Signs and Symptoms - P to Q

pain & erythema

acrodynia, erythromelalgia, erythermalgia, erythropoietic protoporphyria, palmar-plantar erythrodysesthesia s., photosensitivity, phototoxic reactions, Raynaud’s s., SSSS, sunburn, TEN

pain & erythema, papules or plaques

arthropod assault, chilblains, dermatitis herpetiformis, nasociliary neuralgia parapsoriasis, psoriasis, thermal injury, urticarial vasculitis

pain, bone

Schnitzler’s s.

painful papules or nodules

adiposus dolorosa, angiolipoma, chondrodermatitis nodularis helices, clavi, eccrine spiradenoma, erythema nodosum, glomus tumor, granular cell tumor, leiomyoma, neuroma, nodulocystic acne, plantar warts

painful piezogenic pedal papules

transdermal fat herniations

painful skin lesions

blue rubber bleb nevus, dermatofibroma, endometriosis (cutaneous), granular cell tumor

painful subcutaneous nodules

angiolipoma, Dercum’s d. (multiple painful lipomas), eccrine spiradenoma, glomus tumor, leiomyoma, neurilemmoma, neuroma

painful tumors

angiolipoma, chondrodermatitis nodularis helices, eccrine spiradenoma, glomus tumor, leiomyoma, neurilemmoma, neuroma, osteoma cutis

painless subcutaneous nodules

granular cell tumor, malignant fibrous histiocytoma

pallor

anemia, cold exposure, emotion, epinephrine, iron deficiency anemia, megaloblastic anemia, panhypopituitarism, shock

palmar erythema

alcoholism, carcinoid, chemotherapy induced acral erythema, cirrhosis, DM, erythema palmare hereditorium, GVHD, Grave’s d., hemochromatosis, Kawasaki’s d., LE, leukemia, liver metastases, peeling skin s., pregnancy, rheumatoid arthritis, Wilson’s d.

palmar hyperlinearity

ichthyosis vulgaris

palmar/plantar desquamation

Kawasaki’s s., lamellar dyshidrosis, scarlet fever, toxic shock s.

palmoplantar keratoderma

acrokeratoelastoidosis of Costa, basal cell nevus s., bullous ichthyosiform erythroderma, Cantu’s s., circumscribed keratoderma, Darier’s d., dermal duct nevus, disseminate keratoderma with corneal dystrophy, dyskeratosis congenita (Zinsser-Cole-Engman s.), epidermolytic palmoplantar keratoderma (of Vorner), focal acral hyperkeratosis, glucan induced keratoderma in AIDS, hidrotic ectodermal dysplasia (Clouston’s s.), Howell-Evans s., keratosis pilaris decalvans, keratosis punctata palmaris et plantaris, keratosis punctata of the palmar creases, keratoderma climactericum, keratoderma with deafness, lichen planus, Mal de Meleda, mutilating keratoderma of Vohwinkel, Naegeli’s s., non-bullous ichthyosiform erythroderma, Olmstead s., pachydermoperiostosis, pachyonychia congenita, Papillion-Lefevre s., peeling skin s., PRP, porokeratosis plantaris discreta, pachyonychia congenita, progressive keratoderma (Greither’s s.), punctate keratoderma (Buschke-Fischer), Richner-Hanhart s., Sezary s., Sjogren-Larson s., striate keratoderma, Unna-Thost s., yaws

palmoplantar pitting

basal cell nevus s., Darier’s d., erythema multiforme, generalized follicular hamartoma, pneumonitis, reticulated acropigmentation of Kitamura

palmoplantar sign

yellow discoloration of palms & soles; typhoid fever, AKA Filipovitch’s sign

pancreatic insufficiency

Schwachman’s s.

paper money skin

thread-like telangiectasias similar to threads in US currency; alcoholism

papillomatosis, oral

Cowden’s s.

