Signs and Symptoms - I to O

ice pick scars

post acne scarring

ichthyosis linearis circumflexa

migratory polycyclic double-edged scale; Netherton’s s. (pathognomonic)

immune deficiency

Griscelli s.

induration ***

amyloidosis, lichenification, myxedema, scleroderma

infections, recurrent

Omenn’s s., prolidase deficiency, Schwachman’s s., severe combined immunodeficiency s., Wiskott-Aldrich s.

infertility

keratosis follicularis (Darier’s d.), trichothiodystrophy

insect bites

dermatofibromatosis, granuloma annulare, lymphocytoma cutis, papular urticaria, prurigo nodularis

intussusception

Peutz-Jeghers s.

invisible dermatoses

adrenoleukomyeloneuropathy, agyria, anhidrotic ectodermal dysplasia, anetoderma, atrophoderma, connective tissue nevus, dermal melanocytosis, dystonic juvenile lipidoses, epidermal hyperpigmentation, ganglioside storage d., hypopigmentation, ichthyosis, inclusion cell d., lipoatrophy, macular amyloidosis, mastocytosis, mucopolysaccharidoses, neuronal ceroid lipofuscinosis, onchocerciasis, porokeratosis, psychiatric disorders, tinea, urticaria

iritis

Behçet’s d., leprosy, relapsing polychondritis, Reiter’s s., rosacea, sarcoidosis, secondary lues, Sweet’s s.

ironed out appearance

epidermal atrophy leading to flattening; DLE, injury

ischemia, cutaneous

kidney, leukemia, lymphoma, myeloma, ovary, pancreas, polycythemia rubra vera, small bowel, stomach

island sparing

uninvolved skin in erythrodermic plaques; PRP

isomorphic response

lesion appearance at sight of trauma; AKA Koebner phenomenon (see eponym section)

jaundice

bile duct stricture/tumor, congenital toxoplasmosis, drugs, hepatic d., hepatitis, hemolysis, leptospirosis (Weil’s d.), pancreatitis, Q fever, TORCH s., yellow fever

jazz ballet bottom

buttock cleft abscess

jogger’s nipples

eroded, swollen, painful hyperkeratotic nipples from shirt rubbing

joint hypermobility

Job s.

keratitis

erythema multiforme, gold administration, lepromatous leprosy, Richner-Hanhart s., rosacea

keratodermic sandal

hyperkeratosis of soles extending up sides of feet; PRP

keratoses ***

Graham Little s., xeroderma pigmentosa

keratotic papules, palms

Cowden’s s.

keratotic pits, palms

nevoid BCC s.

keratotic plaques

Papillon-Lefevre s.

kidney shaped plaque

large plaque parapsoriasis, mycosis fungoides

kissing lesions

verrucae

knotty cypress

lesion appearance; erythema gyratum repens

knuckle pads

thickened extensor surface of IP joints; Dupuytren’s contracture, diffuse epidermolytic PPK, esophageal cancer, hyperkeratosis, idiopathic, oral leukoplakia, Peyronie’s d., pseudoxanthoma elasticum, trauma

kyphoscoliosis

epidermal nevus s.

lacrimation abnormalities

Riley-Day s.

lead lines

blue-black macule on gingiva margin from insoluble sulfide salts; bismuth, lead intoxication

lentigines

Carney’s s., centrofacial lentiginosis, Danoff’s s., generalized lentiginosis, LAMB s., LEOPARD s., Laugier-Hunziger s., Louis-Bar s., Moynahan’s s., NAME s., Peutz-Jeghers s., Tay’s s. , unilateral lentiginosis

lentigines, genital

Sotos’ s.

leonine facies

folds of facial skin giving lion-like appearance; actinic reticuloid, amyloidosis, kala-azar, leprosy, leukemia cutis, lepromatous leprosy, mucinosis, multicentric reticulohistiocytosis, mycosis fungoides, pachydermoperiostosis, progressive nodular histiocytoma, Sezary s., scleromyxedema

leopard skin

hypopigmented areas in darkly pigmented Africans; onchocerciasis

leopard spotting

yellow mottling of posterior pole of eye; PXE

leukocytosis

EM, erythroderma, pustular miliaria, pustular psoriasis

leukoderma

metastatic melanoma, Rozychi’s s., vitiligo

leukodystrophy

Siemerling-Creutzfeldt d.

leukopenia

chickenpox, Felty’s s., leishmaniasis, measles, rickettsial pox, RMSF, rubella, SLE

leukoplakia

Zinsser-Cole-Engman s.

lichenification

atopic dermatitis, Chanarin-Dorfman s. (dorsal hands), eczema, lichen simplex chronicus, neurodermatitis, stasis dermatitis

limb defects

Adams-Oliver s., CHILD s., epidermal nevus s., Maffucci’s s., Neu-Laxova s., proteus s., Roberts phocomelia s.

