542, 1981 Mycobacterium fortuitum Clin Inf Dis 19:263-273, 1994; post-surgical wound infection J Infect Dis 143:533-542, 1981 Mycobacterium haemophilum – necrotic ulcer Clin Inf Dis 33-330-337, 2001; Rook p.1213, 1998, Sixth Edition; Clin Inf Dis 19:263-273, 1994; J Infection 23:303-306, 1991; inguinal ulcer AD 138:229-230, 2002 Mycobacterium kansasii JAAD 36:497-499, 1997; Clin Inf Dis 19:263-273, 1994; swollen fingers with ulcers JAAD 45:620-624, 2001 Mycobacterium marinum – ecthyma-like ulcers Clin Inf Dis 19:263-273, 1994; ulcers mimicking M. ulcerans Med J Austral ii:434-437, 1973 Mycobacterium scrofulaceum Clin Inf Dis 20:549-556, 1995; Clin Inf Dis 19:263-273, 1994

ULCERS

Mycobacterium tuberculosis NEJM 347:1412-1418, 2002; Ned Tidjschr Geneeskd 145:1523-1524, 2001; tuberculous ulcer JAAD 19:1067-1072, 1988; chancre, primary inoculation; scrofuloderma (ulceroglandular disease) JAAD 47:766-769, 2002; BJD 134:350-352, 1996; miliary tuberculosis; large crops of vesicles, vesicles become necrotic to form ulcers Practitioner 222:390-393, 1979; Am J Med 56:459-505, 1974; AD 99:64-69, 1969; tuberculous gumma Cutis 66:277-279, 2000; malacoplakia of tuberculous origin – scalp ulcer JAAD 18:577-579, 1988; erythema induratum; papulonecrotic tuberculid Ped Derm 15:450-455, 1998; Ped Derm 7:191-195, 1990; ulcer of the nose Ann DV 110:731-732, 1983; phagedenic tuberculous ulcers Int J Dermatol 9:283-289, 1970; lupus vulgaris; starts as red-brown plaque; ulcerative and mutilating forms, vegetating forms – ulcerate, areas of necrosis, invasion of mucous membranes with destruction of cartilage (lupus vorax; head, neck, around nose, extremities, trunk Int J Dermatol 26:578-581, 1987; Acta Tuberc Scand 39 (Suppl 49):1-137, 1960; eschar and ulceration JAAD 47:766-769, 2002 Mycobacterium ulcerans (Buruli ulcer) NEJM 348:1065-1066, 2003; Lancet 354:1013-1018, 1999; Med Trop (Mars) 57:83-90, 1997 (French); Med Trop (Mars) 55:363-373, 1995; Aust J Dermatol 26:67-73, 1985; Pathology 17:594-600, 1985 Myiasis, erosive AD 117:59-60, 1981 Necrotizing fasciitis – painless ulcer Ghatan p.26, 2002, Second Edition Nocardiosis AD 130:243-248, 1994; Nocardia brasiliensis J Inf Dis 134:286-289, 1976 North American blastomycosis Clin Inf Dis 22 (suppl 2) S102-111, 1996; ulceration of the lip Rook p.3135, 1998, Sixth Edition Orf – eschar and ulceration JAAD 47:766-769, 2002 Osteomyelitis – leg ulcer overlying osteomyelitis Rook p.2265, 1998, Sixth Edition Paracoccidioidomycosis – near mouth, anus, or genitalia J Clin Inf Dis 23:1026-1032, 1996; ulceration of the lip Rook p.3135, 1998, Sixth Edition Pasteurella multocida (P. haemolytica, P. pneumotropica and P. ureae) – cellulitis with ulceration with hemorrhagic purulent discharge with sinus tracts Medicine 63:133-144, 1984 Penicillium marneffei NEJM 347:1412-1418, 2002; Clin Inf Dis 18:246-247, 1994 Perirectal abscess Phaeohyphomycosis – inoculation phaeohyphomycosis AD 137:815-820, 2001 Plague – eschar and ulceration; ulceroglandular JAAD 47:766-769, 2002 Portuguese man-of-war stings Prevotella species J Clin Inf Dis (Suppl 2):S88-93, 1997 Progressive symmetric gangrene (DIC) Protothecosis JAAD 32:758-764, 1995; AD 125:1249-1252, 1989; red plaque with pustules and ulcers BJD 146:688-693, 2002 Pseudomonas – interdigital web space infection; periumbilical pustules with necrotic ulcers; extensive necrosis in neutropenic patients JAAD 11:781-786, 1984; AD 97:312-318, 1968; Pseudomonas sepsis – bullae which rupture to yield necrotic ulcers (ecthyma gangrenosum) – eschar and ulceration JAAD 47:766-769, 2002; Ped Derm 4:18-20, 1987; Medicine 64:115-133, 1985 Pyoderma Pythiosis (Pythium insidiosum) (alga) – cellulitis, infarcts, ulcers JAAD 52:1062-1068, 2005 Rat bite fever – eschar and ulceration JAAD 47:766-769, 2002

Rickettsial pox – eschar and ulceration JAAD 47:766-769, 2002 Scedosporium apiospermum – ulcer of hand JAAD 39:498-500, 1998 Schistosomiasis Derm Clinics 17:151-185, 1999 Scopulariopsis brevicaulis Scorpion stings Rook p.2265, 1998, Sixth Edition Scrofuloderma Ped Derm 18:328-331, 2001 Scrub typhus – punched out ulcer with adherent crust, then morbilliform eruption Clin Inf Dis 18:624, 1994; JAAD 2:359-373, 1980; eschar and ulceration JAAD 47:766-769, 2002 Serratia marcescens JAAD 25:565, 1991 Snake bites Rook p.2265, 1998, Sixth Edition Sparganosis – Spirometra proliferum Derm Clinics 17:151-185, 1999 Spiders – necrotic arachnidism – brown recluse spider, wolf spider, sac spider, jumping spider, fishing spider, hobo spider, green lynx spider JAAD 44:561-573, 2001; Int Surg 46:24-28, 1966; eschar and ulceration JAAD 47:766-769, 2002 Sporotrichosis – finger ulcer Cutis 69:371-374, 2002; mimicking pyoderma gangrenosum NEJM 347:1412-1418, 2002; Derm Clinics 17:151-185, 1999; AD 122:691-694, 1986 Stonefish sting Staphylococcal adenitis – ulceroglandular disease JAAD 47:766-769, 2002 Streptococcal adenitis – ulceroglandular disease JAAD 47:766-769, 2002 Streptococcus pneumoniae Clin Inf Dis 21:697-698, 1995; necrotizing fasciitis Acta Chir Belg 98:102-106, 1998; JAAD 20:774-781, 1989; Surgery 92:765-770, 1982; group B streptococcal disease – foot ulcers, decubitus ulcers Clin Inf Dis 33:556-561, 2001 Subcutaneous phaeohyphomycosis – Exophiala jeanselmei; finger ulcer BJD 150:597-598, 2004 Syphilis – primary (chancre), secondary (noduloulcerative syphilis, lues maligna) AD 113:1027-1028, 1030-1031, 1997; BJD 136:946-948, 1997; Cutis 45:119-122, 1990; Jarisch-Herxheimer reaction – reactivation of primary chancre Acta DV 76:91-92, 1996; tertiary – gumma Rook p.1251, 1998, Sixth Edition; tabes dorsalis – painless neurotrophic ulcer of weight bearing regions of sole Arch Neurol 42:606-613, 1985; syphilitic aortic aneurysm eroding through the sternum Dur M Cardiothorac Surg 10:922-924, 1996 Tick bites – especially soft ticks JAAD 49:363-392, 2003 Tick typhus (Boutonneuse fever, Kenya tick typhus, African and Indian tick typhus) (ixodid ticks) – small ulcer at site of tick bite (tache noire) – black necrotic center with red halo; pink morbilliform eruption of forearms, then generalizes, involving face, palms, and soles; may be hemorrhagic; recovery uneventful JAAD 2:359-373, 1980; eschar and ulceration JAAD 47:766-769, 2002 Trichophyton rubrum in AIDS JAAD 34:1090-1091, 1996 Trichosporosis, neonatal – cellulitis evolving into necrotic ulcer Textbook of Neonatal Dermatology, p.147, 2001 Tropical phagedenic ulcer – Corynebacterium pyogenes – fusiform bacilli; eschar and ulceration JAAD 47:766-769, 2002 Tularemia – Francisella tularensis – punched-out painful ulcer with raised ragged edges and necrotic base with regional lymphadenopathy, lymphadenitis, or nodular lymphangitis (ulceroglandular disease) JAAD 47:766-769, 2002; Clin Inf Dis 33:573-576, 2001; Cutis 63:49-51, 1999; eschar and ulceration; scalp ulcer with lymphadenopathy AD 140:1531-1536, 2004 Typhoid fever J Trop Med Hyg 97:298-299, 1994

Ulcers with regional adenopathy – anthrax, ecthyma, Pasteurella multocida infection, sporotrichosis, cat scratch disease, plague, glanders, lymphogranuloma venereum, tularemia JAAD 49:363-392, 2003 Varicella – congenital varicella syndrome – linear and unilateral ulceration and scarring; congenital absence of skin; maternal varicella in the last trimester J Infect Dis 7:77-78, 1983 Veldt sore – desert sore Vibrio extorquens JAAD 9:262-8, 1983 Vibrio haemolyticum Vibrio vulnificus sepsis JAAD 24:397-403, 1991; J Infect Dis 149:558-564, 1984 Wound infection Yaws Rook p.2265, 1998, Sixth Edition; Clin Dermatol 8:157-165, 1990 Yersinia enterocolitica J Clin Inf Dis 21:223-224, 1995 Zygomycosis NEJM 347:1412-1418, 2002; neonatal – cellulitis evolving into necrotic ulcer Textbook of Neonatal Dermatology, p.147, 2001

Amyloidosis – familial amyloid polyneuropathy – atrophic scars and poorly healed ulcers BJD 152:250-257, 2005 Eosinophilic granuloma Langerhans cell histiocytosis NEJM 347:1412-1418, 2002; axillary, vulvar ulcers AD 137:1241-1246, 2001; extensive paravertebral skin ulcers BJD 145:137-140, 2001 Mucinosis, primary cutaneous

Crohn’s disease – local extension, fissures, metastatic Crohn’s disease – post-auricular ulcer NEJM 347:1412-1418, 2002; JAAD 36:986-988, 1996; AD 129:1607-1612, 1993; AD 126:645-648, 1990; JAAD 10:33-38, 1984; peristomal ulcers Cytophagic histiocytic panniculitis J Eur Acad DV 10:267-268, 1998; AD 121:910-913, 1985 Dermatitis gangrenosum infantum – multiple necrotic ulcers complicating varicella, seborrheic dermatitis, etc BJD 75:206-211, 1963 Edematous scarring vasculitic panniculitis – hydroa vacciniforme-like lesions with vesicles, deep ulcers, varicelliform scars JAAD 32:37-44, 1995 Hidradenitis suppurativa Inflammatory bowel disease – fissures Kikuchi’s histiocytic necrotizing lymphadenitis JAAD 36:342-346, 1997 Malacoplakia JAAD 34:325-332, 1996 Malignant pyoderma – head and neck variant of pyoderma gangrenosum Eur J Dermatol 11:595-596, 2001; AD 122:295-302, 1986; JAAD 13:1021-1025, 1985 Panniculitis Pyoderma gangrenosum NEJM 347:1412-1418, 2002; Dermatology 195:50-51, 1997; J Derm Surg Oncol 20:833-836, 1994; JAAD 18:559-568, 1988; pyoderma gangrenosum with C7 deficiency JAAD 27:356-359, 1992; scalp ulcers and destruction of the calvarium BJD 5:32-36, 1995; peristomal pyoderma gangrenosum BJD 143:1248-1260, 2000; associations with Crohn’s disease, ulcerative colitis, arthritis, HIV infection, sarcoid, hereditary hypogammaglobulinemia JAAD 53:273-283, 2005

Pyoderma sinifica pustulans (fox den disease) Pyoderma vegetans – crusted hyperplastic plaques, mimic blastomycosis; ulceration mimicking pyoderma gangrenosum; crusted red plaques with pustules JAAD 20:691-693, 1989; J Derm Surg Onc 12:271-273, 1986 Sarcoidosis – ulcerative sarcoidosis Dermatology 202:367-370, 2001; J Eur Acad Dermatol Venereol 12:78-79, 1999; AD 133:215-219, 1997; J Derm Surg Oncol 15:679-683, 1989; AD 123:1531-1534, 1987; Dermatologica 174:135-139, 1987 Superficial granulomatous pyoderma Toxic epidermal necrolysis Rook p.2086, 1998, Sixth Edition; BJD 68:355-361, 1956

Acrodermatitis enteropathica Calcinosis cutis Calciphylaxis J Dermatol 28:272-275, 2001; Am J Clin Pathol 113:280-287, 2000; JAAD 40:979-987, 1999; JAAD 33:53-58, 1995; JAAD 33:954-962, 1995; AD 131:63-8, 1995 Chronic renal failure – prolonged wound healing Rook p.2730, 1998, Sixth Edition Cryofibrinogenemia Am J Med 116:332-337, 2004 Cryoglobulinemia JAAD 48:311-340, 2003; type I or mixed cryoglobulinemia NEJM 347:1412-1418, 2002 Diabetes mellitus – small vessel disease, neurotrophic ulcers (mal perforans) – painless circular punched out ulcer in middle of a callus Rook p.2675, 1998, Sixth Edition; necrobiosis lipoidica diabeticorum Int J Dermatol 28:195-197, 1989; arteriosclerotic ulcers – ulcers at side or back of ankle, along heel Rook p.2266, 1998, Sixth Edition Gaucher’s disease Gigantomastia of pregnancy – ulceration of breast Br J Surg 74:585-586, 1987 Gout Hematologic diseases