papules, annular

alopecia mucinosa, arthropod bites, EED, elastosis perforans serpiginosa, GA, Jessner’s lymphocytic infiltrate, leukemia cutis, lichen planus, lymphoma cutis, lymphocytoma cutis, Meischer’s granuloma

papules, blue-black

blue nevus, nodular melanoma, angiokeratoma, Kaposi’s sarcoma

papules, hemorrhagic

meningococcemia, vasculitis

papules, hyperkeratotic

acrokeratosis verruciformis of Hopf, confluent and reticulated papillomatosis, Darier’s d., follicular LP, folliculitis, keratosis pilaris, keratosis punctata, Kyrle’s d., lichen spinulosis, PRP

papules, lichenoid

lichen amyloidosis, lichen myxedematosus, lichen nitidus, lichenoid drug eruption, lichen simplex, lichen spinulosis, lichen striatus, LP, papular GA, sarcoidosis

papules, linear

contact dermatitis, GA, insect bites, lichen striatus, linear epidermal nevus, linear porokeratosis, nevus verrucosus, verruca vulgaris

papules, yellow

xanthomatosis

papulosquamous

scaling papules; psoriasis

paraproteinemia

amyloidosis, angioedema, angioimmunoblastic LAD, edema, macroglossia, myeloma, necrobiotic xanthogranuloma, purpura, PG, Raynaud’s phenomenon, scleroderma, Sneddon-Wilkinson s., xanthoma

parotid enlargement

AIDS (pediatric), alcoholism, ancyclosomiasis, DLE, Heerfordt s., pellagra, sarcoidosis, SSKI intake

pathergy

localization of disease to sights of trauma; Behçet’s s., bowel associated dermatitis-arthritis s., pyoderma gangrenosum, Wegener’s granulomatosis AKA Koebner phenomenon

peau d’orange

skin appears like an orange, thickened with minute dells; erysipelas, pretibial myxedema, PXE, scleredema, shagreen patch, traumatic fat necrosis, tuberous sclerosis AKA chicken skin

pebbling, scapular

Hunter’s s.

pebbly skin (dorsal hand)

roughened like small pebbles; erythropoietic protoporphyria

pencil-in-cup deformity

radiographic finding; symmetric, conical osteolysis of proximal head; psoriatic arthritis (rare)

perianal dermatitis

Candida, contact dermatitis, cutaneous amebiasis, enterobiasis, Group B streptococcus, larva currens, psoriasis, psychogenic, seborrheic dermatitis, Sjögren’s s., spice ingestion, TCN administration

periodontitis

cell associated glycoprotein deficiency, Hand-Schuller-Christian d., Letterer-Siwe d., Papillion-Lefevre s.

perioral eruption

acrodermatitis enteropathica, arteriovenous hemangioma, biotin responsive multiple carboxylase deficiency, blepharocholasis, chrysiasis, chronic bullous disease of childhood, Cowden’s d. (trichilemmomas), essential fatty acid deficiency, glucagonoma, JEB-Herlitz, perioral dermatitis, primary amyloidosis, staphylococcal scalded skin s., zinc deficiency

perioral sparing

adenoma sebaceum, infantile atopic dermatitis, erythrose perubuccale pigmentaire of Brocq, perioral dermatitis, scarlet fever

periorbital edema

anticonvulsant hypersensitivity s., carcinoid, Chagas d. (Romana’s sign), contact dermatitis, cretinism, dermatomyositis, EBV infection, Fabry’s d., Henoch-Schönlein purpura, myxedema, PSS, roseola, Sezary s., trichinosis

periorbital eruption

necrobiotic xanthogranuloma

peritonitis

familial Mediterranean fever

perleche

fissures at angle of the mouth; avitaminosis, dentures, idiopathic moniliasis

petechiae, newborn

congenital infection, hypoprothrombinemia (vitamin K deficiency), protein C deficiency, SLE, thrombocytopenia, trauma, von Willebrand’s d., Wiskott-Aldrich s.

petechiae, non-palpable

platelet alterations: autoimmune thrombocytopenia, CLL, congestive splenomegaly, DIC, diet deficiency (B₁₂, folate, iron), drugs, lupus, lymphoma, marrow toxicity, May-Hegglin anomaly TTP, viral (CMV, EBV, rubella), Wiskott-Aldrich s.

