Signs and Symptoms - R to Z

radii, absent

Rothmund-Thomson s.

radiotherapy; lesions arising in areas treated with

BCC, malignant fibrous histiocytoma, lymphangiectasia, angiosarcoma, leiomyosarcoma, SCC

ram’s horn

onychogryphosis

rapidly evolving

atypical fibroxanthoma, keratoacanthoma, malignant granular cell tumor, merkel cell ca, metastasis, nodular malignant melanoma, nodular pseudocarcinomatous fasciitis

recur after surgery

atypical fibroxanthoma, dermatofibrosarcoma protuberans, epithelioid sarcoma, lymphangioma circumscriptum, pyogenic granuloma

red man s.

exfoliative erythroderma

reflux, gastric

PSS

renal disease

Fabry’s d., hypocomplementemic urticarial vasculitis s., polyarteritis nodosa, Wegener’s granulomatosis

renal disease worsens

SSSS, Vibrio vulnificus infection

renal failure

half and half nails (Lindsay’s nails), Kyrle’s d.

reticular

net-like pattern; cutis marmorata, erythema ab igne, lichen planus (Wickham’s striae), livedo reticularis

reticulated pigmentation

Dowling-Degos’ d., Franceschetti-Jadassohn s., Kindler-Weary s.

retinal glistening dots

white macular dots; Sjogren-Larsson s. (pathognomonic)

retinitis pigmentosa

Cockayne’s d., Refsum’s d.

rheumatoid nodules

idiopathic, rheumatic fever, rheumatoid arthritis, scleroderma, SLE (5%)

rose spots

2-3 mm blanching pink papules in crops on trunk, extremities; Salmonellosis-enteric fever (10-60%)

rower’s rump

lichenification of buttock from friction

runner’s nails

multiple Beau’s lines, periodic nail plate shedding

runner’s rump

ecchymoses of superior gluteal cleft

saber shins

orthopedic shin abnormality; congenital syphilis

sacroiliitis

Reiter’s s.

saddle nose deformity

anhidrotic ectodermal dysplasia, Conradi’s d., Hurler’s s., late congenital lues, lepromatous leprosy, prolidase deficiency, relapsing polychondritis, Rothmund-Thomson s., SHORT s., syphilis (congenital)

salmon colored

large plaque parapsoriasis

salmon patch

fading macular stain

salt and pepper skin

hypopigmentation and hyperpigmentation; PSS

sandpaper skin

roughness due to minute papules; scarlet fever, TSS

satellite pustules

Candida intertrigo

sausage digit

appearance of fingers from swelling of PIP and DIP joints; MCTD, psoriatic arthritis

scale

arsenic dermatitis, atopic dermatitis, dermatophytosis (superficial), drug eruption, eczema, epidermolytic hyperkeratosis, exfoliative dermatitis, ichthyosis, keratoderma, keratosis pilaris, lichen planus, mycosis fungoides, parapsoriasis, pellagra, pityriasis alba, pityriasis rosea, pityriasis, PRP, psoriasis, scarlet fever, seborrheic dermatitis, secondary syphilis, xerosis

scale, double edged

Netherton’s s. (ichthyosis linearis circumflexa)

scale, erythema superimposed

SCLE

scale, ostraceous

scale that appears like an oyster shell; psoriasis

scale, trailing

EAC

scalp lesions in adults

adenoid cystic carcinoma, arteriovenous fistulas, developmental anomalies, eccrine epithelioma, epidermal cysts, eosinophilic granuloma, heterotopic brain tissue, intracranial hemangioma, lipomas, meningioma, metastatic tumors,  myeloma, osteomas, osteogenic sarcoma

scalp lesions in children

aplasia cutis congenita, cephalocele, cephalohematoma deformans, dermal sinus tumors, dermoid and epidermoid cysts, eosinophilic granuloma, hemangiomas, heterotropic brain tissue, leptomeningeal cysts, lipoma, meningioma, metastases, osteoma and osteogenic sarcoma, pilomatrixoma, sinus pericranii

scapula lesions

elastofibroma dorsi, hereditary localized pruritus, hibernomas (interscapular), macular amyloidosis, notalgia paresthetica, pebbling of Hurler’s s., pediculosis corporis, rheumatoid nodules, satellitosis with pyogenic granuloma

scarring

acne, brown recluse spider bite, cicatricial pemphigoid, deep infections, Degos’ d., epidermolysis bullosa, folliculitis decalvans, herpes zoster, hidradenitis suppurativa, keratoacanthoma, leishmaniasis, lichen sclerosis, mixed connective tissue disease, morphea, nevus comedonicus, poikiloderma vasculare atrophicans, PCT, porphyria, sarcoidosis, syphilis, SLE, trauma, varicella

scars, lesions arising in

amyloidosis, BCC, Crohn’s d., cutaneous endometriosis, generalized plane xanthoma, lichen planus, lichen sclerosis et atrophicus, milia, pityriasis rubra pilaris, psoriasis, sarcoidosis, SCC, verruca, xanthoma

sclera, blue-gray

nevus of Ota

scleroatrophy

Huriez s., Kindler-Weary s.