Dysproteinemia Cryopathies Cold agglutinins Ghatan p.26, 2002, Second Edition Cryofibrinogenemia JAAD 28:71-74, 1993; Lancet 338 (8763):347-348, 1991 Cryoglobulinemia JAAD 25:21-27, 1991; mixed cryoglobulinemia with hepatitis C virus Am J Med 96:124-132, 1994

Macroglobulinemia Red cell disease

Sickle cell anemia Thalassemia Spherocytosis Polycythemia vera

White blood cell disease Leukemia

Platelet disorders Hemolytic anemia, congenital Ghatan p.26, 2002, Second Edition Hyperparathyroidism and calcinosis Arch Pathol Lab Med 114:484-484, 1990 Marasmus – severe protein and caloric deprivation; skin ulcers due to wrinkled, loose, dry skin; extensive loss of subcutaneous fat JAAD 21:1-30, 1989 Necrobiosis lipoidica diabeticorum NEJM 347:1412-1418, 2002; Int J Derm 33:605-617, 1994; JAAD 18:530-537, 1988; JAAD 17:351-354, 1987; foot ulcers BJD 143:668-669, 2000

ULCERS

Osteoma cutis – ulcerating yellow-white plaques BJD 146:1075-1080, 2002 Porphyria – porphyria cutanea tarda Tyring p.361, 2002; congenital erythropoietic porphyria (Gunther’s disease) Semin Liver Dis 2:154-63, 1982 Prolidase deficiency BJD 121:405-409, 1989; Hautarzt 39:247-249, 1988

Angioimmunoblastic lymphadenopathy with granulomatous vasculitis JAAD 14:492-501, 1986 Atrial myxoma Cutis 62:275-280, 1998; JAAD 32:881-883, 1995; JAAD 21:1080-1084, 1989 Basal cell carcinoma, including basal cell arising in venous ulcers J Derm Surg Oncol 19:150-152, 1993 Bowen’s disease Chordoma – sacral ulcers JAAD 52:S105-108, 2005 Elastofibroma dorsi JAAD 21:1142-1144, 1989 Essential thrombocythemia JAAD 24:59-63, 1991 Fibrosarcoma/spindle cell sarcoma – extensive local destruction Rook p.2352, 1998, Sixth Edition Hemophagocytic syndrome AD 128:193-200, 1992 Keratoacanthoma Leukemia – large granular lymphocytic leukemia – pyoderma gangrenosum-like ulcer NEJM 347:1412-1418, 2002; JAAD 27:868-871, 1992; JAAD 27:553-559, 1992 Lymphoma JAAD 27:553-559, 1992; JAAD 11:121-128, 1984; angiocentric T-cell lymphoma NEJM 347:1412-1418, 2002; AD 132:1105-1110, 1996; cutaneous T-cell lymphoma JAAD 31:819-822, 1994; pyoderma gangrenosum-like ulcers as manifestation of CTCL J Eur Acad Dermatol Venereol 16:401-404, 2002; Hautarzt 53:114-117, 2002; anaplastic large-cell T-cell lymphoma NEJM 347:1412-1418, 2002; mycosis fungoides bullosa NEJM 347:1412-1418, 2002; lymphomatoid granulomatosis AD 127:1693-1698, 1991; HTLV-1 adult T-cell lymphoma/leukemia JAAD 46:S137-141, 2002; primary cutaneous B-cell lymphoma – pyoderma gangrenosum-like lesion BJD 151:250-252, 2004; Hodgkin’s disease – scalp ulcer Cutis 39:247-248, 1987 Malignant fibrous histiocytoma JAAD 47:463-464, 2002; AD 121:529-531, 1985 Melanocytic nevus, congenital – giant ulcer JAAD 49:752-754, 2003; Textbook of Neonatal Dermatology, p.151, 2001 Melanoma, including melanoma in Marjolin’s ulcer JAAD 32:1058-9, 1995 Metastases – carcinoma of breast Rook p.2709, 1998, Sixth Edition Mucinous eccrine carcinoma Mucoepidermoid carcinoma – index finger BJD 149:1091-1092, 2003 Multiple myeloma – hyperkeratotic filiform follicular spicules and ulcers JAAD 49:736-740, 2003 Myelodysplastic syndrome JAAD 33:187-191, 1995 Plasmacytoma – extramedullary plasmacytoma Transplantation 68:901-904, 1999 Porocarcinoma BJD 152:1051-1055, 2005 Porokeratosis Dermatology 196:256-259, 1998 Post-transplant Epstein-Barr virus-associated lymphoproliferative disorder – ulcerated plaques JAAD 51:778-780, 2004

Proliferating pilar cyst Squamous cell carcinoma Derm Surg 28:268-273, 2002; Rook p.1689-1690, 1998, Sixth Edition; Marjolin’s ulcer – squamous cell carcinoma arising in a chronic ulcer; may present as induration and persistence of ulceration, elevated border at edge of ulcer, breakdown of burn scar with indurated base, nodule formation within burn scar Rook p.953-954, 1998, Sixth Edition; Dictionnaire de Medicine. In:Adelon N (ed.) Paris:Bechet, 1828:31-50 Transient myeloproliferative disorder associated with mosaicism for trisomy 21 – vesiculopustular rash NEJM 348:2557-2566, 2003; in trisomy 21 or normal patients; periorbital vesiculopustules, red papules, crusted papules, and ulcers; with periorbital edema Ped Derm 21:551-554, 2004 Trichoepitheliomas Waldenström’s macroglobulinemia AD 134:1127-1131, 1998; cryoglobulin-associated ulcers JAAD 45:S202-206, 2001

Bullous pyoderma gangrenosum Int J Dermatol 40:327-329, 2001 Glucagonoma syndrome – necrolytic migratory erythema Necrobiotic xanthogranuloma with paraproteinemia AD 133:97-102, 1997; JAAD 29:466-469, 1993; Medicine (Baltimore) 65:376-388, 1986; BJD 113:339-343, 1985; JAAD 3:257-270, 1980 Paraneoplastic vasculitis – ulcers of the buttocks J Rheumatol 18:721-727, 1991; Medicine (Baltimore) 67:220-230, 1988

Acne fulminans JAAD 52:S118-120, 2005; AD 124:414-417, 1988 Aplasia cutis congenita (ACC)

Type 1 – ACC without associated anomalies JAAD 13:429-433, 1985; AD 108:252-253, 1973 Type 2 – ACC with distal limb reduction abnormalities (Adams-Oliver syndrome) – autosomal dominant; persistent cutis marmorata; congenital heart disease in 8%; differentiate from ACC with split hand deformities Birth Defects 18:123-128, 1982; differentiate from ACC with postaxial polydactyly Hum Genet 71:86-88, 1985; J Med Genet 24:493-496, 1987 Type 3 – ACC of scalp with epidermal nevi Clin Res 33:130, 1985; including bullous ACC J Med Genet 30:962-963, 1993 Type 4 – ACC overlying developmental malformations – hair collar sign; surface is translucent or membranous AD 125:1253-1256, 1989; may overlie defects of the vertebrae and spinal cork J Pediatr 96:687-689, 1980 Type 5 – ACC associated with fetus papyraceus – delivery of dead twin or triplet (death during second trimester) AD 141:554-556, 2005; ACC on trunk and extremities with linear or stellate configuration JAAD 25:1983-1985, 1991; fibrous constriction bands of extremities Aust Paediatr J 18:294-296, 1982 Type 6 – ACC as presentation of junctional and dystrophic epidermolysis bullosa; ulcerations of feet and lower legs AD 93:296-303, 1966 Type 7 – ACC caused by teratogens – methimazole or carbimazole Ped Derm 3:327-330, 1986; Can Med Assoc 130:1264, 1984 Type 8 – ACC as sign of intrauterine infection – herpes simplex JAAD 15:1148-1155, 1986; varicella-zoster – linear ulcers or scars; zosteriform NEJM 314:1542-1546, 1986

Type 9 – ACC as feature of malformation syndromes Trisomy 13 – ACC of scalp with holoprosencephaly, eye anomalies, cleft lip and/or palate, polydactyly, port wine stain of forehead Am J Dis Child 112:502-517, 1966 Deletion of short arm of chromosome 4 (4p-syndrome) – ACC of scalp with hypertelorism, beaked or broad nose, microcephaly, low-set ears, pre-auricular tags or pits, mental retardation Am J Dis Child 122:421-425, 1971 Oculocerebrocutaneous syndrome (Delleman-Oorthuys syndrome) – ACC of scalp, neck, lumbosacral area; orbital cysts, microphthalmia, skull defects, porencephaly, agenesis of corpus callosum, skin tags around eyes and nose Am J Med Genet 40:290-293, 1991 Johanson-Blizzard syndrome – autosomal recessive; growth retardation, microcephaly, ACC of scalp, sparse hair, hypoplastic ala nasi, CALMs, hypoplastic nipples and areolae, hypothyroidism, sensorineural deafness Clin Genet 14:247-250, 1978 Focal dermal hypoplasia Facial focal dermal dysplasias

Autosomal dominant focal facial dermal dysplasia without other facial anomalies – oval symmetrical scarred areas on temples, cheeks, rim of fine lanugo hairs BJD 84:410-416, 1971 Autosomal recessive focal facial dermal dysplasia without other facial anomalies JAAD 27:575-58, 1992 Focal facial dermal dysplasia with other facial anomalies (Setleis syndrome) – leonine aged facies with absent eyelashes, eyebrows, puckered periorbital skin, scar-like defects of temples AD 110:615-618, 1974

Amniotic band syndrome Congenital erosive and vesicular dermatosis with reticulate supple scarring Lumpy scalp, odd ears, and rudimentary nipples BJD 99:423-430, 1978 ACC with nipple and breast hypoplasia, nail dysplasia, delayed dentition Am J Med Genet 14:381-384, 1983 ACC with tricho-odonto-onychodermal ectodermal dysplasia BJD 105:371-382, 1981 ACC with EEC Minerva Pediatr 34:627-632, 1982 and AEC syndromes Ped Derm 10:334-340, 1993 ACC with intestinal lymphangiectasia Am J Dis Child 139:509-513, 1985 ACC with 46,XY gonadal dysgenesis, cleft lip and palate, ear deformity and pre-auricular pits J Pediatr 97:586-590, 1980 Dellemann syndrome (oculocerebrocutaneous syndrome) J Med Genet 25:773-778, 1988

Atopic dermatitis Congenital erosive dermatosis with reticulated supple scarring – most infants premature; extensive symmetrical erosions with scattered vesicles; scarring with hypohidrosis, patchy alopecia, hypoplastic nails AD 126:544-546, 1990 Congenital localized abscence of skin in epidermolysis bullosa (Bart’s syndrome) AD 128:1087-1090, 1992 Epidermolysis bullosa, multiple types Erythema of Jacquet – erosive diaper dermatitis; shallow, round ulcers with raised edges Rook p.470, 1998, Sixth Edition Febrile ulceronecrotic Mucha-Habermann disease (acute parapsoriasis) – painful hemorrhagic ulcers BJD 152:794-799, 2005; JAAD 49:1142-1148, 2003; AD 100:200-206, 1969 Lichen planus AD 93:692-701, 1966; ulcerative lichen planus of the soles Acta DV 81:378-379, 2001; AD 127:405-410, 1991; Acta DV 66:366-367, 1986; AD 93:692-671, 1966 Lichen sclerosus et atrophicus BJD 144:387-392, 2001 Lichen simplex chronicus Reactive perforating collagenosis

Factitial dermatitis Ped Derm 21:205-211, 2004; NEJM 347:1412-1418, 2002; Klin Wochenschr 64:149-164, 1986; JAAD 11:1065-1069, 1984; factitial panniculitis – ulcers of the thigh and buttocks JAAD 2:47-55, 1980 Neurotic excoriations Self-mutilation

Acro-osteolysis associated with spinal dysraphism – blister, ulcers of the foot, hyperhidrosis of the affected limb Ped Derm 18:97-101, 2001 Adams-Oliver syndrome – aplasia cutis congenita of scalp and transverse limb defects Ped Derm 15:48-50, 1998 Antiphospholipid antibody syndrome NEJM 347:1412-1418, 2002; Semin Arthritis Rheum 31:127-132, 2001; JAAD 36:149-168, 1997; JAAD 36:970-982, 1997; Semin Thromb Hemost 20:71-78, 1994; JAAD 15:211-219, 1986; eschar and ulceration JAAD 47:766-769, 2002; IgA antiphospholipid antibodies J Rheumatol 25:1730-1736, 1998; ulcer resembling pyoderma gangrenosum J La State Med Soc 147:357-361, 1995; lupus anticoagulant – pyoderma gangrenosum-like Dermatology 189:182-184, 1994 Ataxia telangiectasia – ulcerated plaque of cutaneous granuloma of ataxia telangiectasia AD 134:1145-1150, 1998 Behçet’s syndrome – extragenital ulcers JAAD 36:689-696, 1997 Carpal tunnel syndrome Dermatology 201:165-167, 2000 Charcot-Marie-Tooth syndrome – neurotrophic ulcer Chediak-Higashi syndrome Rook p.2742, 1998, Sixth Edition Congenital insensitivity to pain Cutis 51:373-374, 1993 Congenital sensory neuropathy with anhidrosis (self-multilation) AD 124:564-566, 1988 Ectodermal dysplasias Ehlers-Danlos syndrome Familial dysautonomia (Riley-Day syndrome) Flynn-Aird syndrome – skin atrophy, ulceration, alopecia, and dental caries J Neurol Sci 2:161-182, 1965 Goltz’s syndrome Ghatan p.199, 2002, Second Edition Hereditary sensory and autonomic neuropathy type I-V (congenital insensitivity to pain) – ulcers with self-mutilation Ped Derm 19:333-335, 2002 Hereditary sensory radicular neuropathy Hyper-IgM syndrome – diaper area ulcers Ped Derm 18:48-50, 2001 Hypereosinophilic syndrome, idiopathic Blood 83:2759-2779, 1994; digital ulcers Semin Dermatol 14:122-128, 1995 Johanson-Blizzard syndrome – aplasia cutis congenita of the scalp, sparse hair, deafness, absence of permanent tooth buds, hypoplastic ala nasi, dwarfism, microcephaly, mental retardation, hypotonia, pancreatic insufficiency with malabsorption, hypothyroidism, genital and rectal anomalies Clin Genet 14:247-250, 1978; J Pediatr 79:982-987, 1971 Lesch-Nyhan syndrome – X-linked recessive; hypoxanthineguanine phosphoribosyltransferase deficiency; self-mutilation; biting of lower lip AD 94:194-195, 1966 Lumpy scalp syndrome – autosomal dominant; scalp ulcers at birth heal as irregular scalp nodules; deformed pinnae, rudimentary nipples Clin Exp Dermatol 15:240, 1989 Marfan-like phenotype – deep skin ulcers JAAD 35:814-818, 1996 Neutrophilic dermatosis (pustular vasculitis of the dorsal hands) (variant of Sweet’s syndrome) – ulcers AD 138:361-365, 2002