non-platelet: benign hypergammaglobulinemic purpura, chronic pigmented purpura, Hermansky-Pudlak s., intravascular venous pressure elevations

petechiae, perifollicular

scurvy

phakoma

asymptomatic nodular retinal mass; tuberous sclerosis

photoexacerbation

Darier’s d., Grover’s d., psoriasis, reticulated erythematous mucinosis

photophobia

acrodynia, acrodermatitis enteropathica, albinism Behçet’s d., Chediak-Higashi s., chloroquine ingestion, Hermansky-Pudlak s., ichthyosis follicularis, IFAP s., interstitial keratitis of late congenital syphilis, juvenile xanthogranuloma, keratosis follicularis spinulosa decalvans, measles, oculocutaneous albinism, pretibial leptospirosis, Richner-Hanhart s., Sjögren’s s., xeroderma pigmentosum

photosensitivity

amiodarone, Bloom’s s., Cockayne’s s., DLE, Darier’s d., dermatomyositis, Hartnup’s d., hereditary coproporphyria, INH treatment, lymphocytoma cutis, lymphogranuloma venereum, PIBIDS s., pellagra, pemphigus erythematosus, PIBIDS, porphyria, prolidase deficiency, reticular erythematous mucinosis, Rothmund-Thomson s., SCLE, SLE, trichothiodystrophy, xeroderma pigmentosa

photosensitivity, infants

non telangiectatic; erythropoietic porphyria, erythropoietic protoporphyria, xeroderma pigmentosum

telangiectatic; Bloom’s s., Cockayne’s s., Rothmund-Thomson s.

phyrenoderma

hypothyroidism

phytophotodermatitis

Compositae, Moraceae, Papilionaceae, Rutaceae, Umbelliferae

phytosterolemia

betasitosterol, campestenol, stigmasterol

pigmentary demarcation lines

type A; Futcher’s (Voigt’s) lines 

type B; posteromedial lower extremities during pregnancy 

type C; mediosternal from clavicle to inferior sternum 

type D; posteromedian spine 

type E; bilateral symmetric periareolar hypopigmented macules

Ping-Pong patches

traumatic ecchymotic patches from Ping-Pong balls

pins and needles

follicular degeneration s. (scalp)

pitting scars of digits

PSS

pitting, lip

popliteal web s.

pitting, palms and soles

Darier’s d., nevoid BCC s., pitted keratolysis

plaque primitive

herald patch of PR

plaques, annular

alopecia mucinosa, deep fungus, DLE, EAC, fixed drug eruption, GA, granuloma faciale, Jessner’s lymphocytic infiltrate, leprosy, leukemia cutis, lichen planus, lichen simplex, lues, lupus vulgaris, lymphocytoma cutis, lymphoma cutis, MF, necrobiosis lipoidica, nummular eczema, papular mucinosis, parapsoriasis, porokeratosis, psoriasis, sarcoid, tinea

plaques, erythematous

alopecia mucinosa, Bowen’s d., DLE, eosinophilic granuloma, fixed drug eruption, Jessner’s lymphocytic infiltrate, leishmaniasis, leprosy, leukemia cutis, lupus vulgaris, lymphoma cutis, MF, PMLE, pseudolymphoma, psoriasis, sarcoidosis

platyspondyly

Morquio’s s.

plethoric facies

persistent facial erythema due to chronic vasodilatation & vasoregulatory loss; alcoholism

pleurisy

familial Mediterranean fever

pneumonia, recurrent

Churg-Strauss s.

poikiloderma

triad of atrophy, mottled pigmentation & telangiectasia; acrodermatitis chronica atrophicans, acrokeratotic poikiloderma, Bloom’s s., dermatomyositis, COPS s., diffuse & macular atrophic dermatosis, drugs (arsenic, busulfan, steroids), dyskeratosis congenita, erythrokeratoderma viriabilis, Fanconi’s anemia, GVHD (chronic), Hartnup d., heat/cold exposure, hereditary sclerosing poikiloderma, Kindler’s s., large plaque parapsoriasis, LE, mycosis fungoides, parapsoriasis, poikiloderma of Civatte, radiodermatitis, Rothmund-Thomson s., Werner’s s.

