Signs and Symptoms - C to E

café-au-lait macules

sharply defined brown macules; Albright’s s., ataxia-telangiectasia, Bannayan-Zonana s., basal cell nevus s., Bloom’s s., Cowden’s s., dyskeratosis congenita, epidermal nevus s., Fanconi’s s., Gaucher’s s., Hunter’s s., juvenile xanthogranuloma, Leschke’s d., Louis-Bar s., McCune-Albright s., multiple lentigines s., neurofibromatosis, nevus spilus, normal persons, Russell-Silver s., Ruvalcaba-Myhre-Smith s., Tay’s s., tuberous sclerosis, Turner’s s., von Hippel-Lindau d., Watson’s s., Westerhof’s s.

calcification/calcinosis

calciphylaxis, CREST, dermatomyositis (15% adults, 50% children), Down s., Ehlers-Danlos s., hypervitaminosis D, infection, IV calcium infusion milk-alkali s., neoplasms, nevoid basal cell s., panniculitis, PCT, PSS, PXE, Rothmund-Thomson s., sarcoidosis, SLE, subepidermal calcified nodule, trauma, Werner’s s.

Calcinosis

COPS s., CREST s., dermatomyositis, scleroderma

capillary malformations

proteus s.

caput medusae ***

dilated periumbilical veins secondary to portal hypertension; alcoholism

cardinal signs of inflammation

dolor (pain), calor (heat), rubor (erythema), tumor (swelling), & functio laesa (loss of function)

cardiomyopathy

Fabry d., Hermansky-Pudlak s., hypereosinophilic s., LEOPARD s.

cardiopulmonary d.

amyloidosis, collagen vascular d., cystic fibrosis, LE, LEOPARD s., lipoid proteinosis, lymphomatoid granulomatosis, multicentric reticulohistiocytosis, PXE, relapsing polychondritis, RA, sarcoidosis, scleroderma, SLE, yellow nail s.

cardiovascular d.

Kawasaki d., Lyme borreliosis, Marfan’s s., Reiter’s s., syphilis

Carotenemia

anorexia nervosa, diabetes mellitus, hepatic disease, hypothyroidism, hypopituitarism, inborn errors of metabolism

carp’s mouth

narrowed mouth width; de Lange s., Plummer-Vinson s.

cartilage inflammation

MAGIC s.

cat bite sign

osteochondritis of medial proximal tibial metaphysis; congenital syphilis AKA Wimberger sign

Cataracts

Albright’s s., atopic dermatitis (8%, usually posterior & shield shaped), Behçet’s d., cerebrotendinous xanthomatosis, congenital rubella, Christ-Siemens-Touraine s., Clouston’s s., Cockayne’s s., Conradi’s s., Cross-McKusick-Breen s., DeBarsy’s s., Fabry’s d., Hallermann-Streiff s., hidrotic ectodermal dysplasia, incontinentia pigmenti, Marinesco-SjØgren s., nail-patella s., pachyonychia congenita, pangeria, Rothmund-Thomson s., thymic hypoplasia (DiGeorge s.), thymoma with immunodeficiency, Werner’s s., Wiskott-Aldrich s.

cayenne pepper spots

minute red petechiae on lesion borders; Schamberg’s d.

Ceruloderma

drugs, Mongolian spot, nevus of Ota

Chagasids

morbilliform or erythema marginatum-like eruption; acute phase of Chagas d.

Chagoma

erythematous subcutaneous nodule; Chagas d.

Chancre

painless ulcer; primary syphilis

Cheilosis

Candida, riboflavin deficiency

Chelitis

AK, Bloom’s s., contact chelitis, factitial chelitis, Gamborg-Nielson PPK, granulomatosis chelitis, necrotizing sialometaplasia, plasma cell chelitis, Plummer-Vinson s.

chicken skin

see peau d’orange

Christmas tree pattern

papules & plaques following skin tension lines on the back; erythema dyschromicum perstans, KS, lichen planus, lichenoid reaction, pityriasis lichenoides, pityriasis rosea, syphilis (secondary)

cigarette paper skin

epidermal & dermal atrophy; acrodermatitis chronica atrophicans, Ehlers-Danlos s., parapsoriasis (large plaque), mycosis fungoides (patch stage)

claw hand

***; leprosy

cleft lip/palate

EEC s., popliteal web s., Rapp-Hodgkin s.

Clinodactyly

nail-patella s.