ULCERS

Oligodontia, keratitis, skin ulceration, and arthroosteolysis Am J Med Genet 15:205-210, 1983 Partial trisomy 2p – scalp defect Rook p.2812, 1998, Sixth Edition Patau’s syndrome (trisomy 13) – parieto-occipital scalp defects, abnormal helices, low-set ears, loose skin of posterior neck, simian crease of hand, hyperconvex narrow nails, polydactyly Ped Derm 22:270-275, 2005; Rook p.3016, 1998, Sixth Edition POEMS syndrome JAAD 37:887-920, 1997 Prader-Willi syndrome – self-induced ulcers Ann DV 124:390-392, 1997 Pseudoacromegaly – autosomal recessive; skin ulcers, arthro-osteolysis, keratitis, oligodontia Am J Med Genet 15:205-210, 1983 Reflex sympathetic dystrophy JAAD 44:1050, 2001 Rowell’s syndrome – lupus erythematosus and erythema multiforme-like syndrome – papules, annular targetoid lesions, vesicles, bullae, necrosis, ulceration, oral ulcers; perniotic lesions JAAD 21:374-377, 1989 SAPHO syndrome Scalp-ear-nipple syndrome – autosomal dominant; aplasia cutis congenita of the scalp, irregularly shaped pinna, hypoplastic nipple, widely spaced teeth, partial syndactyly Am J Med Genet 50:247-250, 1994 Sneddon syndrome – cutaneous thrombosis, cerebrovascular thrombosis, and lupus anticoagulant Int J Dermatol 29:45-49, 1990 Trigeminal trophic syndrome (Wallenberg’s syndrome) JAAD 6:52-57, 1982 Werner’s syndrome AD 133:1293-1295, 1997; Acta DV 50:237-239, 1970 Xeroderma pigmentosum – acute sunburn, persistent erythema, freckling – initially discrete, then fuse to irregular patches of hyperpigmentation, dryness on sun-exposed areas; with time telangiectasias and small angiomas, atophic white macules develop; vesiculobullous lesions, superficial ulcers lead to scarring, ectropion; multiple malignancies; photophobia, conjunctivitis, ectropion, symblepharon, neurologic abnormalities Adv Genet 43:71-102, 2001; Hum Mutat 14:9-22, 1999; Mol Med Today 5:86-94, 1999; Derm Surg 23:447-455, 1997; Dermatol Clin 13:169-209, 1995; Recent Results Cancer Res 128:275-297, 1993; AD 123:241-250, 1987; Ann Intern Med 80:221-248, 1974; XP variant AD 128:1233-1237, 1992

Burns – actinic, thermal; electrical burns from enuresis blanket Rook p.952, 1998, Sixth Edition; galvanic burn Chilblains – in elderly with peripheral arterial disease Rook p.961, 1998, Sixth Edition; with ulcers on fingers, toes, nose and ears in patients with monocytic leukemia AD 121:1048, 1052, 1985 Decubitus ulcers – overlying sacrum, greater trochanter, ischial tuberosity, calcaneal tuberosity, lateral malleolus, point of the shoulder Rook p.897,2265, 1998, Sixth Edition Galvanic burn – battery and coins in pants pocket Intravenous drug abuse BJD 150:1-10, 2004; NEJM 347:1412-1418, 2002 Laser burns Rook p.953, 1998, Sixth Edition Physical injury Perinatal scalp monitor – scalp ulcer AD 135:697-703, 1999 Prenatal amniography with accidental injection of contrast material AD 135:697-703, 1999

Pressure Clin Inf Dis 35:1390-1396, 2002; Adv Wound Care 9:35-38, 1996; Prev Med 22:433-450, 1993; pressure necrosis of scalp due to cardiac surgery Radiation injury JAAD 49:417-423, 2003; JAAD 42:453-458, 2000; JAAD 30:719-723, 1994; radiation therapy Head Neck Surg 6:836-841, 1984 Spinal cord injury – decubitus ulcers AD 83:379-385, 1961

Acroangiodermatitis – ulceration of hand signifies arteriovenous shunt Rook p.2238, 1998, Sixth Edition Arteriosclerosis – ischemic ulcers at pressure sites; linear fissure of heel Rook p.2229, 2231, 1998, Sixth Edition Atrophie blanche C2 deficiency vasculitis Am J Gastroenterol 78:1-5, 1983 Cholesterol emboli BJD 146:511-517, 2002; Medicine 74:350-358, 1995; AD 122:1194-1198, 1986; Angiology 38:769-784, 1987 Churg-Strauss syndrome JAAD 47:209-216, 2002; JAAD 37:199-203, 1997 Cutis marmorata telangiectatica congenita Diffuse dermal angiomatosis – breast ulcer JAAD 45:462-465, 2001 Disseminated intravascular coagulation Erythromelalgia – all types exacerbated by warmth; associated with thrombocythemia; may affect one finger or toe; ischemic necrosis JAAD 22:107-111, 1990; primary (idiopathic) – lower legs, no ischemia JAAD 21:1128-1130, 1989; secondary to peripheral vascular disease JAAD 43:841-847, 2000; AD 136:330-336, 2000 Hemangiomas – Textbook of Neonatal Dermatology, p.150, 2001 Hemangiosarcoma Hypertensive ulcer Klippel-Trenaunay-Weber syndrome NEJM 347:1412-1418, 2002 Leukocytoclastic vasculitis with secondary infection NEJM 347:1412-1418, 2002 Livedo reticularis Rook p.964, 1998, Sixth Edition Livedoid vasculopathy NEJM 347:1412-1418, 2002 Malignant hemangioendothelioma J Dermatol 22:253-261, 1995 Polyarteritis nodosa NEJM 347:1412-1418, 2002; JAAD 31:561-566, 1994; punched out ulcers JAAD 48:311-340, 2003; in children Ann Rheum Dis 54:134-136, 1995 Purpura fulminans, neonatal – purpura or cellulitis-like areas evolving into necrotic bullae or ulcers Textbook of Neonatal Dermatology, p.151, 2001 Pustular vasculitis of hands JAAD 32:192-198, 1995 Raynaud’s disease or phenomenon Lancet 342 (8863):80-83, 1993 Reactive angioendotheliomatosis – red purple-purpuric patches and plaques with necrotic ulcers; includes acroangiomatosis, diffuse dermal angiomatosis, intravascular histiocytosis, glomeruloid angioendotheliomatosis, angioperictomatosis (angiomatosis with luminal cryoprotein deposition), reactive angiomatosis-like reactive angioendotheliomatosis; associated with subacute bacterial endocarditis, hepatitis, cholesterol emboli, cryoglobulinemia, arteriovenous shunt, antiphospholipid antibody syndrome, chronic lymphocytic leukemia, monoclonal gammopathy, chronic renal failure, rheumatoid arthritis, severe peripheral vascular disease, arteriovenous fistulae JAAD 49:887-896, 2003; BJD 147:137-140, 2002

Sclerosing lymphangitis of the penis (non-venereal sclerosing lymphangitis of the penis) Sinus pericranii JAAD 46:934-941, 2002 Small vessel occlusive arterial disease NEJM 347:1412-1418, 2002 Subcutaneous calcification (post-phlebitic subcutaneous calcification) – chronic venous insufficiency; non-healing ulcers; fibrosis Radiology 74:279-281, 1960 Takayasu’s arteritis – cutaneous necrotizing vasculitis NEJM 347:1412-1418, 2002; Dermatology 200:139-143, 2000 Thromboangiitis obliterans (Buerger’s disease) Rook p.2233, 1998, Sixth Edition; Am J Med Sci 136:567-580, 1908 Thrombophlebitis with gangrene (venous gangrene) Vasculitis – small AD 120:484-489, 1984; medium (polyarteritis nodosa) JAAD 31:561-566, 1994; and large vessel (temporal arteritis) – scalp ulcer BJD 120:843-846, 1989; AD 126:1225-1230, 1990; leukocytoclastic vasculitis AD 134:309-315, 1998; idiopathic hypersensitivity vasculitis Int J Dermatol 34:786-789, 1995 Venous gangrene Venous stasis ulcers NEJM 347:1412-1418, 2002 Wegener’s granulomatosis JAAD 48:311-340, 2003; NEJM 347:1412-1418, 2002; JAAD 31:605-612, 1994; AD 130:861-867, 1994; Ann Intern Med 116:488-498, 1992; JAAD 10:341-346, 1984

ULCERS, LEG JAAD 25:965-987, 1991

Allergic contact dermatitis BJD 148:388-401, 2003 Anti-centromere antibodies – ulcers and gangrene of the extremities Br J Rheumatol 36:889-893, 1997 Antineutrophil cytoplasmic antibody syndrome – purpuric vasculitis, orogenital ulceration, fingertip necrosis, pyoderma gangrenosum-like ulcers BJD 134:924-928, 1996 Bullous pemphigoid Rook p.2265, 1998, Sixth Edition Dermatomyositis Graft vs. host reaction, chronic AD 134:602-612, 1998 Immune complex disease Lupus erythematosus, systemic – malleolar, foot ulcers in areas of livedo or vasculitis Rook p.2474, 1998, Sixth Edition; J Rheumatol 6:204-209, 1979; discoid BJD 148:388-401, 2003 Morphea, including pansclerotic morphea of childhood JAAD 53:S115-119, 2005; Ped Derm 16:245-247, 1999 Mixed connective tissue disease Acta DV 61:225-231, 1981 Pemphigus vulgaris Polymyalgia rheumatica BJD 148:388-401, 2003 Rheumatoid arthritis BJD 152:1062-1064, 2005; J Rheumatol 10:507-509, 1983; AD 92:489-494, 1965

Arteritis Felty’s syndrome Sem Arthr Rheum 21:129-142, 1991 Gravitational ulcers Lymphedema due to immobility with ulceration Associated with mononeuritis multiplex Pyoderma gangrenosum Pressure ulcers

Rheumatoid vasculitis – ulcers of the lateral malleolus or pretibial area JAAD 53:191-209, 2005 Vasculitis, necrotizing BJD 147:905-913, 2002; Med J Aust 153:585-587, 1990 Rheumatoid nodules, ulcerated at pressure sites Rook p.2267, 1998, Sixth Edition Traumatic ulcers

Scleroderma – painful ulcers over bony prominences Rook p.2527, 1998, Sixth Edition; AD 84:359-374, 1961 Sjögren’s syndrome Still’s disease Rook p.2267, 1998, Sixth Edition

Aplasia cutis congenita with epidermolysis bullosa

Neuropathic ulcer (trophic ulcer) Charcot-Marie-Tooth syndrome with neurotrophic foot ulcer Decubitus Diabetes Hereditary sensory neuropathy Clin Exp Derm 1:91-92, 1976 Leprosy Neuropathy Paraplegias Syringomyelia – trophic ulcer Rook p.2265, 1998, Sixth Edition Tabes dorsalis Trigeminal trophic syndrome J Dermatol 18:613-615, 1991

Corticosteroid induced leg ulcers – systemic, intralesional, topical Rook p.2266, 1998, Sixth Edition; AD 92:52-53, 1965 Coumarin necrosis AD 122:1408, 1412, 1986 Ergot Ghatan p.74, 2002, Second Edition Granulocyte-colony stimulating factor BJD 148:388-401, 2003 Halogens Ghatan p.74, 2002, Second Edition Heparin necrosis Hydroxyurea – ulcers of the lower legs and feet; often over lateral malleoli; atrophic, scaling, poikilodermatous patches with erosions on the backs of the hands, sides of the feet JAAD 45:321-322, 2001; AD 137:467-470, 2001; Leuk Lymphoma 35:109-118, 1999; AD 135:818-820, 1999; JAAD 39:372-374, 1998; JAAD 36:178-182, 1997; Cutis 52:217-219, 1993 Levophed ischemic necrosis Methotrexate BJD 148:388-401, 2003 Pentazocine abuse Vasculitis, drug-induced – furosemide, captopril

Contact dermatitis, irritant Halogenoderma BJD 148:388-401, 2003 Silicone injection Rook p.2422, 1998, Sixth Edition Tibial cement extrusion J Arthroplasty 13:826-829, 1998

Acanthamebiasis in AIDS AD 131:1291-1296, 1995 Actinomycosis Aeromonas hydrophila