sclerodactyly

CREST s., Huriez s., Kindler-Weary s., MCTD, PACK s., PSS, scleroderma, SLE

sclerodermatous skin changes

acrogeria, amyloidosis, acrodermatitis atrophicans, ataxia telangiectasia, bleomycin, Borrelia infection, carbidopa, carcinoid, chloreythlene, dermatomyositis, diabetes mellitus, epoxy resins, GVH, gravitational edema, Hurlers s., hydrocarbons, hypothyroidism, IgA deficiency, industrial oil poisoning, Louis-Bar s., melorheostosis, PCT, PKU, POEMS s., pentazocine, perchlorethyelene and other organic solvents, pesticides, primary amyloid, progeria, rheumatoid arthritis, Rothmund-Thomson s., SLE, scurvy, scleroderma, Sheehan’s s., shoulder-hand s., silica, silicon/paraffin implants, Sjögren’s s., sodium valproate, toxic oil s., vinyl chloride exposure, Vitamin K administration, Werner’s s., Winchester’s s.

scleromalacia

RA

sclerosis

amyloidosis, carcinoid s., medication, GVHD (chronic), leprosy, lymphogranuloma venereum, morphea, myxedema, PCT, scleredema, scleroderma, scleromyxedema

congenital; ataxia telangiectasia, congenital generalized fibromatosis, erythropoietic protoporphyria, Hunter’s s., Hurler’s s., lipoid proteinosis, phenylketonuria, progeria, Werner’s s.

scoliosis

proteus s.

scutula

cup-shaped yellow crust surrounding hairs; favus (Trichophyton schoenleinii)

seal finger

erysipeloid-appearing finger after seal bite

seasonal

spring worsens; Kawaski’s s., erythema multiforme

summer improves; monilethrix, psoriasis

summer worsens; Coxsackie infections, Hailey-Hailey d., itching purpura, PMLE, reactive perforating collagenosis

seborrheic distribution

Darier’s d., seborrheic dermatitis

seeds

thrombosed dermal capillaries from transepithelial elimination seen after paring lesion; clots, connective tissue chromoblastomycosis, fungal elements, wart AKA black dots

seizures

biotin deficiency, centrofacial lentiginosis, citrullinemia, cutis verticis gyrata, cystocercosis, Dupuytren’s contracture, Elejalde s., epidermal nevus s., hypomelanosis of Ito, incontinentia pigmenti, knuckle pads, late congenital lues, midline nevus sebaceous, Moynahan’s s., multiple carboxylase deficiency, neurofibromatosis, nevus sebaceous s., Pallister-Killian s., Partingtons s., Parry-Romberg s., partial unilateral lentiginosis, palmar/planter fibromatosis, phenylketonuria, Rud’s s., SLE, seborrheic dermatitis, Sjogren-Larson s., Sturge-Weber s., toxocariasis, tuberous sclerosis, Wyburn-Mason’s s.

serpiginous

snakelike lesions; larva migrans, lupus vulgaris, syphilis

shagreen patch

skin colored indurated plaque (collagenoma) usually on lumbosacral area; tuberous sclerosis

shin spots

macules or papules on anterior legs; diabetes, normal persons AKA diabetic dermopathy

siezures

biotin dependent carboxylase deficiency, tuberous sclerosis

sign of Leser-Trelat

see Leser-Trelat sign in Eponym section

signe de la bandera

flag sign of hair; kwashiorkor

simian crease

single palmar crease; de Lange s., cri du chat s., Down s., Seckel’s s., trisomy 13

sinuses

acne conglobata, hidradenitis suppurativa, kerion, lymphogranuloma venereum, mycetoma, onchocerciasis, paracoccidiodomycosis, pilonodal cyst, schistosomiasis

neck: actinomycosis, branchial cleft cyst, dental sinus, scrofuloderma, thyroglossal duct cyst

rectal: bowel carcinoma, Crohn’s d., rectal abscess

skeletal abnormalities

hypomelanosis of Ito, Satoyoshi’s s., Schimmelpenning-Feverstein-Mims s., Schwachman’s s., Seckel’s s., Sotos’ s., Tay’s s., Zinsser-Cole-Engman s.