CNS calcification

BCC s., lipoid proteinosis, Papillon-Lefevre s., toxoplasmosis, tuberous sclerosis

coast of California

smooth bordered café-au-lait spots; neurofibromatosis

coast of Maine

jagged pigmented café-au-lait spots, may be dermatomal; McCune-Albright s.

cobblestone knuckles

hyperkeratosis; Unna-Thost d.

cobblestone papules, mouth

Darier’s d.

cobblestone skin

appearance; Crohn’s d., Cowden d., Darier’s d., lichen amyloidosis, lipoid proteinosis, MEN IIb, tuberous sclerosis

cold agglutinins

acrocyanosis, elderly, gangrene, Raynaud’s

colic

Peutz-Jeghers s.

collarette

peripheral lesional scale; EAC, mycoses (superficial), pityriasis rosea, PLC, syphilis (secondary)

collarette, necrolytic

pemphigus foliaceus

collodion membrane

Gaucher’s d., ichthyosis (congenital erythrodermic (67%), lamellar recessive), Johnston’s s., Netherton’s s., self-healing collodion baby, trichothiodystrophy

condyloma lata

moist verrucous genital plaques; secondary syphilis

confetti macules

chemical leukoderma, tuberous sclerosis, vitiligo, leukoderma punctatum, tinea versicolor, IGH, photoaging

congestive heart failure

progeria

conjunctivitis & conjunctival involvement

actinic prurigo, Behçet’s d., bullous dyskeratosis congenita, cat scratch d., cicatricial pemphigoid, erythema multiforme, erythema nodosum, Fabry d., iodides, Kawasaki’s s., lamellar ichthyosis, LP, Lyme d., molluscum contagiosum, moth dermatitis, psoriatic arthritis, Reiter’s s., rosacea, sarcoidosis, Sweet’s s., trichinosis, Wegener’s granulomatosis, X-linked aggamaglobulinemia, Zinsser-Cole-Engman s.

cool skin

arterial insufficiency, hypothyroidism, venous stasis

copper colored papules

secondary syphilis

copra itch

pruritus due to mite bites

corn flake sign

flaking keratinous papules of legs in Flegel’s d.

cornea, clouding

chlorpromazine, Tangiers’ d.

cornea, dystrophy

anhidrotic ectodermal dysplasia, angiokeratoma corporis diffusum, Darier’s d., epidermolysis bullosa of the polydysplastic type, Hurler’s s., keratosis follicularis spinulosa, non-bullous ichthyosiform erythroderma, PRP, Rothmund-Thomson s., xeroderma pigmentosum

cornea, erosion

cicatricial pemphigoid, DEB (Hallopeau-Siemens), DEB-inversa

cornea, opacities

antimalarials, chlorpromazine, cicatricial pemphigoid, Fabry’s d., Lawrence-Seip d., lepromatous leprosy, Morquio’s s., mucopolysaccharidoses, Richner-Hanhart s., PUVA, prolidase deficiency, Winchester s., xeroderma pigmentosa, X-linked ichthyosis

coup de sabre

linear, atrophic depression of central forehead; scleroderma

cracked skin

fine desquamation with cracking along natural skin lines; kwashiorkor

crazy paving dermatitis

erosive, peeling skin; kwashiorkor

crust, honey-colored

thick, dried fluid; eczematous dermatitis, impetigo

crust, varnish-like

dried exudate; bullous impetigo

cryptorchidism

Cockayne’s s., popliteal pterygium s., Tay’s d., X-linked ichthyosis

cutaneous horn

AK, basal cell epithelioma, granular cell tumor, Kaposi’s sarcoma, KA, renal carcinoma (metastatic), sebaceous carcinoma, SCC, SK, trichilemmal keratosis, verrucae vulgaris

cutis laxa

loose, redundant skin; amyloidosis, cutis laxa s., DeBarsy’s s., geroderma osteodysplastica, Patterson’s s., plasma cell dyscrasias, PXE, SCARF s., wrinkly skin s.

cutis marmorata

physiologic reaction to cold exposure; Cushing’s s., de Lange s., Down s., normal persons (children), trisomy 18

cutis verticis gyrata

acromegaly, amyloidosis

cysts, multiple

basal cell nevus s., congenital leukonychia, Dowling-Degos d., Gardner’s d., hexachlorobenzene-induced PCT, steatocystoma multiplex

deafness

knuckle pads, pili torti, relapsing polychondritis

congenital: albinism, Alezzandrini’s s., BADS s., Bart-Pumphrey s., BjØrnstad’s s., Cockayne’s s., congenital lues, congenital rubella, congenital syphilis, Crandall’s s., ectodermal dysplasia, Fisch’s s., HID s., hypomelanosis of ITO, JEB-progressiva, KID s., LEOPARD s., Marfan’s s., Morquio’s s., Moynahan s., Muckle-Wells s., multiple lentigines s., osteogenesis imperfecta, palmoplantar keratoderma (AD), Pallister-Killian s., Ramsay-Hunt s., Refsum’s d., Rozychi’s s., Tietze’s s., TORCH s., Waardenburg’s s., Wegener’s s., Woolf’s s., xeroderma pigmentosum, Ziprowski-Margolis s.