Alternariosis Clin Inf Dis 32:1178-1187, 2001 Amebiasis Bolognia p.1301, 2003 Animal bites Anthrax BJD 148:388-401, 2003 Arcanobacterium haemolyticum J Clin Inf Dis 18:835-836, 1994 Aspergillosis, primary cutaneous JAAD 31:344-347, 1994; resembling pyoderma gangrenosum JAAD 29:656-658, 1993 Bacillary angiomatosis AD 131:963-964, 1995 Bacillus cereus JAAD 47:324-325, 2002 Bacterial endocarditis BJD 148:388-401, 2003 BCG vaccination BJD 148:388-401, 2003 Bipolaris spicifera AD 125:1383-1386, 1989 Botryomycosis Brucellosis Rook p.2267, 1998, Sixth Edition Candida albicans – granulomatous panniculitis JAAD 28:315-317, 1993; J Cut Pathol 16:183-193, 1989 Cat scratch disease Rook p.2267, 1998, Sixth Edition Chromomycosis – feet, legs, arms, face, and neck AD 113:1027-1032, 1997; BJD 96:454-458, 1977; AD 104:476-485, 1971 Clostridial gas gangrene – acute ulcer BJD 148:388-401, 2003; Rook p.2265, 1998, Sixth Edition Coccidioidomycosis BJD 148:388-401, 2003 Corynebacterium pyogenes Int J Dermatol 21:407-409, 1987; epidemic leg ulcers of children in Thailand Southeast Asian J Trop Med Public Health 13:568-574, 1982 Corynebacterium ulcerans – medial and lateral lower leg ulcers mimicking cutaneous diphtheria with gray membrane and sweet smell Clin Inf Dis 33:1598-600, 2001 Cryptococcosis JAAD 5:32-36, 1981 Cytomegalovirus Tyring p.187, 2002 Desert sore (Veldt sore) – acute leg ulcer Rook p.2265, 1998, Sixth Edition Diphtheria (Corynebacterium diphtheriae) – in drug users Clin Inf Dis 18:94-96, 1994; cutaneous diphtheria BJD 148:388-401, 2003 Dracunculosis – bulla which ruptures leaving an ulcer J Clin Inf Dis 25:749, 1997 Ecthyma Tyring p.322, 2002; Rook p.1158, 1998, Sixth Edition Ecthyma gangrenosum – Pseudomonas, Escherichia coli, Aeromonas hydrophila BJD 148:388-401, 2003 Epstein-Barr virus (infectious mononucleosis) – cold urticaria with cold agglutinins and leg ulcers Acta DV 61:451-452, 1981 Erysipelas BJD 148:388-401, 2003 Eumycetoma Filariasis – secondary lymphedema Furuncle Fusarium, localized JAAD 47:659-666, 2002 Glanders Rook p.2267, 1998, Sixth Edition Granulomatous panniculitis

Actinomyces Atypical mycobacteria – Mycobacterium chelonei AD 129:1189-1194, 1993 Nocardia

Herpes simplex, chronic in AIDS BJD 148:388-401, 2003 Histoplasmosis BJD 148:388-401, 2003 Hyalohyphomycosis – Acremonium species BJD 150:789-790, 2004 Insect bites BJD 148:388-401, 2003

Leishmaniasis BJD 151:1165-1171, 2004; Rook p.1413, 1998, Sixth Edition; Trans R Soc Trop Med Hyg 81:606, 1987; Cutis 38:198-199, 1986 Leprosy – lepromatous leprosy with ulcerated nodules of the legs and feet Rook p.1225, 1998, Sixth Edition; Lucio’s phenomenon JAAD 48:958-961, 2003; AD 135:983-988, 1999 Lyme borreliosis (Borrelia burgdorferi) – acrodermatitis chronica atrophicans – red to blue nodules or plaques; sclerosis of lower legs with ulceration BJD 121:263-269, 1989; Int J Derm 18:595-601, 1979 Meleney’s synergistic gangrene Rook p.2266, 1998, Sixth Edition Melioidosis – pretibial ulcerative vegetative plaque Cutis 72:310-312, 2003 Meningococcemia BJD 148:388-401, 2003 Mosquito bite hypersensitivity syndrome in Epstein-Barr virus-associated natural killer cell leukemia/lymphoma – clear or hemorrhagic bullae with necrosis, ulceration and scar formation JAAD 45:569-578, 2001 Mucormycosis resembling pyoderma gangrenosum JAAD 29:462-465, 1993 Mycetoma BJD 148:388-401, 2003 Mycobacterium abscessus BJD 152:727-734, 2005 Mycobacterium avium complex – traumatic inoculation leg ulcers, ulcerated nodules, panniculitis, folliculitis, or papules BJD 130:785-790, 1994; JAAD 19:492-495, 1988 Mycobacterium chelonei Am Rev Resp Dis 119:107-159, 1979 Mycobacterium fortuitum Mycobacterium haemophilum – ulcerated plaque Ann Intern Med 120:118-125, 1994 Mycobacterium intracellulare Mycobacterium kansasii Mycobacterium marinum Mycobacterium scrofulaceum Mycobacterium szulgai Mycobacterium tuberculosis – scrofuloderma, erythema induratum, lupus vulgaris, erythema induratum JAAD 14:738-742, 1986; tuberculous chancre Clin Dermatol 8 (3/4):49-65, 1990; papulonecrotic tuberculid BJD 148:388-401, 2003 Mycobacteria ulcerans (Buruli ulcer) NEJM 348:1065-1066, 2003; Trans R Soc Trop Med Hyg 94:277-279, 2000; Med Trop (Mars) 57:83-90, 1997 (French); Clin Inf Dis 21:1186-1192, 1995; Med Trop (Mars) 55:363-373, 1995; Aust J Dermatol 26:67-73, 1985; Pathology 17:594-600, 1985 Necrotizing fasciitis BJD 148:388-401, 2003 Nocardia North American blastomycosis – ulcers of the leg and foot Osteomyelitis J Derm Surg Oncol 10:384-388, 1984; chronic ulcer of the heel with underlying osteomyelitis Pasteurella multocida (also P. haemolytica, P. pneumotropica and P. ureae) – cellulitis with ulceration with hemorrhagic purulent discharge with sinus tracts Medicine 63:133-144, 1984 Phaegedenic ulcer BJD 148:388-401, 2003 Phaeohyphomycosis – Curvularia pallescens JAAD 32:375-378, 1995 Pinta Ghatan p.74, 2002, Second Edition Protothecosis AD 136:1263-1268, 2000 Pseudomonas aeruginosa Pyoderma BJD 148:388-401, 2003 Pyomyositis Tyring p.322, 2002

Rat bite fever Rhizopus azygosporus BJD 153:428-430, 2005 Scorpion stings Rook p.2265, 1998, Sixth Edition Septic emboli Serratia marcescens JAAD 49:S193-194, 2003 Shewanella alga Clin Inf Dis 22:1036-1039, 1996 Snake bites Rook p.2265, 1998, Sixth Edition Spider bites Sporotrichosis BJD 148:388-401, 2003; Ghatan p.74, 2002, Second Edition Streptococcal ulcers of the legs – serpiginous margins with granular base AD 104:271-280, 1971 Syphilis – secondary (malignant lues), tertiary (gumma) Rook p.1251, 1998, Sixth Edition; tabes dorsalis – trophic ulcer Rook p.2265, 1998, Sixth Edition; tertiary syphilis with chronic leg ulcers Clin Dermatol 8 (3/4):157-165, 1990 Tinea corporis, pedis, Majocchi’s granuloma Rook p.2265, 1998, Sixth Edition Tropical phagedenic ulcers – mixed infection; mixed infection with Fusobacterium ulcerans, anaerobic cocci, Bacteroides species, Borrelia vincenti and other organisms; papule or bulla which breaks down to form ulcer with undermined border BJD 148:388-401, 2003; Rook p.2266, 1998, Sixth Edition; Int J Dermatol 27:49-53, 1988; Trans R Soc Trop Med Hyg 82:185-189, 1988; BJD 116:31-37, 1987; tropical ulcers – anaerobic (35%) and coliform (60%) organisms Trypanosoma brucei rhodiense J Clin Inf Dis 23:847-848, 1996 Tularemia Clin Inf Dis 20:174-175, 1995; Cutis 54:279-286, 1994 Vibrio extorquens Vibrio vulnificus JAAD 46:S144-145, 2002 Yaws – gumma Clin Dermatol 8:157-165, 1990 Zygomycosis JAAD 30:904-908, 1994

Langerhans cell histiocytosis BJD 148:388-401, 2003

Crohn’s disease, metastatic – granulomatous ulcer JAAD 41:476-479, 1999; JAAD 28:115-117, 1993 Erythema multiforme BJD 148:388-401, 2003 Fibrosis from longstanding edema – ischemic ulcers Rook p.2264, 1998, Sixth Edition Hidradenitis suppurativa Pancreatic panniculitis (fat necrosis) Panniculitis, including Weber-Christian disease, lupus profundus, α1-antitrypsin deficiency AD 123:1655-1661, 1987 Pyoderma gangrenosum Dermatology 195:50-51, 1997; J Derm Surg Oncol 20:833-836, 1994; JAAD 18:559-568, 1988; pyoderma gangrenosum with C7 deficiency JAAD 27:356-359, 1992; AD 22:655-680, 1930; bullous pyoderma gangrenosum Sarcoid – ulcerative sarcoid – tender, ‘punched out’, and often bilateral JAAD 53:917, 2005; AD 133:215-219, 1997; AD 123:1531-1534, 1987; AD 118:9331-933, 1982

Acrodermatitis enteropathica – foot ulcers Antiphospholipid deficiency BJD 148:388-401, 2003

Antithrombin III deficiency BJD 148:388-401, 2003 C3 deficiency BJD 148:388-401, 2003 Calcinosis – calcinosis cutis; calcinosis of muscles or subcutaneous tissue – overlying ulceration Rook p.2267, 1998, Sixth Edition Calciphylaxis (vascular calcification cutaneous necrosis syndrome) AD 140:1045-1048, 2004; BJD 143:1087-1090, 2000; JAAD 40:979-987, 1999; JAAD 33:53-58, 1995; JAAD 33:954-962, 1995 Cold agglutinins BJD 148:388-401, 2003 Cryofibrinogenemia Am J Med 116:332-337, 2004 Cryoglobulinemia – type I NEJM 347:1412-1418, 2002; mixed – bilateral in 87% of patients AD 139:391-393, 2003; hemorrhagic crusted leg ulcer Cutis 70:319-323, 2002 Defective organization of the extracellular matrix of fibronectin BJD 142:166-170, 2000 Defective fibrinolysis BJD 148:388-401, 2003 Diabetes mellitus Diabet Med 16:889-909, 1999; Diabetes 40:1305-1313, 1991; necrobiosis lipoidica diabeticorum, ulcerative Rook p.2267, 1998, Sixth Edition; neuropathic and large vessel and microvascular foot ulcers (mal perforans) Factor V Leiden deficiency BJD 148:388-401, 2003; factor V Leiden mutation and cryofibrinogenemia JAAD 51:S122-124, 2004; heterozygous factor V Leiden deficiency BJD 143:1302-1305, 2000 Factor XIII deficiency BJD 148:388-401, 2003 Gamma heavy chain disease Gaucher’s disease Gout – subcutaneous tophus AD 134:499-504, 1998 Am J Pathol 32:871-895, 1956 Hematologic disease

Dysproteinemias – cryoglobulinemia, cold agglutinins, macroglobulinemia, cryofibrinogenemia, myeloma, polyclonal dysproteinemia BJD 148:388-401, 2003 Red blood cell disorders – sickle cell disease, hereditary spherocytosis Ped Derm 20:427-428, 2003; Clin Exp Dermatol 16:28-30, 1991; in atypical locations (backs of feet) Dermatologica 181:56-59, 1990; thalassemia, polycythemia vera, G-6PD deficiency, hereditary elliptocytosis, hereditary non-spherocytichemolytic anemia BJD 148:388-401, 2003 White blood cell disease – leukemia, granulocytopenia BJD 148:388-401, 2003 Platelet disorders – essential thrombocythemia Hautarzt 35:259-262, 1984; Br J Surg 60 (5):377-380, 1973; thrombotic thrombocytopenic purpura BJD 148:388-401, 2003 Felty’s syndrome BJD 148:388-401, 2003; Ghatan p.74, 2002, Second Edition Thrombotic angiopathy

Edema due to cardiac or renal failure Extramedullary hematopoiesis JAAD 4:592-596, 1981 Gamma heavy chain disease Gout BJD 148:388-401, 2003 Homocysteinemia Ned Tijdschr Geneeskd 142:2706-2707, 1998 (Dutch) Hyperoxaluria – livedo reticularis, ulcers, and peripheral gangrene JAAD 49:725-728, 2003; AD 136:1272-1274, 2000 Hyperparathyroidism BJD 83:263-268, 1970 Hyperviscosity – paraproteinemia, leukemia BJD 148:388-401, 2003 Malnutrition Myxedema BJD 148:388-401, 2003 Necrobiosis lipoidica diabeticorum JAAD 17:351-354, 1987

Paget’s disease of Bone – leg ulcer overlying focus of Paget’s disease AD 141:1050, 2005 Pancreatic fat necrosis BJD 148:388-401, 2003 Paraproteinemia Ghatan p.74, 2002, Second Edition Porphyria cutanea tarda BJD 148:388-401, 2003 Prolidase deficiency – autosomal recessive; skin spongy and fragile with annular pitting and scarring; leg ulcers; photosensitivity, telangiectasia, purpura, premature graying, lymphedema BJD 144:635-636, 2001; Ped Derm 13:58-60, 1996; AD 127:124-125, 1991 Protein C or S deficiency BJD 148:388-401, 2003 Scurvy – hemorrhagic leg ulcers Ann DV 127:510-512, 2000; JAAD 41:895-906, 1999 Sickle cell disease – chronic leg ulcers Clin Sci (Lond) 98:667-672, 2000; J Trop Med Hyg 85:205-208, 1982 Spherocytosis – thrombotic vasculitis Rook p.2265, 1998, Sixth Edition Subcutaneous calcification (post-phlebitic subcutaneous calcification) – chronic venous insufficiency; non-healing ulcers; fibrosis Radiology 74:279-281, 1960 Subcutaneous fat necrosis TAP 1 mutation BJD 148:388-401, 2003