livedo reticularis

anticardiolipin s., arteriosclerosis, cryoglobulinemia, cutis marmorata, dermatomyositis, drugs, emboli, idiopathic, LE, lymphoma, PAN, pancreatitis, RA, syphilis, TB

liver palms

palmar erythema 1) warm hands & exaggerated palmar mottling 2) well-demarcated hypothenar erythema (more common); alcoholism

liver spots

solar lentigines

lizard skin

atrophy of skin; onchocerciasis

lumpy jaw

nodular submandibular swelling; cervicofacial actinomycosis

lymphadenopathy, generalized

connective tissue d.: dermatomyositis, LE, RA, Still’s d.

infectious: brucellosis, cat-scratch d., Chagas d., HIV, kala-azar, mononucleosis, plague, rubella, rubeola, scarlet fever, toxoplasmosis, tularemia, sporotrichosis, syphilis

neoplastic: leukemia, lymphoma, metastasis, mycosis fungoides, Sezary s.

other: amyloidosis, atopic dermatitis, exfoliative dermatitis, Gaucher’s d., Kawasaki’s d., Niemann-Pick d., phenytoin, Rosai-Dorfman s., sarcoidosis, Schnitzler’s s., serum sickness, Whipple’s d.

lymphatic malformations

Klippel-Trenaunay-Weber s.

macrocephaly

proteus s., Riley-Smith s., Sanfilippo’s s., Sotos’ s.

macrodactyly

proteus s.

macroglossia

Beckwith-Wiedemann s., EMG s.

maculae caeruleae (sky blue spots)

blue to slate colored macules on lower trunk & upper thighs; Pthirus pubis infestation (crab lice)

macules, confetti

1-2 mm macules; vitiligo, chemical leukoderma, tuberous sclerosis

macules, genital

Ruvalcaba-Myhre-Smith s.

maculosquamous

flat lesion with fine scale; erythrasma, PR, tinea versicolor

malabsorption

collagen vascular d., dermatitis herpetiformis, dermatogenic enteropathy

malaise

Weber-Christian s.

malar rash

SLE

malignancy (internal)

bullous pemphigoid, Cowden’s d., dermatitis herpetiformis, dermatomyositis, epidermolysis bullosa acquisita, erythema gyratum repens, erythema multiforme, erythroderma, Gardner’s s., herpes gestationis, hypertrichosis lanuginosa acquisita, leukoderma, mucosal neuroma s., Muir-Torre s., necrolytic migratory erythema, neurofibromatosis, paraneoplastic acrokeratosis of Bazex, pemphigus vulgaris, Peutz-Jeghers s., porphyria cutanea tarda, Sweet’s s., systemic amyloidosis, tuberous sclerosis, Wiskott-Aldrich s., xanthomas

mamillated

closely arranged pseudovesicular papules; Sweet’s s.

marble cake pattern

whorled hypopigmentation; hypomelanosis of Ito

mastocytosis

cardiopulmonary; chest pain, dizziness, dyspnea, palpitations, syncope  

cutaneous; bullae, flushing, pruritus, urticaria  

GI; cramps, diarrhea, epigastric pain, N/V  

neurologic; H/A, cognitive disorder  

other; bone pain, fatigue, fever, malaise, weight loss

matchbox sign

patient presents with material (skin, lint, tissue) in small container; delusion of parasitosis

mechanic’s hands

hyperkeratosis, fissuring, hyperpigmentation of hands; dermatomyositis (rare)

melanoma signs

A B C D E; Asymmetry, Border irregularity, Color mottling (brown, black, gray, red, white), Diameter, Elevation, Enlargement history

menstruation (worsens)

cutaneous endometriosis, dermatitis herpetiformis

mental retardation

Baraitser’s s., BIDS s., Bourneville’s s., cardio-facio-cutaneous s., CHIME s., Christ-Siemens-Touraine s., Clouston’s s., cri du chat s., cutis marmorata telangiectatica congenita, de Lange s., De Sanctis-Cacchione s., DeBarsy’s s., Down s., Dubokowitz’s s., EEC s., Elejalde s., epidermal nevus s., Fischer-Jacobsen-Clouston s., Gorlin’s s., hypomelanosis of Ito, IBIDS s., Marinesco-Sjogren s., Moynahan’s s., Netherton’s s., Nicolaides-Baraitser s., Pallister-Killian s., phenylketonuria, proteus s., Richner-Hanhart s., Riyadh chromosome breakage s., Roberts phocomelia s., Rubinstein-Taybi s., Rud’s s., Sabinas s., Sanfilippo’s s., Schafer’s s., Schimmelpenning-Feverstein-Mims s., Shokeir’s s., Steijlen’s s., Sturge-Weber s., Tay’s s., trichomegaly, Vogt triad, Watson’s s., Westerhof’s s., Wyburn-Mason’s s., Zinsser-Cole-Engman s.