poliosis

Alezzandrini’s s., alopecia areata, inflammatory processes, neurofibromatosis, piebaldism, poliosis with multiple malformations, prolidase deficiency, Tietze’s s., tuberous sclerosis, vitiligo, Vogt-Koyanagi-Harada s., Waardenburg’s s.

polygonal

shape of macules; idiopathic guttate hypomelanosis

polymorphous eruption

dermatitis herpetiformis, erythema multiforme, histiocytosis X, pityriasis lichenoides, PMLE

polyps

Cowden’s d., Cronkhite-Canada s., Gardner’s s., multiple hamartoma s., Muir-Torre s., multiple perifollicular fibromas, neurofibromatosis, Peutz-Jeghers s., Ruvalcaba-Myhre-Smith s., skin tags & polyps s.

pre-cancerous lesions

actinic keratosis, arsenical keratosis, Bowenoid papulosis, Bowen’s d., chemical keratoses, cicatrix keratoses, cutaneous horn, erythroplasia of Queyrat, intraepidermal epithelioma, leukoplakia, radiation keratoses, tar keratosis, thermal keratoses

precocious puberty

McCune-Albright s., NAME s., tuberous sclerosis

pregnancy

herpes gestationis, impetigo herpetiformis, papular dermatitis of pregnancy, prurigo gestationis, pruritus gravidarum, PUPPP

pregnancy; exacerbates

acute intermittent porphyria, acrodermatitis enteropathica, aphthae, biological false positive for syphilis, chloasma, condylomata, cutaneous ciliated cysts, dermatomyositis, disseminated gonorrhea, dysplastic nevus, erythema nodosum, erythrokeratoderma viriabilis, estrogen receptor increase on nevus cells, familial cutaneous collagenomas, gonococcemia, granuloma inguinale hematogenous spread, hair thinning, herpes gestationis, hyperhidrosis, hyperpigmentation, hypertrichosis, keloids, lupus erythematosus, labial varicosities, linea nigra, Lofgren’s s., malignant fibrous histiocytoma, melanoma(?), melasma, meralgia paresthetica, neurofibromatosis, onycholysis, palmar erythema, phlegmasia alba dolens, pityriasis rotunda, precipitation of primary lymphedema, progressive mesangiocapillary glomerulonephritis of partial lipodystrophy, purpuric “gloves & socks” s., pustular psoriasis, pyogenic granuloma, skin tags, SLE, spider angiomas, striae, telangiectasia, thrombotic thrombocytopenic purpura, tinea versicolor, unilateral nevoid telangiectasia s., varicosities, verruca, zinc deficiency

pregnancy; improves

alopecia areata, chilblains, dermatomyositis, nail growth, Fox-Fordyce d., hidradenitis suppurativa, lupus erythematosus, monilethrix, psoriasis, sarcoidosis

pregnancy; improves with delivery

herpes gestationis, PUPPPS, papular dermatitis of pregnancy

premature aging

acrogeria, Cockayne’s s., diabetes mellitus, Down s., familial mandibulo-acral dysplasia, generalized lipodystrophy, metageria, neonatal progeroid s. of Wiedemann-Ratenstrauch, osteodysplastic xeroderma, pangeria, poikiloderma congenitale, progeria, prolidase deficiency

prenatal diagnosis

bullous ichthyosiform erythroderma, JEB-Herlitz, xeroderma pigmentosa

pretibial myxedema

non-pitting lower extremity edema; Graves’ d., Hashimoto’s thyroiditis, hypothyroidism

primary medallion

herald patch of PR

prostatitis

Reiter’s s.