Atrial myxoma – leg ulcers, acral red papules with claudication JAAD 32:881-883, 1995; tender red fingertip papule JAAD 21:1080-1084, 1989 Basal cell carcinoma JAAD 25:47-49, 1991; complicating venous stasis ulcers Rook p.2262, 1998, Sixth Edition; J Derm Surg Oncol 19:150-152, 1993 Eccrine syringofibroadenoma – in a burn scar BJD 143:591-594, 2000 Epithelioid sarcoma BJD 118:843-844, 1988 Kaposi’s sarcoma Rook p.2265, 1998, Sixth Edition Leukemia – hairy cell leukemia, chronic myelogenous leukemia South Med J 60:567-572, 1967 Lymphoma – cutaneous T-cell lymphoma Cutis 28:43-44, 1981; gamma/delta T-cell lymphoma with hemophagocytic syndrome Am J Dermatopathol 16:426-433, 1994; angiocentric T-cell lymphoma AD 132:1105-1110, 1996; lymphomatoid granulomatosis AD 117:196-202, 1981; Hodgkin’s disease BJD 148:388-401, 2003; Br J Derm 80:555-560, 1968; subcutaneous panniculitis-like T-cell lymphoma BJD 148:516-525, 2003; JAAD 39:721-736, 1998; cutaneous large B-cell lymphoma BJD 146:144-147, 2002; CD30 + large cell T-cell lymphoma BJD 149:542-553, 2003; CD56 + lymphoma BJD 147:1017-1020, 2000 Lymphoproliferative disorder of granular lymphocytes – ulcerated plaque JAAD 30:339-344, 1994 Marjolin’s ulcer – squamous cell carcinoma arising in a chronic ulcer; may present as induration and persistence of ulceration, elevated border at edge of ulcer, breakdown of burn scar with indurated base, nodule formation within burn scar Rook p.953-954, 1998, Sixth Edition; Cutis 56:168-170, 1995; Dictionnaire de Medicine. In:Adelon N (ed.) Paris:Bechet, 1828:31-50 Melanoma BJD 148:388-401, 2003 Metastases BJD 148:388-401, 2003 Myelofibrosis – extramedullary hematopoiesis in myelofibrosis JAAD 4:592-596, 1981 Neoplastic obstruction with lymphedema

Osteoclastoma Osteosarcoma Polycythemia vera – thrombotic vasculitis Rook p.2265, 1998, Sixth Edition Porocarcinoma BJD 152:1051-1055, 2005 Porokeratosis – congenital linear porokeratosis Ped Derm 12:318-322, 1995 Rhabdomyosarcoma BJD 148:388-401, 2003 Soft tissue sarcoma BJD 148:388-401, 2003 Squamous cell carcinoma Rook p.1689-1690, 1998, Sixth Edition; complicating venous stasis ulcers South Med J 58:779-781, 1965 Waldenström’s macroglobulinemia AD 134:1127-1131, 1998; cryoglobulin-associated ulcers JAAD 45:S202-206, 2001

Necrobiotic xanthogranuloma with paraproteinemia AD 133:97-102, 1997; JAAD 29:466-469, 1993; Medicine (Baltimore) 65:376-388, 1986; BJD 113:339-343, 1985; JAAD 3:257-270, 1980 Pyoderma gangrenosum, bullous – associated with acute myelogenous leukemia Sweet’s syndrome, bullous – associated with myelodysplasias Vasculitis – paraneoplastic vasculitis J Rheumatol 18:721-727, 1991; leukocytoclastic vasculitis; thrombotic vasculitis associated with plasma cell dyscrasias

Acrodermatitis chronica atrophicans Acute parapsoriasis (Mucha-Habermann disease) Epidermolysis bullosa including pretibial epidermolysis bullosa JAAD 22:346-350, 1990 Erythema elevatum diutinum BJD 148:388-401, 2003 Fibrosis Lichen planus – bullous BJD 148:388-401, 2003; erosive lichen planus of the soles Lipedema BJD 148:388-401, 2003 Malakoplakia – ulcerated papule JAAD 30:834-836, 1994 Nummular dermatitis Psoriasis Rook p.2265, 1998, Sixth Edition Reactive perforating collagenosis Verrucous hyperplasia of the stump

Factitial dermatitis Rook p.2265, 1998, Sixth Edition

Antiphospholipid antibody syndrome NEJM 347:1412-1418, 2002; Semin Arthritis Rheum 31:127-132, 2001; JAAD 36:149-168, 1997; JAAD 36:970-982, 1997; BJD 120:419-429, 1989; anti-cardiolipin syndrome Behçet’s syndrome Arch Int Med 145:1913-1915, 1985 Congenital indifference to pain Defective expression of HLA class I and CD 1a molecules with marfanoid habitus JAAD 35:814-818, 1996 Ehlers-Danlos syndrome

Felty’s syndrome – arthritis, leucopenia, splenomegaly, rheumatoid arthritis JAAD 53:191-209, 2005 Hereditary sensory neuropathy – primary Kawasaki’s disease BJD 148:388-401, 2003 Klinefelter’s syndrome – leg ulcers with stasis ulcers, hyperpigmentation, or atrophie blanche AD 131:230, 1995 Neurofibromatosis – vasculopathy JAAD 51:656-659, 2004 Pachydermoperiostosis (Touraine-Solente-Gole syndrome) Clin Rheumatol 14:705-707, 1995 Reiter’s syndrome – keratoderma blenorrhagicum SAPHO syndrome Sneddon’s syndrome BJD 148:388-401, 2003 Stewart-Bluefarb syndrome BJD 148:388-401, 2003 Werner’s syndrome AD 133:1293-1295, 1997; Acta DV 50:237-239, 1970

Amputation stump friction blisters with ulceration Rook p.905, 1998, Sixth Edition Burns Rook p.2265, 1998, Sixth Edition Chemical injury – corrosive agents, sclerotherapy BJD 148:388-401, 2003; Rook p.2265, 1998, Sixth Edition Cold injury – perniosis (erythrocyanosis frigida); frostbite BJD 148:388-401, 2003; Rook p.2265, 1998, Sixth Edition Coma bullae with ulcers Decubitus – heels and ankles Rook p.2265-2266, 1998, Sixth Edition Drug abuse – intravenous (IVDA); skin popping; delayed cutaneous ulcers at sites of prior drug abuse BJD 150:1-10, 2004; JAAD 29:1052-1054, 1993 Hematoma BJD 148:388-401, 2003 Nerve injury, traumatic – surgical injury to lateral femoral cutaneous nerve with bulla and subsequent ulceration of lateral lower leg Rook p.2776, 1998, Sixth Edition; Dermatol Wochenschri 136:971-973, 1957 Physical trauma – ulcers of shins and ankles Rook p.2266, 1998, Sixth Edition Pressure – decubitus ulcer BJD 148:388-401, 2003 Radiation – ischemic ulcers Rook p.2264, 1998, Sixth Edition Reflex sympathetic dystrophy – bulla and leg ulceration JAAD 44:1050, 2001; JAAD 28:29-32, 1993 Scar tissue – ischemic ulceration Rook p.2264, 1998, Sixth Edition Sclerotherapy – extravasation of sclerosant Rook p.2266, 1998, Sixth Edition Trench foot BJD 148:388-401, 200

Acroangiodermatitis – ulceration of lower leg signifies chronic venous insufficiency or paralysis Rook p.2238, 1998, Sixth Edition Acro-osteopathia ulceromutilans (Bureau-Barriere syndrome) BJD 148:388-401, 2003 Angiosarcoma Ghatan p.74, 2002, Second Edition Anterior tibial syndrome Arterial thrombosis BJD 148:388-401, 2003

Arteriovenous fistulae and venous malformation (arteriovenous malformation) BJD 148:388-401, 2003; Rook p.2265, 1998, Sixth Edition Atherosclerosis – punched out ischemic ulcers over pretibial areas or toes BJD 148:388-401, 2003; Rook p.2264, 1998, Sixth Edition; peripheral vascular disease with foot ulcerations Atrophie blanche (livedo with ulceration) – ivory white plaque of sclerosis with telangiectasias and surrounding hyperpigmentation; venous insufficiency, thalassemia minor Acta DV (Stockh) 50:125-128, 1970; cryoglobulinemia, systemic lupus erythematosus, scleroderma Rook p.2249, 1998, Sixth Edition; JAAD 8:792-798, 1983; AD 119:963-969, 1983 Buerger’s disease (thromboangiitis obliterans) BJD 148:388-401, 2003; AD 134:1019-1024, 1998; Cutis 51:180-182, 1993; Am J Med Sci 136:566-580, 1908 Cholesterol emboli – foot ulcers BJD 146:1107-1108, 2002; Semin Arth Rheum 18 (4):240-246, 1989 Churg-Strauss disease BJD 148:388-401, 2003 Congenital absence of veins Rook p.2265, 1998, Sixth Edition Congenital hypoplasia of venous valves BJD 148:388-401, 2003 Diffuse dermal angiomatosis with arteriosclerotic peripheral vascular disease AD 138:456-458, 2002 Disseminated intravascular coagulation BJD 148:388-401, 2003 Erythrocyanosis Erythromelalgia BJD 143:868-872, 2000; associated with thrombocythemia – may affect one finger or toe; ischemic necrosis JAAD 22:107-111, 1990; primary (idiopathic) – lower legs, no ischemia JAAD 21:1128-1130, 1989; secondary to peripheral vascular disease JAAD 43:841-847, 2000; AD 136:330-336, 2000; all types exacerbated by warmth; may be associated with systemic lupus erythematosus, dermatomyositis, neuropathy, hypertension and vasculitis, calcium antagonists BJD 143:868-872, 2000 Fat embolism BJD 148:388-401, 2003 Fibromuscular dysplasia BJD 148:388-401, 2003 Giant cell arteritis (Takayasu’s arteritis) JAAD 17:998-1005, 1987 Hemangioma BJD 148:388-401, 2003 Hemangiosarcoma in leg ulcer AD 124:1080-1082, 1988 Henoch-Schönlein purpura BJD 148:388-401, 2003 Hypertensive ulcer (Martorell’s ulcer) – very painful ulcer of lower lateral leg (above lateral malleolus) with livedo at edges BJD 148:388-401, 2003; Phlebology 3:139-142, 1988; Mayo Clin 21:337-346, 1946; J Cardiovasc Surg (Torino) 19:599-600, 1978 Klippel-Trenaunay-Weber syndrome NEJM 347:1412-1418, 2002 Lipodermatosclerosis Livedo vasculitis with summer ulcerations (livedoid vasculopathy) BJD 148:388-401, 2003; NEJM 347:1412-1418, 2002 Lymphangiosarcoma BJD 148:388-401, 2003 Lymphedema BJD 148:388-401, 2003 Malignant angioendothelioma Ghatan p.74, 2002, Second Edition Malignant atrophic papulosis (Degos disease) Eur J Pediatr 149:457-458, 1990 Mixed arterial and venous ulceration Nodular vasculitis

Polyarteritis nodosa NEJM 347:1412-1418, 2002; Ann Intern Med 89:66-676, 1978; PAN associated with hepatitis B infection Tyring p.535, 2002; cutaneous PAN BJD 136:706-713, 1997; AD 128:1223-1228, 1992 Pseudo-Kaposi’s sarcoma BJD 148:388-401, 2003 Purpura fulminans BJD 148:388-401, 2003 Scars Sickle cell ulcers Small vessel occlusive arterial disease NEJM 347:1412-1418, 2002 Stewart-Treves tumor (lymphangiosarcoma) Superficial thrombophlebitis Temporal arteritis BJD 76:299-308, 1964 Thrombophlebitis, ulcerated BJD 148:388-401, 2003 Varicose veins Rook p.2265, 1998, Sixth Edition Vasculitis (small, medium, and large vessel) AD 120:484-489, 1984 Venous gangrene – foot ulcers Venous stasis ulceration (chronic venous insufficiency) – medial lower leg and medial malleolus NEJM 347:1412-1418, 2002; AD 133:1231-1234, 1997; Semin Dermatol 12:66-71, 1993; with subcutaneous calcification J Derm Surg Oncol 16:450-452, 1990; venous stasis due to compression or obstruction of veins (pelvic tumors, lymphadenopathy, or pelvic vein thrombosis); dependency syndrome (immobility, arthritis, paralysis, orthopedic malformations); post-thrombotic venous ulcer Rook p.2258,2265, 1998, Sixth Edition Wegener’s granulomatosis BJD 151:927-928, 2004; NEJM 347:1412-1418, 2002; JAAD 28:710-718, 1993

Anti-centromere antibodies – ulcers and gangrene of the extremities Br J Rheumatol 36:889-893, 1997 Antineutrophil cytoplasmic antibody syndrome – purpuric vasculitis, orogenital ulceration, fingertip necrosis, pyoderma gangrenosum-like ulcers BJD 134:924-928, 1996 Defective expression of HLA class I and CD 1a molecules with marfanoid habitus JAAD 35:814-818, 1996 Graft vs. host reaction, chronic AD 134:602-612, 1998 Morphea – pansclerotic morphea JAAD 53:S115-119, 2005; Ped Derm 16:245-247, 1999 Rheumatoid vasculitis BJD 147:905-913, 2002 Still’s disease Rook p.2267, 1998, Sixth Edition