metastases late >5 years

breast, colon, melanoma, renal

metastasize

atypical fibroxanthoma, epithelioid sarcoma, leiomyosarcoma, malignant fibrous histiocytoma, malignant melanoma, neurofibrosarcoma, SCC

microcephaly

cri du chat s., DeBarsy’s s., Neu-Laxova s., TORCH s.

micrognathia

progeria

microphthalmia

MIDAS s.

midline lesions

anterior cervical hypertrichosis, bronchogenic cysts, dermoid cysts, dimples, faun tails, hemangiomas, lipomas, pigmented macules, sinuses, skin tags, thyroglossal duct cysts

milia

bullous lichen planus, bullous pemphigoid, epidermolysis bullosa, lichen sclerosis, porphyria cutanea tarda, radiotherapy, trauma

mitral valve prolapse

cutis laxa, Ehlers-Danlos s. (type V), Marfan’s s., osteogenesis imperfecta type I, PXE

mitral valve stenosis

Moynahan’s s.

mitten deformity

pseudosyndactyly; recessive dystrophic EB

moccasin foot

erythema, hyperkeratosis, scale in moccasin distribution; tinea pedis (T rubrum usually)

mogul skier’s palm

traumatic hypothenar ecchymosis from ski poles

molting

epidermal fragility leading to collarette-like scale; ichthyosis bullosa of Siemens

monkey facies

wrinkled face; marasmus

moon facies

rounded face; Cushing’s s.

mosaic skin

fine desquamation with cracking along natural skin lines; kwashiorkor

mother patch

herald patch of PR

mulberry molars

abnormal teeth; congenital syphilis AKA Moon’s molars

mutilations

carcinoma, leprosy, Raynaud’s d., syphilis, tuberculosis

myalgia

toxic shock s.

myocardial infarction

progeria

myocarditis

Kawasaki d., SLE

myopathy

Chanarin-Dorfman s., polyarteritis nodosa

myositis

dermatomyositis, synergistic necrotizing myositis

myxomas

Carney’s s., LAMB s., NAME s.

neck webbing

de Lange s., Noonan’s s., Turner’s s.

necklace of Venus

see Venus’ necklace in Eponym section

necklace sign

skin burns from cigarette ash falling on sleeping, intoxicated persons

necrolytic migratory erythema

glucagonoma (90%)

necrosis

infectious; bacterial (actinomycosis, anthrax, nocardia, Pseudomonas, RMSF, Streptococcus, typhus), fungal (blastomycosis, cryptococcosis, histoplasmosis, mucormycosis, sporotrichosis), viral (herpes zoster, vaccinia)

other; DIC, medication, pyoderma gangrenosum, trauma, venom

vascular; arteriosclerosis, Buerger’s d, cryoglobulinemia, embolic, Kasabach-Merritt s., PAN, temporal arteritis, Wegener’s granulomatosis

necrosis, distal extremities

arteriosclerosis, calciphylaxis, carcinoma, cholesterol emboli, CREST s., mixed connective tissue d., myeloid metaplasia, PAN, scleroderma, septic emboli, Sjögren’s s., SLE

needle tracks

hyperpigmented linear scars along veins; intravenous drug injection

nephritis

serum sickness s.

neuralgia

benign cutaneous polyarteritis nodosa

neurocutaneous disease

acrodermatitis acidemica, adrenoleukodystrophy, albinism-deafness s., Björnstad’s s., Brachmann-de Lange s., bullous dystrophy (Mendes da Costa type), CHILD s., CHIME d., Cockayne’s s., Cross’ s., DeBarsy s., Delleman’s s., Down s., Elejalde’s s., encephalocraniocutaneous lipomatosis, Goltz’s s., Hartnup d., HID s., incontinentia pigmenti, Johnston’s s., Kallmann’s s., KID s., Klinefelter’s s., Klippel-Trenaunay s., LEOPARD s., Lesch-Nyan s., Menkes d., MIDAS s., multiple sulfatase deficiency, nevoid basal cell carcinoma s., nevus comedonicus s., Nicolaides-Baraitser s., Noonan’s s., OFD I s., Osler-Weber-Rendu d., Pallister-Killian s., Partington’s s., phacomatosis pigmentokeratotica, piebald trait, pigmentary mosaicism of Ito, preaxial anonychia, proteus s, Satoyoshi’s s., Schimmelpenning’s s., Shapira’s s., Steijlen’s s., Sturge-Weber s., Tangier d., Ullrich-Turner s., Van Lohuizen’s s., variegate porphyria, Verbov-Sharland s., Waardenburg’s s., xeroderma pigmentosum

neurofibromas

NAME s., Watson’s s.