pruritus ani

Candida, contact dermatitis, dermatitis medicamentosa, leakage, lichen planus, penicillin allergy, pinworm, psoriasis, psychogenic, seborrheic dermatitis, spice ingestion, threadworm

pruritus, absent skin findings

AIDS, brain disease (abscess, infarct, tumor), carcinoid, hepatobiliary d., Hodgkin’s d., hydroxyethyl starch infusion, hyperthyroidism, hypothyroidism, iron deficiency anemia, lymphoma, mastocytosis, MS, myeloma, paraproteinemia, polycythemia vera, Sjögren’s s., uremia, visceral tumor

pruritus, after bathing

aquagenic pruritus, hypereosinophilic s., myelodysplasia, polycythemia vera AKA bath pruritus

pruritus, recurrent

onchocerciasis

pruritus, scalp

diabetic neuropathy

pruritus, with cancer

carcinoid (upper trunk, legs, extensor arms), carcinoma (breast, pancreatic, lung, stomach), CNS tumors, Hodgkin’s d., leukemia, lymphoma, multiple myeloma

pruritus, with infection

ascaris, candidiasis, hookworm, neurosyphilis, trichinosis

pruritus, with skin diseases, moderate

actinic reticuloid, bullous pemphigoid, chiggers, cutaneous larva migrans, eosinophilic pustular folliculitis, folliculitis, fungal infection, herpes gestationis, lichen simplex chronicus, linear IgA, miliaria, mycosis fungoides, pediculosis, pemphigus foliaceous, pityriasis lichenoides, pityriasis rosea, PMLE, progressive systemic sclerosis, psoriasis, psychogenic, PUPPP, seborrheic dermatitis, Sezary s., Sjögren’s s., steroid acne, sunburn, sweat retention s., swimmer’s itch, urticaria pigmentosa, xerosis

pruritus, with skin diseases, severe

acne necrotica miliaris, atopic dermatitis, contact dermatitis, dermatitis herpetiformis, dermographism, drug eruption, fiberglass dermatitis, Fox-Fordyce d., Grover’s d., insect bites, lice, lichen planus, prickly heat, scabies, Sezary s., stasis dermatitis, urticaria

pruritus, with systemic diseases

AIDS, biliary disease/obstruction, cancer (breast, CNS, gastric, lung), diabetes insipidus (nasal tip), diabetes mellitus (scalp & candidal), hepatic cirrhosis, hepatitis C (30%), Hodgkin’s d. (6%), hypereosinophilic s., hypertriglyceridemia (eruptive xanthomas), hyperthyroidism, hypothyroidism, intestinal parasites, intrahepatic cholestasis of pregnancy, leukemia, lymphoma (<5%), multiple myeloma, multiple sclerosis (paroxysmal), myelodysplastic s., neurological disorders,  polycythemia vera (50%), SLE, Sjögren’s s., thrombocytopenia (essential), uremia (90% of dialysis patients)

pseudoainhum

ancylostomiasis, burns, cholera, congenital ectodermal defects, diabetes mellitus, ergot poisoning, erythropoietic protoporphyria, frostbite, hereditary palmoplantar keratoderma, keratosis striata, leprosy, mal de Meleda, Olmsted’s s., pachyonychia congenita, PRP, psoriasis, Raynaud’s s., scleroderma, syringomyelia, spinal cord tumors, syphilis (tertiary), trauma, Vohwinkel’s s.

pseudopelade

folliculitis decalvans, keratosis pilaris, lichen planus, lupus erythematosus, progressive systemic sclerosis

psoriasiform

psoriasis, SCLE

psychiatric symptoms

acute intermittent porphyria, autoerythrocyte sensitization s., basal cell nevus s., delusions of parasitosis, dysmorphic delusions, Dercum’s d., factitial, Hartnup’s d., hereditary coproporphyria, Klinefelter’s s., Marshall White s., neurotic excoriation, psychogenic pruritus, SLE, trigeminal trophic s.

ptosis

Noonan’s s., Pallister-Killian s.

puberty exacerbates

cutis verticis gyrata, familial acanthosis nigricans, familial cylindroma, Koenen’s tumors, pretibial dystrophic EB lesions, steatocystoma multiplex, syringocystadenoma papilliferum, unilateral nevoid telangiectasia s.

puberty improves or initiates

EB albopapuloidea (Pasini), acatalesemia (Takahara’s d.), EBS-Koebner, granulosis rubra nasi, erythrokeratoderma viriabilis, hydroa vacciniforme, pili torti, progressive symmetric erythrokeratoderma, tinea

puberty, precocious

McCune-Albright s., Rabson-Mendenhall s., Russell-Silver s.,

pulling boat hands

friction and damp cold with exposure create pernio-like condition

pulmonary disease

amyloidosis, blastomycosis, coccidioidomycosis, histoplasmosis, hypocomplementemic urticarial vasculitis s., Kaposi’s sarcoma, Langerhan’s histiocytosis, lipoid proteinosis, lymphomatoid granulomatosis, multicentric reticulohistiocytosis, Osler-Weber-Rendu s., paracoccidiodomycosis, scleroderma, Sweet’s s., Wegener’s granulomatosis, yellow nail s.