Aplasia cutis congenita with epidermolysis bullosa

Neuropathy

Calcium gluconate extravasation Hydroxyurea JAAD 49:339-341, 2003

Silicone injection Rook p.2422, 1998, Sixth Edition

Acanthamoeba J Clin Inf Dis 20:1207-1216, 1995; JAAD 42:351-354, 2000 Anthrax Bacillary angiomatosis in HIV disease AD 131:963, 1995 Bacillus cereus JAAD 47:324-325, 2002 Cat scratch disease Rook p.2267, 1998, Sixth Edition Corynebacterium diphtheriae in drug users Clin Inf Dis 18:94-96, 1994 Cryptococcosis – mimicking pyoderma gangrenosum JAAD 5:32-36, 1981 Diphtheria Ecthyma Rook p.1158, 1998, Sixth Edition Ecthyma gangrenosum – Pseudomonas, Escherichia coli, Aeromonas hydrophila Epstein-Barr virus (infectious mononucleosis) – cold urticaria with cold agglutinins and leg ulcers Acta DV 61:451-452, 1981 Herpes simplex in atopic dermatitis; in AIDS Histoplasmosis Leishmaniasis Rook p.1413, 1998, Sixth Edition; Trans R Soc Trop Med Hyg 81:606, 1987; Cutis 38:198-199, 1986 Melioidosis – pretibial ulcerative vegetative plaque Cutis 72:310-312, 2003 Mosquito bite hypersensitivity syndrome in EBV-associated natural killer cell leukemia/lymphoma – clear or hemorrhagic bullae with necrosis, ulceration and scar formation JAAD 45:569-578, 2001 Mycobacterium avium complex – traumatic inoculation leg ulcers, ulcerated nodules, panniculitis, folliculitis, or papules BJD 130:785-790, 1994; JAAD 19:492-495, 1988 Mycobacterium tuberculosis – scrofuloderma, lupus vulgaris JAAD 14:738-742, 1986; tuberculous chancre Clin Dermatol 8(3/4):49-65, 1990 Mycobacterium ulcerans (Buruli ulcer) NEJM 348:1065-1066, 2003; Med Trop (Mars) 57:83-90, 1997 (French); Clin Inf Dis 21:1186-1192, 1995; Med Trop (Mars) 55:363-373, 1995; Aust J Dermatol 26:67-73, 1985; Pathology 17:594-600, 1985 Mycobacteria, non-tuberculous, including M. chelonae Am Rev Resp Dis 119:107-159, 1979; M. marinum, M. kansasii Necrotizing fasciitis Nocardia North American blastomycosis – primary infection Ped Derm 20:128-130, 2003 Pasteurella multocida (also P. haemolytica, pneumotropica, and ureae) – cellulitis with ulceration with hemorrhagic purulent discharge with sinus tracts Medicine 63:133-144, 1984 Rat bite fever Scorpion stings Rook p.2265, 1998, Sixth Edition Septic emboli Snake bites Rook p.2265, 1998, Sixth Edition Spider bites Syphilis – secondary (malignant lues) Tropical phagedenic ulcers – mixed infection; mixed infection with Fusobacterium ulcerans, anaerobic cocci, Bacteroides species and other organisms; papule or bulla which breaks down to form ulcer with undermined border Rook p.2266, 1998,

Sixth Edition; Int J Dermatol 27:49-53, 1988; BJD 116:31-37, 1987; Trans R Soc Trop Med Hyg 82:185-189, 1988 Tularemia Clin Inf Dis 20:174-175, 1995; Cutis 54:279-286, 1994 Yaws

Pyoderma gangrenosum Dermatology 195:50-51, 1997; J Derm Surg Oncol 20:833-836, 1994; JAAD 18:559-568, 1988; pyoderma gangrenosum with C 7 deficiency JAAD 27:356-359, 1992; AD 22:655-680, 1930

Antithrombin III deficiency Calciphylaxis Metastatic Crohn’s disease – granulomatous ulcer JAAD 41:476-479, 1999 Cryofibrinogenemia Cryoglobulinemia Essential thrombocythemia JAAD 24:59-63, 1991 Factor XII deficiency – livedo with ulceration BJD 143:897-899, 2000 Gaucher’s disease Hemoglobinopathy (sickle cell anemia) Homocysteinuria JAAD 40:279-281, 1999; Ned Tijdschr Geneeskd 142:2706-2707, 1998 (Dutch) Porphyrin retention Prolidase deficiency – autosomal recessive; skin spongy and fragile with annular pitting and scarring; leg ulcers; photosensitivity, telangiectasia, purpura, premature graying, lymphedema BJD 147:1227-1236, 2002; Ped Derm 13:58-60, 1996; AD 127:124-125, 1991; AD 123:493-497, 1987 Protein C deficiency – including IV catheter-induced thrombosis in protein S deficiency JAAD 23:975-989, 1990 Protein S deficiency Red blood cell disorders – sickle cell disease, hereditary spherocytosis, thalassemia, polycythemia vera, hereditary elliptocytosis, hereditary nonspherocytic hemolytic anemia Sickle cell ulcer Hematol Oncol Clin North Am 10:1333-1344, 1996

Kaposi’s sarcoma Rook p.2265, 1998, Sixth Edition Lymphoma – subcutaneous panniculitis-like T-cell lymphoma BJD 148:516-525, 2003 Melanoma

Epidermolysis bullosa, including pretibial epidermolysis bullosa JAAD 22:346-350, 1990 Lichen planus, erosive

Factitial dermatitis Rook p.2265, 1998, Sixth Edition

Antiphospholipid antibody syndrome NEJM 347:1412-1418, 2002; Semin Arthritis Rheum 31:127-132, 2001; JAAD 36:149-168, 1997; JAAD 36:970-982, 1997; BJD 120:419-429, 1989 Behçet’s syndrome Arch Int Med 145:1913-1915, 1985 Felty’s syndrome – leg ulcers, granulocytopenia, rheumatoid arthritis, skin nodules, pigmentation, splenomegaly Ghatan Second Edition, 2002, p.199; Semin Arthr Rheum 21(3):129-142, 1991 Hereditary sensory neuropathy – primary Klinefelter’s syndrome – venous and arterial ulcers; leg ulcers with hyperpigmentation or atrophie blanche AD 133:1051-1052, 1997; AD 131:230, 1995; Cutis 38:110-111, 1986 Neurofibromatosis – vasculopathy JAAD 51:656-659, 2004 Phakomatosis pigmentovascularis IIb – with hypoplasia of the inferior vena cava, iliac and femoral veins with stasis leg ulcers JAAD 49:S167-169, 2003 Reflex sympathetic dystrophy – bulla and leg ulceration JAAD 44:1050, 2001; JAAD 28:29-32, 1993 Werner’s syndrome AD 133:1293-1295, 1997

Burn Chemical injury Rook p.2265, 1998, Sixth Edition Chilblains Intravenous drug abuse (IVDA) BJD 150:1-10, 2004 Pressure ulcer

Atrophie blanche Erythromelalgia BJD 143:868-872, 2000; associated with thrombocythemia – may affect one finger or toe; ischemic necrosis JAAD 22:107-111, 1990; primary (idiopathic) – lower legs, no ischemia JAAD 21:1128-1130, 1989; secondary to peripheral vascular disease JAAD 43:841-847, 2000; AD 136:330-336, 2000; all types exacerbated by warmth; may be associated with systemic lupus erythematosus, dermatomyositis, neuropathy, hypertension and vasculitis, calcium antagonists BJD 143:868-872, 2000 Polyarteritis nodosa Ann Intern Med 89:66-676, 1978; cutaneous PAN BJD 136:706-713, 1997; AD 128:1223-1228, 1992; in children Ann Rheum Dis 54:134-136, 1995 Vasculitis Venous gangrene

Allergic contact dermatitis – medications Rook p.3164, 1998, Sixth Edition; nickel allergic contact dermatitis with periumbilical dermatitis in children Ped Derm 19:106-109, 2002 Bullous pemphigoid Rook p.3165, 1998, Sixth Edition Cicatricial pemphigoid Rook p.3165, 1998, Sixth Edition Herpes (pemphigoid) gestationis JAAD 40:847-849, 1999; JAAD 17:539-556, 1987; Clin Exp Dermatol 7:65-73, 1982

Linear IgA disease Morphea Pemphigoid vegetans AD 115:446-448, 1979 Pemphigus foliaceus Cutis 63:271-274, 1999; Dermatologica 180:102-105, 1990 Pemphigus vulgaris

AD 90:160, 1964 Associated anomalies of GU/GI tract Associated fistulas Choristia, periumbilical – intestinal mucosal cells; crusted, red perimbilical plaques Ann DV 105:601-606, 1978 Congenital band Embryologic rests AD 123:105-110, 1987 Umbilical hernia – omphalocele Postgrad Med 57:635-639, 1981; herniation of umbilical cord Rook p.3164, 1998, Sixth Edition Granulation tissue Omphalomesenteric duct remnants – cutaneous remnants of the omphalomesenteric duct – completely patent duct – red nodule with a fistula with fecal discharge or intestinal prolapse Am J Surg 88:829-834, 1954; patent peripheral portion – red, polypoid nodule (ectopic gastrointestinal mucosa) (umbilical polyp); discharges mucus; resemble prolapsed urachal mucosa and talc granuloma; fistulae, cysts Ped Derm 4:341-343, 1987; AD 90:463-470, 1964 Patent urachal duct AD 90:160-165, 1964 Persistent vascular anomalies Persistent vitelline duct and polyp – fecal or mucoid discharge Dermatologica 150:111-115, 1975 Prolapsed urachal mucosa Umbilical granuloma – most common umbilical mass Textbook of Neonatal Dermatology, p.95,132, 2001 Urachal and vascular abnormalities (ectopic transitional epithelium of bladder) – urachal remnants with cyst, sinus, or fistula Textbook of Neonatal Dermatology, p.132, 2001; Cutis 62:83-84, 1998; complete patency of the urachus – urine emanating from umbilicus; nodule Ped Clin N Am 6:1085-1116, 1959; urachal cyst (partial patency of the urachus) – tender midline swellings between the umbilicus and symphysis pubis Br J Urol 28:253-256, 1956; urachal sinus Yolk sac remnant – umbilico-ileal fistula

Foreign body granuloma AD 139:1497-1502, 2003; secondary infection Rook p.3164, 1998, Sixth Edition Irritant dermatitis Talc granuloma – older individuals BJD 83:151-156, 1970 Umbilical ring

Candidiasis – candidal intertrigo Rook p.3164, 1998, Sixth Edition; candidal sepsis Cellulitis Chigger mite bites Ghatan p.101, 2002, Second Edition Clostridial cellulitis AD 113:683-684, 1977 Cysticercosis J Trop Med Hyg 88:25-29, 1985

Diphtheria – superficial round ulcer with overhanging edge; gray adherent membrane; later edge thickens and becomes raised and rolled; umbilicus, post-auricular, groin, finger or toe web; heals with scarring; crusts around nose and mouth with faucial diphtheria Schweiz Rundsch Med Prax 87:1188-1190, 1998; Postgrad Med J 72:619-620, 1996; Am J Epidemiol 102:179-184, 1975 Erythrasma Herpes simplex Herpes zoster Impetigo Lyme disease Molluscum contagiosum Mycobacterium tuberculosis – granuloma Ghatan p.101, 2002, Second Edition Omphalitis – neonatal omphalitis and cellulitis; coagulase-negative staphylococcus Textbook of Neonatal Dermatology, p.184, 190, 2001; Arch Derm 113:683, 1977 Pediculosis pubis Pseudomonas Rook p.3164, 1998, Sixth Edition Rubella, congenital – hyperpigmentation of forehead, cheeks, umbilical area J Pediatr 71:311-331, 1967 Scabies – periumbilical papules Rook p.1460-1461, 1998, Sixth Edition Schistosomiasis – ectopic cutaneous granuloma – periumbilical papules skin-colored papule, 2-3-mm; group to form mamillated plaques; nodules develop with overlying dark pigmentation, scale, and ulceration; periumbilical Dermatol Clin 7:291-300, 1989; BJD 114:597-602, 1986; Ann DV 107:759-767, 1980; Br J Vener Dis 55:446-449, 1979 Staphylococcus aureus Rook p.3164, 1998, Sixth Edition Staphylococcal scalded skin syndrome Strongyloidiasis – periumbilical thumb-print purpura JAAD 256:1170-1171, 1986 Tinea corporis Urachal abscess J Clin Ultrasound 19:203-208, 1991 Verruca vulgaris Genitourin Med 70:49-50, 1994

Crohn’s disease – metastatic Clin Exp Dermatol 21:318-319, 1996 Cullen’s sign – periumbilical purpura; acute pancreatitis, ruptured ectopic pregnancy, perforated duodenal ulcer Rook p.3165, 1998, Sixth Edition; Br Med J i:154, 1971 Deep umbilicus – purulent umbilical drainage JAAD 44:687-688, 2001 Endometriomas (32% of all umbilical tumors, most common); cutaneous endometrioma J Derm Surg 20:693-695, 1994; South Med J 70:147-152, 1977; AD 112:1435-1436, 1976; JAMA 191:167, 1965 Erythema multiforme Funisitis – inflammation of the umbilical cord or stump; increased secretions and/or foul odor Textbook of Neonatal Dermatology, p.184, 2001 Pilonidal sinus of umbilicus (hair sinus) – pain, tenderness, and discharge in hirsute men Cutis 62:83-84, 1998; J Fam Pract 29:205-209, 1989 Hidradenitis suppurativa Necrotizing fasciitis, retroperitoneal – periumbilical erythema JAAD 53:527-528, 2005; Crit Care Med 29:1071-1073, 2001

Omphalitis – periumbilical erythema JAAD 53:527-528, 2005; Scand J Gastroenterol 39:1021-1024, 2004 Pilonidal granulomata

Angiokeratoma corporis diffusum (Fabry’s disease (α-galactosidase A) – X-linked recessive; periumbilical rosette NEJM 276:1163-1167, 1967; fucosidosis (α1-fucosidase) AD 107:754-757, 1973; Kanzaki’s disease (α-N-acetylgalactosidase) AD 129:460-465, 1993; aspartylglycosaminuria (aspartylglycosaminidase) Paediatr Acta 36:179-189, 1991; umbilical hernia Clin Genet 23:427-435, 1983 adult-onset GM1 gangliosidosis (β-galactosidase) Clin Genet 17:21-26, 1980; galactosialidosis (combined β-galactosidase and sialidase) AD 120:1344-1346, 1984; no enzyme deficiency) – telangiectasias or small angiokeratomas Cirrhosis – ulceration of umbilical vein; umbilical hemorrhage Postgrad Med 57:461-462, 1981 Colonic mucosa implantation – umbilical nodule BJD 90:108, 1974 Cretinism – coarse facial features, lethargy, macroglossia, cold dry skin, livedo, umbilical hernia, poor muscle tone, coarse scalp hair, synophrys, no pubic or axillary hair at puberty Rook p.2708, 1998, Sixth Edition Cullen’s sign Mannosidosis – umbilical hernia Johns Hopkins Med J 151:113-117, 1982 Pruritic urticarial papules and plaques of pregnancy (PUPPP) Stein-Leventhal syndrome (polycystic ovarian disease)