death, premature

Proteus s., Sanfilippo’s s., SCIDs, Siemerling-Creutzfeldt d., xeroderma pigmentosa

delirium

erysipelas

dell

central depression in papule; anetoderma, lichen sclerosis, molluscum contagiosum, sebaceous hyperplasia

dermal thinning

Cushing’s s.

dermatoglyphic absence

Rapp-Hodgkin s.

dermographism

urticaria due to physical allergy--response to firm stroking with dull instrument; hypereosinophilic s. (>75%), mastocytosis, NERD s., normal persons, urticaria

dermographism, white

blanch at sites of stroking; atopic dermatitis, GVHD

desquamation

dermatophyte infection, GVHD, ichthyosis, Kawasaki d., kwashiorkor, PR, syphilis, SSSS, TEN, vitamin A deficiency, vitamin A toxicity

desquamation, latent

scale that appears only after scratching; parapsoriasis, psoriasis, PR (early), tinea versicolor

dew drop on a rose petal

vesicle on pink base; varicella (chickenpox)

diaphoresis, nocturnal

acromegaly, carcinoid s., diabetes mellitus, lymphoma, vasculitis

diarrhea

acrodermatitis enteropathica, carcinoid s., chronic granulomatous d., dermatitis herpetiformis, Leiner’s d., lymphopenic agammaglobulinemia, mastocytosis, Nezelof’s s., runting s., SCIDS, Whipple’s d.

digitate dermatosis

fingerprint shape yellowish patches on trunk; SPP

dimple sign

lateral pressure results in depression; dermatofibroma

dirty appearance

skin (especially nuchal) appears dirt covered; Darier’s d., ichthyosis

dollar paper markings

minute telangiectasia similar to paper money fibers; chronic liver d.

drumstick fingers

finger shape with wider proximal portion; Fischer-Jacobsen-Clouston s.

dryness

aged skin, atropine-like drugs, cholesterol reducing drugs, chronic nephritis, ichthyosis, myxedema, niacin, retinoids

dwarfism

de Lange s., Moynahan’s s., trichomegaly

dysphagia

acanthosis nigricans, Behçet’s s., bullous pemphigoid, celiac d., Darier’s d., DEB, dermatitis herpetiformis, dermatomyositis, lichen planus, Plummer-Vinson s., PSS, PV, Steven-Johnson s., systemic sclerosis, tylosis

ear nodules

chondrodermatitis nodularis chronica helices, collagenous papules of the aural conchae, elastotic nodules of the antihelix, multicentric reticulohistiocytosis, Unverricht’s s.

ear pit

preauricular cyst

earlobe creases

risk factor for cardiovascular death (1.5x)

ecchymoses

actinic purpura, amyloidosis, anticoagulants, benign hypergammaglobulinemic purpura, Cushing’s s., DIC, Ehlers-Danlos s., glucocorticoid use, Hermansky-Pudlak s., hemophilia, hepatic insufficiency, psychogenic purpura, PXE, scurvy, vitamin K deficiency

eclabion

Neu-Laxova s.

ectopia lentis

homocystinuria, Marfan’s s.

ectropion

Neu-Laxova s., Rapp-Hodgkin s.

edema, eyelid

aldosteronism, dermatomyositis, MEN 3 (nodular swelling) trichinosis, urticaria

edema, facial

Melkersson’s s.

edema, hands & feet

NERD s.

edema, periorbital

Chagas’ d., trichinosis

elderly

actinic: photoaging, cutis rhomboidalis nuchae, solar lentigo, Favre-Racouchot d., solar purpura, venous lakes, stellate scars, radiodermatitis

autoimmune: amyloidosis, cryoglobulinemia, dermatomyositis, giant cell arteritis, hypersensitivity vasculitis, LE, livedo reticularis, morphea, pemphigus vulgaris, progressive psoriatic arthritis, sarcoidosis, systemic sclerosis, Wegener’s granulomatosis

eczema: nummular, gravitational, asteatotic, lichen simplex chronicus, atopic, auto-sensitization, prurigo nodularis

feet: bunions, calluses, clavi, corns, onychauxis, onychocryptosis, onycholysis, onychogryphosis, onychophosis, subungual exostosis

infections: acrodermatitis chronica obliterans, Candida, dermatophyte, cellulitis, herpes simplex, herpes zoster, pyoderma

lymphoma: CTCL, cutaneous B cell lymphoma, leukemia cutis, multiple myeloma, macroglobulinemia, parapsoriasis en plaque, Sezary s.