pulmonary fibrosis

Bruton’s XLR agammaglobulinemia, chronic mucocutaneous candidiasis, dermatomyositis, MCTD, MTX, nitrofurantoin, PSS, sarcoid, vinyl chloride exposure

pulmonary infections

leukocyte alkaline phosphatase deficiency, Louis-Bar s.

pulmonary stenosis

LEOPARD s., multiple lentigines s., Noonan’s s., Watson’s s.

pup-tent sign

medial elevation of nail plate; lichen planus

purpura

amyloidosis, annularis telangiectoides, benzoates, cryoglobulins, cutaneous necrotizing venulitis, drugs, familial Mediterranean fever, Hodgkin’s, leukemia, liver disease, lymphoma, measles, multiple myeloma, neoplasm (internal), purpura simplex, tartrazine

purpura fulminans

streptococcus, varicella

purpura, inflammatory retiform

benign cutaneous PAN, chilblains, Churg-Strauss s., leukocytoclastic vasculitis, livedoid vasculitis, PAN, PG, septic vasculitis, Wegener’s granulomatosis

purpura, non-inflammatory retiform

coagulation: antiphospholipid antibody s., coumarin necrosis, DIC, paroxysmal nocturnal hemoglobinuria, livedoid vasculitis, protein C/S deficiency

cold-related: cold agglutinins, cryofibrinogenemia, cryoglobulinemia,

embolic: cholesterol emboli, multiple myeloma, oxalate crystal deposition, thrombus (myxoma, endocarditis)

infection: ecthyma gangrenosum, intra-vessel fungi (Aspergillus, Cephalosporum, Mucormycosis), strongyloidiasis

miscellaneous: calciphylaxis, hypereosinophilic s., sickle cell anemia

occlusion: heparin necrosis, myeloproliferative d., TTP

purpura, non-palpable

actinic, anticoagulants, benign hypergammaglobulinemic purpura, Cushing’s d., DIC, drugs, Ehlers-Danlos s., Gardner-Diamond s., hemophilia, hepatic insufficiency, psychogenic purpura PXE, scurvy, systemic amyloidosis, thrombocythemia, vitamin K deficiency, Waldenstrom’s macroglobulinemia

infections: CMV, epidemic hemorrhagic fever, RMSF, rubella (congenital), SBE, toxoplasmosis, Weil’s d.

purpura, palpable

antiphospholipid antibody s., benign hypergammaglobulinemic purpura, Churg-Strauss s., cryoglobulins or cryofibrinogens, DIC, EM, emboli (cholesterol or arteriosclerotic), Henoch-Schönlein purpura, heparin necrosis, hypersensitivity vasculitis, leukocytoclastic vasculitis, myeloproliferative disease, PAN, PLEVA, protein C or protein S deficiency

purpura, pigmented

itching purpura, lichen aureus, pigmented purpuric lichenoid dermatosis of Gougerot & Blum, purpura annularis telangiectoides, Schamberg’s d.

purpura, pinch

post traumatic periorbital purpura; amyloidosis

pustule

acne vulgaris, drug eruption (bromide, iodide), ecthyma, erythema toxicum neonatorum, fire ant bite, folliculitis, folliculitis barbae, impetigo, miliaria rubra, perleche, pustular psoriasis, Reiter’s s., Ritter’s d., rosacea, scabies, steroid acne, Sweet’s s., tinea, transient neonatal pustular melanosis

pustules, neonate

acropustulosis of infancy, transient neonatal pustular melanosis

pustules, palms & soles

acrodermatitis continua of Hallopeau, infantile acropustulosis, pustulosis palmaris et plantaris

pustulosis

SAPHO s.

pyloric atresia

JEB