Basal cell carcinoma Cutis 71:123-126, 2003 Bowen’s disease – plaque Cutis 42:321-322, 1988 Carcinoid tumor AD 114:570-572, 1978 Dermatofibroma Desmoid tumor – subcutaneous mass in subumbilical paramedian region Rook p.2368-2369, 1998, Sixth Edition Endosalpingosis – ectopic fallopian tube epithelium; umbilical nodule BJD 151:924-925, 2004; post-operative endosalpingosis AD 116:909-912, 1980 Epidermal inclusion cyst Extropy of the bladder Fibroepithelial papilloma Fibrous umbilical polyp – fasciitis-like proliferation; early childhood; male predominance Am J Surg Pathol 25:1438-1442, 2001 Granular cell tumor Ghatan p.102, 2002, Second Edition Keloid AD 139:1497-1502, 2003 Langerhans cell tumor, malignant – periumbilical red nodule JAAD 49:527-529, 2003 Leiomyosarcoma Lipoma Lymphoma – cutaneous T-cell lymphoma; Sister Mary Joseph nodule Ann DV 127:732-734, 2000; granulomatous slack skin syndrome (CTCL); retroperitoneal large B-cell lymphoma – periumbilical erythema JAAD 53:527-528, 2005 Melanocytic nevus Rook p.1722-1723, 1998, Sixth Edition; atypical nevus Melanoma AD 139:1497-1502, 2003 Metastases – Sister Mary Joseph nodule; stomach AD 111:1478-1479, 1975; renal cell carcinoma J Comput Assist

Tomogr 22:756-757, 1998; ovarian JAAD 10:610-615, 1984; pancreas Cutis 31:555-558, 1983; uterus Br J Clin Pract 46:69-70, 1992; leiomyosarcoma AD 120:402-403, 1984; peritoneal mesothelioma Am J Dermatopathol 13:300-303, 1991 Milia Neurofibroma Omphaloma AD 123:105-110, 1987 Paget’s disease BJD 128:448-450, 1993 Polyp of the umbilicus Ped Derm 4:341-343, 1987; J Pediatr Surg 14:741-744, 1979 Porokeratosis – linear porokeratosis Primary umbilical adenocarcinoma Arch Pathol 99:95-99, 1975 Seborrheic keratosis AD 139:1497-1502, 2003 Squamous cell carcinoma AD 139:1497-1502, 2003; J Surg Oncol 47:67-69, 1991

Disseminated superficial actinic porokeratosis

Acanthosis nigricans Atopic dermatitis Cholesteatoma – umbilical nodule Cutis laxa – umbilical hernia Ped Derm 18:365-366, 2001 Epidermolysis bullosa – absent navel syndrome BJD 98:584, 1978 Epidermolytic hyperkeratosis Erythema annulare centrifugum Fox-Fordyce disease Rook p.2002, 1998, Sixth Edition Ichthyosis bullosa of Siemens Intertrigo Lichen nitidus Lichen sclerosus et atrophicus Rook p.2549-2551, 1998, Sixth Edition Mid-dermal elastolysis Omphalith (omphalokeratolith) – the inspissated umbilical bolus Rook p.3164, 1998, Sixth Edition; Cutis 40:144-146, 1987; AD 103:221, 1971 Periumbilical (perforating) pseudoxanthoma elasticum JAAD 39:338-344, 1998; JAAD 26:642-644, 1992; South Med J 84:788-789, 1991; AD 115:300-303, 1979 Psoriasis Pseudomyxoma peritonei – blue translucent umbilical lesion AD 96:462-463, 1967 Seborrheic dermatitis (intertrigo) Rook p.3164, 1998, Sixth Edition Supraumbilical mid-abdominal raphe Ped Derm 10:71-76, 1998 Umbilicolith

Factitial dermatitis

Aarskog syndrome – prominent umbilicus with protruding buttonlike central area surrounded by deep ovoid depression J Pediatr 86:885-891, 1975

Beare-Stevenson syndrome – cutis gyrata (furrowed skin), acanthosis nigricans, hypertelorism, swollen lips, swollen fingers, prominent eyes, ear anomalies, and umbilical hernia Ped Derm 20:358-360, 2003 Beckwith-Wiedemann syndrome – omphalocele or other umbilical anomalies Syndromes of the Head and Neck, 1990:323-328 Carpenter syndrome (acrocephalosyndactyly) – omphalocele Am J Med Genet 28:311-324, 1987 Coffin-Siris syndrome – webbed neck, bifid scrotum, umbilical and inguinal hernias JAAD 46:161-183, 2002 Congenital total lipodystrophy (Lawrence-Seip syndrome lipoatrophic diabetes; Berardinelli syndrome, Seip syndrome) – umbilical hernia; extreme muscularity and generalized loss of body fat from birth, acanthosis nigricans, acromegalic features, hyperinsulinemia (fasting and postprandial), early onset diabetes mellitus or glucose intolerance, hypertriglyceridemia/low HDL-C level, hirsutism, clitoromegaly J Clin Endocrinol Metab 85:1776-1782, 2000; AD 91:326-334, 1965 Cornelia de Lange syndrome – umbilical hernia Syndromes of the Head and Neck, p.303, 1990 DeBarsey syndrome – umbilical hernia Ped Derm 18:365-366, 2001 Dup (3q) syndrome – omphalocele Birth Defects 14:191-217, 1978 Dyskeratosis congenita Ehlers-Danlos syndrome type IX – umbilical hernia Ped Derm 18:365-366, 2001 Elejalde syndrome (acrocephalopolydactylous dysplasia) – omphalocele Birth Defects 13:53-67, 1977 Goltz’s syndrome Hunter’s syndrome – umbilical and inguinal hernias; reticulated 2-10-mm skin-colored papules over scapulae, chest, neck, arms; X-linked recessive; MPS type II; iduronate-2 sulfatase deficiency; lysosomal accumulation of heparin sulfate and dermatan sulfate; short stature, full lips, coarse facies, macroglossia, clear corneas (unlike Hurler’s syndrome), progressive neurodegeneration, communicating hydrocephalus, valvular and ischemic heart disease, lower respiratory tract infections, adenotonsillar hypertrophy, otitis media, obstructive sleep apnea, diarrhea, hepatosplenomegaly, skeletal deformities (dysostosis multiplex), widely spaced teeth, dolichocephaly, deafness, retinal degeneration Ped Derm 21:679-681, 2004 I-cell disease (mucolipidosis II) – umbilical hernia Helv Paediatr Acta 35:85-95, 1980 Idaho syndrome – umbilical hernia; premature fusion of the sagittal suture, micrognathia, anomalous pulmonary venous return, anterior dislocation of the tibiae, contractures of PIP joints J Neurosurg 47:886-898, 1977 Lethal omphalocele and cleft palate Hum Genet 64:99, 1983 Marshall-Smith syndrome – omphalocele Syndromes of the Head and Neck, p.340-342, 1990 MC/MR syndrome with multiple circumferential skin creases – multiple congenital anomalies including high forehead, elongated face, bitemporal sparseness of hair, broad eyebrows, blepharophimosis, bilateral microphthalmia and microcornea, epicanthic folds, telecanthus, broad nasal bridge, puffy cheeks, microstomia, cleft palate, enamel hypoplasia, micrognathia, microtia with stenotic ear canals, posteriorly angulated ears, short stature, hypotonia, pectus excavatum, inguinal and umbilical hernias, scoliosis, hypoplastic scrotum, long fingers, overlapping toes, severe psychomotor retardation, resembles Michelin tire baby syndrome Am J Med Genet 62:23-25, 1996

Menke gene variant – umbilical hernia Ped Derm 18:365-366, 2001 Mucopolysaccharidoses (Hurler’s, Hurler-Schei, Sanfilippo, Morquio, Maroteaux-Lamy, Sly syndromes) – umbilical hernias Rook p.2624-2625, 1998, Sixth Edition Occipital horn syndrome – umbilical hernia Ped Derm 18:365-366, 2001 Olmsted syndrome – periumbilical fissured keratotic plaques Pseudoxanthoma elasticum Rieger syndrome (hypodontia and prmary mesodermal dysgenesis of the iris) – failure of periumbilical skin to involute; exomphalos Br J Ophthalmol 67:529-534, 1983 Short stature, mental retardation, facial dysmorphism, short webbed neck, skin changes, congenital heart disease – xerosis, dermatitis, low-set ears, umbilical hernia Clin Dysmorphol 5:321-327, 1996 Simpson-Golabi-Behmel syndrome – pre-and post-natal overgrowth, large cystic kidneys, limb abnormalities, wide mouth, cleft palate, midline facial clefts, umbilical hernia, supernumerary nipples Clin Genet 51:375-378, 1997 Sjögren-Larsson syndrome – verrucous hyperkeratosis of flexures, neck, and periumbilical folds; mental retardation, spastic diplegia, short stature, kyphoscoliosis, retinal changes, yellow pigmentation, intertrigo – deficiency of fatty aldehyde dehydrogenase Chem Biol Interact 130-132:297-307, 2001; Am J Hum Genet 65:1547-1560, 1999; JAAD 35:678-684, 1996 Stein-Leventhal syndrome – hypertrichosis of umbilicus Trisomy 13 syndrome (Patau syndrome) – omphalocele J Genet Hum 23:83-109, 1975

Hernia AD 139:1497-1502, 2003; incarcerated hernias – umbilical nodules Ileoumbilical fistula – after surgery for Crohn’s disease Dig Dis Sci 24:316-318, 1979 Neonatal umbilical hemorrhage from slipped ligatures

Angiokeratoma Cullen’s sign Granulation tissue, exuberant Hemangioma Henoch-Schönlein purpura Pyogenic granuloma Ped Derm 4:341-343, 1987 Umbilical hemorrhage due to ulceration of the umbilical vein Vasculitis

UMBILICAL NODULES AD 128:1265-1270, 1992 Basal cell carcinoma AD 139:1497-1502, 2003 Bowen’s disease – plaque Cutis 42:321-322, 1988 Carcinoid tumor AD 114:570-572, 1978 Cholesteatoma Colonic mucosa implantation BJD 90:108, 1974 Condyloma acuminata Cutis laxa – umbilical hernia Ped Derm 18:365-366, 2001

DeBarsey syndrome – umbilical hernia Ped Derm 18:365-366, 2001 Dermatofibroma Desmoid tumor Ehlers-Danlos syndrome type IX – umbilical hernia Ped Derm 18:365-366, 2001 Embryologic rests AD 123:105-110, 1987 Endometriomas (32% of all umbilical tumors, most common); cutaneous endometrioma AD 112:1435-1436, 1976; JAMA 191:167, 1965 Endosalpingosis – ectopic fallopian tube epithelium; umbilical nodule BJD 151:924-925, 2004; post-operative endosalpingosis AD 116:909-912, 1980 Epidermal inclusion cyst Exstropy of the bladder Fibroepithelial papilloma Fibrous umbilical polyp – fasciitis-like proliferation; early childhood; male predominance Am J Surg Pathol 25:1438-1442, 2001 Foreign body granuloma AD 139:1497-1502, 2003 Granular cell tumor Ghatan p.102, 2002, Second Edition Hemangioma Cutis 76:233-235, 2005; Hernia AD 139:1497-1502, 2003 Hidradenitis suppurativa Incarcerated hernias Keloid AD 139:1497-1502, 2003 Leiomyosarcoma Lipoma Melanocytic nevus Rook p.1722-1723, 1998, Sixth Edition Melanoma AD 139:1497-1502, 2003 Malignant Langerhans cell tumor – periumbilical red nodule JAAD 49:527-529, 2003 Menke gene variant – umbilical hernia Ped Derm 18:365-366, 2001 Metastases – Sister Mary Joseph nodule BJ Surg 76:728-729, 1989; stomach AD 111:1478-1479, 1975; renal cell carcinoma J Comput Assist Tomogr 22:756-757, 1998; ovarian JAAD 10:610-615, 1984; pancreas Cutis 31:555-558, 1983; uterus Br J Clin Pract 46:69-70, 1992; leiomyosarcoma AD 120:402-403, 1984; peritoneal mesothelioma Am J Dermatopathol 13:300-303, 1991; BJ Surg 76:728-729, 1989; JAAD 10:610-615, 1984; acute promyelocytic leukemia AD 140:1161-1166, 2004 Mycobacterium tuberculosis – granuloma Ghatan p.101, 2002, Second Edition Neurofibroma Occipital horn syndrome – umbilical hernia Ped Derm 18:365-366, 2001 Omphalith (omphalokeratolith) – the inspissated umbilical bolus AD 103:221, 1971; Cutis 40:144-146 Omphalitis Omphaloma AD 123:105-110, 1987 Omphalomesenteric duct remnants (vitelline duct remnant) – umbilical mucosal polyp (cherry red nodule); may vary from simple mucosal protrusion to moderate or complete prolapse of the duct and herniation fo the ileum to complete prolapse of the duct and prolapse of the ileum Cutis 76:233-235, 2005; Textbook of Neonatal Dermatology, p.132, 2001; AD 126:1639-1644, 1990; other omphalomesenteric duct remnants (deep cyst, Meckel’s diverticulum or sinuses with ectopic

gastrointestinal tissue) Cutis 62:83-84, 1998; remnant may persist as open umbilical enteric fistula or patent vitellointestinal duct connecting the lumen of the small intestine to the umbilicus Cutis 76:233-235, 2005 Patent urachal duct AD 123:105-110, 1987 Periumbilical choristia Periumbilical perforating pseudoxanthoma elasticum JAAD 39:338-344, 1998; AD 132:223-228, 1996; JAAD 26:642-644, 1992; AD 115:300-303, 1979 Persistent vitelline duct and polyp AD 123:105-110, 1987 Pilonidal granulomata Pilonidal sinus of umbilicus Cutis 62:83-84, 1998 Polyp of the umbilicus Ped Derm 4:341-343, 1987 Pyogenic granuloma Cutis 76:233-235, 2005; Ped Derm 4:341-343, 1987 Sarcoma, congenital Cutis 76:233-235, 2005; Schistosomiasis – ectopic cutaneous granuloma – skin-colored papule, 2-3-mm; group to form mamillated plaques; nodules develop with overlying dark pigmentation, scale, and ulceration; periumbilical Dermatol Clin 7:291-300, 1989; BJD 114:597-602, 1986 Seborrheic keratosis AD 139:1497-1502, 2003 Squamous cell carcinoma AD 139:1497-1502, 2003 Supraumbilical mid-abdominal raphe Ped Derm 10:71-76, 1998 Talc granuloma – older individuals BJD 83:151-156, 1970 Tanapox infection NEJM 350:361-366, 2004 Umbilical granuloma – most common umbilical mass Textbook of Neonatal Dermatology, p.95,132, 2001 Umbilical hair granuloma and/or sinus Umbilical hernia, ligated Cutis 76:233-235, 2005 Umbilicolith Urachal and vascular abnormalities (patent urachus) (ectopic transitional epithelium of bladder) – urachal remnants with cyst, sinus, or fistula Textbook of Neonatal Dermatology, p.132, 2001; Cutis 62:83-84, 1998 Verrucous carcinoma AD 141:779-784, 2005 Yolk sac remnant – umbilico-ileal fistula Malignant tumors (8.4% of all tumors) SA Med Jnl Sept 1980, p.457; Cancer 18:907, 1965 53% Adenocarcinoma 23% Sarcomas 18% Melanomas 3% Squamous cell carcinoma 3% Basal cell carcinoma Carcinoid Mt Sinai J Med 44:257, 1977