mucous membranes: cheilitis, perleche, leukoplakia, oral cancer

nails: dystrophy

neoplasia, benign: acrochordons, cherry angioma, clear cell acanthoma, colloid millium, cutaneous horns, fibroepithelioma, KA, sebaceous adenoma, seborrheic keratosis

neoplasia: actinic keratoses, angiosarcoma, BCC, Bowen’s d., cutaneous metastases, melanoma (desmoplastic, lentigo maligna, nodular, superficial spreading), lentigo maligna, Merkel cell carcinoma, Paget’s d., SCC

en coup de sabre

forehead lesion; linear scleroderma

enamel paint spot

darkened plaques; kwashiorkor

enchondromatosis

Maffucci’s s.

endocrine abnormalities

Carney’s s., POEMS s.

ephelides

NAME s.

epicanthal fold

Down s., Dubokowitz’s s., Klinefelter’s s., Turner’s s.

epidermal translucency

Cushing’s s.

epiphora

Rapp-Hodgkin s.

epistaxis

glanders, hereditary hemorrhagic telangiectasia, Henoch-Schönlein purpura, Hermansky-Pudlak s., idiopathic thrombocytopenic purpura, kala-azar, Lucio’s phenomenon, polyarteritis nodosa, polycythemia rubra vera, PXE, SLE, systemic mastocytosis, universal telangiectasia, Waldenstrom’s macroglobulinemia, Wegener’s granulomatosis

erythroderma

dermatologic: actinic reticuloid, airborne contact dermatitis, atopic dermatitis, candidiasis, contact dermatitis (generalized), crusted scabies, hypereosinophilic s., ichthyosis, Leiner’s d., lichen planus, LE, mastocytosis, nummular eczema, peeling skin s., pemphigus foliaceus, phytophotodermatitis, PRP, psoriasis (20%), Reiter’s d., scalded skin s., seborrheic dermatitis, stasis dermatitis

neoplastic: carcinoma (colon, lung, liver, pancreas, prostate, stomach, thyroid), CTCL, Hodgkin’s d., lymphoma (30%), mycosis fungoides, Sezary s., T-cell leukemia, T-cell lymphoma

systemic: complement deficiency, dermatomyositis, erythrodermic mastocytosis, sarcoidosis

other: GVH disease, drug reactions

erythroderma, exfoliative

skin disease; atopic dermatitis, chronic actinic dermatitis, contact dermatitis, CTCL, dermatophytosis, drug allergy, Hailey-Hailey d., ichthyosis (hereditary), LE, Leiner’s d., lichen planus, mycosis fungoides, pemphigoid, pemphigus foliaceus, pityriasis rubra pilaris, psoriasis, Reiter’s s., Sarcoid, seborrheic dermatitis, SSSS, stasis dermatitis,

systemic disease; AML, CML, fallopian tube carcinoma, GVH d., HIV infection, lung carcinoma, lymphoma, multiple myeloma, rectal carcinoma, reticulum cell sarcoma

erythroderma, neonatal

Chanarin-Dorfman s., infantile atopic dermatitis, Netherton’s s.,

esophageal abnormality

CREST s., PACK s., PSS

esophageal cancer

arsenic, Plummer-Vinson s., tylosis

esophageal strictures

Zinsser-Cole-Engman s.

ethnic groups

American Indians; actinic prurigo, cutaneous diphtheria, oral focal epithelial hyperplasia (Heck’s s.), PMLE

Amish; Ellis van Crevhold d., yellow mutant albinism

Asian; macular amyloidosis

Canadian Indians; PMLE (lip involvement)

Chinese; lichen amyloidosis

Dutch; Hermansky-Pudlak s.

French Canadian; Clouston’s hidrotic ectodermal dysplasia

Hispanic; lichen planus pigmentosis, melasma

Japanese; Behçet’s d., congenital onychodysplasia of the index finger, HTLV-1, lipodystrophia centrifugalis abdominalis infantalis, Rieh’s melanosis, syringomas

Jews (Ashkenazi); Bloom’s s., distinctive exudative discoid & lichenoid dermatitis (oid-oid), familial Mediterranean fever, Gaucher’s d., Niemann Pick d., pemphigus foliaceus, pemphigus vulgaris, Riley-Day s., thromboangiitis obliterans, vitiligo, Ziprokowski-Margolis s.

Mediterranean; Chanarin-Dorfman s., KS (classic)

Middle Eastern; Behçet’s d.. Chanarin-Dorfman s., macular amyloidosis

Puerto Rican; Hermansky-Pudlak s.

South American; macular amyloidosis

South African; pseudomonilethrix

excoriation

atopy, contact dermatitis, DH, infestations, neurodermatitis, stasis dermatitis

exfoliation, palmar

Kawasaki d., scarlet fever, TSS

exophthalmos

Hand-Schòller-Christian d., hyperthyroidism, Langerhan’s cell histiocytosis, rhinoscleroma

expressionless appearance

panhypopituitarism, scleredema, scleroderma

Eyelid lesions

multiple clear cell hidradenomas, primary mucinous carcinoma of the skin, sebaceous carcinoma, signet ring cell carcinoma, syringomas