neuropathy

acute intermittent porphyria, allergic granulomatosis, antimalarials, lymphomatoid granulomatosis, metronidazole administration, rheumatoid arthritis, Refsum’s d., POEMS s., polyarteritis nodosa, primary neuritic leprosy, RA, SLE, thalidomide, vincristine

neutrophilia

pustular psoriasis (Von Zambusch), Sweet’s s.

nevi, spider

alcoholics, familial, liver cirrhosis, normal persons (10%), OCPs, pregnancy, RA (on estrogen), thyrotoxicosis

nevus flammeus

Wyburn-Mason’s s.

nevus flammeus (trigeminal distribution)

Sturge-Weber s.

nicotine sign

yellow discoloration of distal fingers & fingernails; smokers

nipples, hyperkeratotic

acanthosis nigricans, Darier’s d., ichthyosiform erythroderma, idiopathic, lymphoma, prostate cancer treated with estrogens

nodule

NERD s.

nodule, dermal

deep mycosis, DF, GA, lymphoma, metastases, syphilis, TB, xanthomatosis

nodule, dermal-subdermal

erythema nodosum, thrombophlebitis (superficial)

nodule, epidermal

BCC, KA, verruca vulgaris

nodule, epidermal-dermal

compound nevi, melanoma, MF, SCC

nodules, erythematous

histiocytic: AFX, DFSP, eosinophilic granuloma, eruptive xanthoma, foreign body granuloma, sarcoidosis

infectious: abscess, atypical mycobacteria, KS, leishmaniasis, milker’s nodule, myiasis, nodular scabies, orf, tularemia

inflammatory: erythema induratum, erythema nodosum, insect bite reactions, Sweet’s s., Weber-Christian d.

miscellaneous: endometriosis

neoplasm: clear cell acanthoma, clear cell hidradenoma, eccrine poroma, leiomyoma leukemia cutis, lymphoma cutis, metastasis

vascular: angiokeratoma, angiosarcoma, hemangiopericytoma, periarteritis nodosa, pyogenic granuloma

nodules, inflammatory hand

atypical mycobacteria, cowpox, deep fungi, foreign body granuloma, furuncle, milker’s nodule, orf, primary TB, tularemia

nodules, inflammatory leg

Buerger’s d., deep fungi, embolism, erythema induratum, erythema nodosum, metastasis, nodular vasculitis, PAN, panniculitis, pyoderma, sarcoidosis, subcutaneous fat necrosis, Wegener’s granulomatosis

numbness

leprosy, morphea, necrobiosis lipoidica diabeticorum, necrotizing fasciitis, primary neuritic leprosy, rhinoscleroma

nutmeg grater skin

hard nodules around hair follicles; starvation

nystagmus

Louis-Bar s., Wyburn-Mason’s s.

obesity

acanthosis nigricans, acrochordons, candidiasis, hidradenitis suppurativa, intertrigo, melanocytic nevi, miliaria rubra, panniculitis of abdominal wall, psoriasis vulgaris (flexural), Rud’s s., striae, subcutaneous arterial calcification, xerosis

ochronosis

yellow color; alkaptonuria, hydroquinone, phenol

ocular disease

atopic dermatitis, carcinoid s, Fabry d., homocystinuria, leprosy, Lyme borreliosis, Marfan’s s., neurofibromatosis, onchocerciasis, pemphigus, PXE, PUVA-induced, retinoids, rosacea, sarcoidosis, syphilis, toxocariasis, tyrosinemia type II, vitamin A deficiency, vitiligo, xeroderma pigmentosum

odoriferous skin

EHK

oil spot

yellow-brown subungual macule; psoriasis

oligomenorrhea

Stein-Leventhal s.

oligophrenia

Sjögren-Larsson s.

omphalocele

Beckwith-Wiedemann s.

onycholysis

drugs, fungal infections, hyperhidrosis, hyperthyroidism, hypothyroidism, impaired peripheral circulation, maceration, peeling skin s., psoriasis, shell nail s., solvents, trauma, yellow nail s., wetting

ophiasis

hair loss in a band around the lower occipital & temporal scalp (Greek; snake); alopecia areata

organomegaly

POEMS s.

osteitis

SAPHO s.

osteoma cutis

COPS s.,

osteomas

Gardner’s s.

ovarian dysgenesis

Noonan’s s., primary lymphedema, Turner’s s.

oyster shell-like

black; pityriasis lichenoides ulceronecrotic (hyperacute)