Bowel-associated dermatitis arthritis syndrome – umbilicated pustules BJD 142:373-374, 2000 Linear IgA disease Lupus erythematosus – discoid lupus erythematosus – umbilicated papular eruption of the back with acneform hypertrophic follicular scars BJD 87:642-649, 1972

Palisaded neutrophilic and granulomatous dermatitis of collagen vascular diseases (rheumatoid arthritis); cutaneous extravascular necrotizing granuloma; Churg-Strauss granuloma, rheumatoid papule JAAD 47:251-257, 2002; JAAD 34:753-759, 1996; AD 130:1278-1283, 1994

Dermoid cyst and sinus – central dimple JAAD 46:934-941, 2002

Transepidermal elimination of collagen after steroid injections AD 120:539-540, 1984

Caustic drilling fluid in petrochemical industry (acquired perforating disease in oil field workers) – papules with central umbilication due to perforation of calcium JAAD 14:605-611, 1986 Calcium-containing EEG paste – papules with central umbilication due to perforation of calcium Neurology 15:477-480, 1965 Hydrocarbon (tar) keratosis – flat-topped papules of face and hands; keratoacanthoma-like lesions on scrotum JAAD 35:223-242, 1996 Suture material, transepidermal elimination AD 120:539-540, 1984

African histoplasmosis (Histoplasma duboisii ) – umbilicated papules BJD 82:435-444, 1970 Alternaria alternata – molluscum contagiosum-like lesions AD 121:901, 1985 Aspergillosis – primary cutaneous AD 128:1229-1232, 1992; perforating aspergillosis JAAD 15:1305-1307, 1986; molluscum contagiosum-like lesions BCG vaccination, disseminated – umbilicated facial papules Ped Derm 18:205-209, 2001; Ped Derm 14:365-368, 1997; Ped Derm 13:451-454, 1996 Cladosporium carrioni – molluscum contagiosum-like lesions Cowpox – umbilicated pustule; hemorrhagic pustule JAAD 44:1-14, 2001 Cryptococcosis – molluscum contagiosum-like lesions AD 132:545-548, 1996; JAAD 26:122-124, 1992; JAAD 13:845-852, 1985; AD 121:901-902, 1985; keratoacanthoma-like Tyring p.340, 2002 Draining sinus tract Eczema herpeticum (Kaposi’s varicelliform eruption) Cutis 75:33-36, 2005 Fire ant stings (Solenopsis invicta) – clusters of vesicles evolve into umbilicated pustules on red swollen base; crusting, heal with scars; urticaria Ann Allergy Asthma Immunol 77:87-95, 1996; Allergy 50:535-544, 1995 Fusarium sepsis Herpes simplex infection, including eczema herpeticum Herpes zoster, including eczema herpeticum Histoplasmosis with transepidermal elimination – molluscum contagiosum-like lesions JAAD 13:842-844, 1985 Insect bites Leishmaniasis

Leprosy – histoid leprosy Int J Lepr Other Mycobact Dis 65:101-102, 1997; Int J Dermatol 34:295-296, 1995; lepromatous leprosy Milker’s nodule Molluscum contagiosum Tyring p.62-63, 2002 Monkeypox – exanthem indistinguishable from smallpox – papulovesiculopustular; vesicles, umbilicated pustules, crusts CDC Health Advisory, June 7,2003; JAAD 44:1-14, 2001; J Infect Dis 156:293-298, 1987 Mycetoma – eumycetoma AD 141:793-794, 2005 Mycobacterium tuberculosis – congenital tuberculosis – red papule with central necrosis AD 117:460-464, 1981; molluscum contagiosum-like lesions; miliary tuberculosis JAAD 50:S110-113, 2004; Clin Inf Dis 23:706-710, 1996; papulonecrotic tuberculid Indian J Dermatol Venereol Leprol 50:267-268, 1984; miliary Orf – reddish-blue papule becomes hemorrhagic umbilicated pustule or bulla surrounded by gray-white or violaceous rim which is surrounded by a rim of erythema Tyring p.54, 2002; AD 126:356-358, 1990; large lesions may resemble pyogenic granulomas or lymphoma; rarely widespread papulovesicular or bullous lesions occur Int J Dermatol 19:340-341, 1980 Paecilomyces lilacinus – resemble molluscum contagiosum JAAD 39:401-409, 1998 Penicillium marneffei – molluscum contagiosum-like lesions Tyring p.345, 2002; NEJM 344:1763, 2001; JAAD 37:450-472, 1997; Clin Inf Dis 18:246-247, 1994; JAAD 31:843-846, 1994 Perforating folliculitis Plague (Yersinia pestis) – umbilicated vesicles and pustules J Infect Dis 129:S78-84, 1974 Pneumocystis carinii (molluscum contagiosum-like lesions) AD 127:1699-1701, 1991 Scabies-associated acquired perforating dermatosis JAAD 51:665-667, 2004 Smallpox Smallpox vaccination site Clin Inf Dis 37:241-250, 2003; generalized vaccinia – umbilicated vesicopustules Clin Inf Dis 37:251-271, 2003 Sporotrichosis – molluscum contagiosum-like lesions Syphilis – extragenital chancre (KA-like) JAAD 13:582-584, 1985 Tanapox – umbilicated papule NEJM 350:361-366, 2004; JAAD 44:1-14, 2001 Trombiculosis – fowl mite bites Tungiasis – Tunga penetrans JAAD 20:941-944, 1989 Vaccinia – umbilicated vesicle (Jennerian vesicle) JAAD 44:1-14, 2001 Varicella The Clinical Management of Itching; Parthenon Publishing, 2000; p.xi; Rook p.1017-1018, 1998, Sixth Edition Warts

Langerhans cell histiocytosis – masquerading as molluscum contagiosum JAAD 45:S233-234, 2001; JAAD 13:481-496, 1985

Necrotizing infundibular crystalline folliculitis – follicular papules with waxy keratotic plugs BJD 145:165-168, 2001

Pyoderma gangrenosum-like lesions, polyarthritis, and lung cysts with ANCA to azurocidin – umbilicated necrotic lesions Clin Exp Immunol 103:397-402, 1996 Sarcoid JAAD 44:725-743, 2001

Calcinosis cutis – transepidermal elimination of dystrophic or metastatic calcinosis cutis AD 134:97-102, 1998; subepidermal calcified nodule JAAD 49:900-901, 2003 Chronic renal disease – acquired perforating dermatosis of chronic renal disease Acquired perforating disease Rook p.2730, 1998, Sixth Edition; Int J Derm 32:874-876, 1993; Int J Dermatol 31:117-118, 1992; AD 125:1074-1078, 1989 Phrynoderma – hyperkeratotic, umbilicated follicular papules JAAD 41:322-324, 1999 Xanthomas, eruptive AD 137:85-90, 2001

Acantholytic acanthoma AD 131:211-216, 1995 Basal cell carcinoma Dermatofibroma Desmoplastic trichoepithelloma Eccrine poroma BJD 146:523, 2002 Epstein-Barr virus associated lymphoproliferative lesions BJD 151:372-380, 2004 Eruptive keratoacanthomas of Grzybowski AD 112:835-836, 1976 Eruptive vellus hair cysts AD 131:341-346, 1995 Fibrofolliculomas JAAD 17:493-496, 1987 Follicular tumors JAAD 15:1123-1127, 1986 Generalized eruptive histiocytoma BJD 144:435-437, 2001 Giant sebaceous hyperplasia AD 122:1101-1102, 1986 Hidradenoma papilliferum JAAD 41:115-118, 1999 Histiocytoma Keratoacanthoma AD 120:736-740, 1984 Leiomyosarcoma Sem Cut Med Surg 21:159-165, 2002; JAAD 38:137-142, 1998; J D Surg Oncol 9:283-287, 1983 Lichen planus-like keratosis Lymphoma – CD30 + anaplastic large cell lymphoma JAAD 49:1049-1058, 2003; HTLV-1 granulomatous T-cell lymphoma – umbilicated red-orange papulonodules JAAD 44:525-529, 2001 Lymphomatoid papulosis Melanoma – amelanotic desmoplastic neurotropic melanoma – umbilicated papule of nose AD 139:1209-1214, 2003 Metastases – adenocarcinoma of the lung Bolognia p.1954, 2003; squamous cell carcinoma Nevus lipomatosis superficialis BJD 153:209-210, 2005 Palisaded encapsulated neuroma (red papule) AD 130:369-374, 1994 Pilar cyst Pilar sheath acanthoma – umbilicated skin-colored papule with central keratinous plug of moustache area AD 114:1495-1497, 1978 Porokeratotic eccrine ostial and dermal duct nevus – resemble nevus comedonicus; linear keratotic papules with central plugged pit; may be verrucous; filiform; anhidrotic or hyperhidrotic; most common on palms and soles AD 138:1309-1314, 2002; JAAD 43:364-367, 2000; JAAD 24:300-301, 1991; Cutis 46:495-497, 1990

Rhabdomyomatous mesenchymal harmartoma (striated muscle hamartoma) (congenital) – asssociated with Dellemann’s syndrome – multiple skin tag-like lesions of infancy Ped Derm 15:274-276, 1998 Sebaceous adenoma Sebaceous hyperplasia Spitz nevus AD 134:1627-1632, 1998 Squamous cell carcinoma Syringocystadenoma papilliferum – umbilicated nodule of trunk (shoulders, axillae, genitalia) AD 71:361-372, 1955; linear syringocystadenoma papilliferum AD 121:1197-1202, 1985; AD 112:835-836, 1976 Syringoma Trichoblastoma – umbilicated scalp nodule with central follicular plug BJD 144:1090-1092, 2001 Trichofolliculoma – tuft of white hair issuing from central pore Verrucous acanthoma Verrucous perforating collagenoma Dermatologica 152:65-66, 1976 Waldenström’s IgM storage papules (macroglobulinosis) – skin-colored translucent papules on extensor extremities, buttocks, trunk; may be hemorrhagic, crusted, or umbilicated JAAD 45:S202-206, 2001; AD 128:377-380, 1992 Warty dyskeratoma Ghatan p.341, 2002, Second Edition

Hydroa vacciniforme – red macules progress to tender papules, hemorrhagic vesicles or bullae, umbilication and crusting; pocklike scars JAAD 42:208-213, 2000; Dermatology 189:428-429, 1994; JAAD 25:892-895, 1991; JAAD 25:401-403, 1991; BJD 118:101-108, 1988; AD 118:588-591, 1982; familial BJD 140:124-126, 1999; AD 114:1193-1196, 1978; AD 103:223-224, 1971; late onset BJD 144:874-877, 2001

Acne necrotica miliaris Rook p.1122, 1998, Sixth Edition Acne necrotica varioliformis AD 132:1365-1370, 1996; JAAD 16:1007-1014, 1987 Acrokeratoelastoidosis of Costa – umbilicated hyperkeratotic papules of palms and soles AD 140:479-484, 2004; Ped Derm 19:320-322, 2002; JAAD 22:468-476, 1990; Acta DV 60:149-153, 1980; Dermatologica 107:164-168, 1953 Darier’s disease – umbilicated white papules on oral mucosa Clin Dermatol 19:193-205, 1994; JAAD 27:40-50, 1992 Degenerative collagenous plaques of the hands – linear crateriform papules; may coalesce to form a band JAAD 47:448-451, 2002; AD 82:362-366, 1960 Elastosis perforans serpiginosa J Dermatol 20:329-340, 1993; Hautarzt 43:640-644, 1992; JAAD 10:561-581, 1984; AD 97:381-393, 1968 Erythema of Jacquet – erosive diaper dermatitis with umbilicated papules Ped Derm 15:46-47, 1998 Focal acral hyperkeratosis (acrokeratoelastoidosis without elastorrhexis) – autosomal dominant; crateriform papules of the sides of the hands and feet JAAD 47:448-451, 2002; AD 120:263-264, 1984; BJD 109:97-103, 1983 Fox-Fordyce disease JAAD 48:453-455, 2003 Granuloma annulare – in HIV disease JAAD:S184-186, 2003; umbilicated papular granuloma annulare AD 140:877-882, 2004; Int J Dermatol 36:207-209, 1997; AD 128:1375-1378,