skier’s toe

subungual hematoma AKA tennis toe

skin lines

dermatomes, skin relaxation, Langer’s lines of embryonic development, Voigt’s lines, Futcher’s lines (see pigmentary demarcation lines) 

skin popping

atrophic, punched-out lesions; subcutaneous drug injection

skip areas

less involved areas between erythema; PRP

sky blue spots

see maculae caeruleae

slapped cheeks

bright erythema of cheeks in children; erythema infectiosum (5^th disease)

smoking

arteriosclerosis obliterans, cancer (oral and lip), erythroplasia, leukoplakia, leukokeratosis nicotina palati, leukokeratosis nicotina glossi, necrotizing ulcerative gingivitis (acute), melanoma (worse prognosis), palmoplantar pustulosis, psoriasis, Raynaud’s d., SCC, skin metastases, thromboangiitis obliterans, wound healing (poor), wrinkles

soft skin

eunuchoid, hypopituitarism, hypothyroidism

sowdah

hyperpigmented areas; onchocerciasis (Arabic persons)

sphacelus

adherent, dry, dense necrotic membrane on ulcer bed; brown recluse spider bite, decubitus, diphtheritic, factitial, irradiation, ischemic

splenomegaly (see HSM also)

cardio-facio-cutaneous s., exfoliative erythroderma, Felty’s s., Gunther’s d., serum sickness s.

splinter hemorrhages

1 to 3 mm brown, red, or black linear discoloration beneath nail plate; dermatitis, hypertension, malignant neoplasms, mitral valve prolapse, mitral valve stenosis, peptic ulceration, psoriasis, rheumatoid arthritis, SLE, subacute bacterial endocarditis, trichinosis, trauma

sporotrichoid pattern

anthrax, bacterial lymphangitis, cat scratch disease, deep fungi inoculation site (blastomycosis, coccidioidomycosis, histoplasmosis), furunculosis, leishmaniasis, Mycobacterium marinum, M. kansasii, M. scrofulaceum, M. cheloni, M. tuberculosis, Nocardia brasiliensis, Scopulariopsis blochi, sporotrichosis, Staphylococcal angiitis, syphilis, tularemia

stable lesions

large plaque parapsoriasis, pagetoid reticulosis

stature

see growth

steatorrhea

acrodermatitis enteropathica, dermatitis herpetiformis (sprue), Whipple’s d.

stellate abscesses

cat scratch d., lymphogranuloma venereum, tularemia

sterility

Silvestrini-Corda s.

sticky skin sensation

hypervitaminosis A s.

stinging skin sensation

erythropoietic protoporphyria

stomatitis, ulcerative

chronic granulomatous d., Hartnup’s d., Reiter’s s.

stork bite

fading macular stain of nuchae

strabismus

Hermansky-Pudlak s.

stress

acne, acne necrotica miliaris, acute necrotizing gingivitis, adrenergic urticaria, alopecia areata, aphthae, atopic dermatitis, cholinergic urticaria, DLE, dermatographism, dermatitis herpetiformis, distinctive exudative discoid and lichenoid dermatitis (oid-oid), dyshidrotic eczema, erythema nodosum leprosum, Fox-Fordyce d., furuncles/carbuncles, hereditary angioedema, hyperhidrosis, lichen simplex chronicus, PSS, pemphigus vulgaris, perioral dermatitis, pompholyx, prurigo nodularis, psoriasis, seborrheic dermatitis, SLE, sycosis, telogen effluvium, trichotillomania, Unna-Thost s., urticaria, vaginal candidiasis, vitiligo

stretcher’s scrotum

scrotal hematoma from aggressive stretching

striae

corticosteroid administration, Cushing’s s., Marfan’s s., normal in adolescent obesity, pregnancy, rapid growth, steroids, weight gain

string of pearls

papules along upper eyelid; lipoid proteinosis (pathognomonic)

stuck-on appearance

seborrheic keratoses

subcutaneous fat absence

Donohue’s s.

sulfur flakes

yellow flakes of skin in facial follicular orifices; pellagra

summer sores

secondarily infected mosquito bites, usually in children

sunken veins

eosinophilic fasciitis

surfer’s nodules

fibrous tissue mass or cystic lesion from trauma AKA athlete’s nodules

swimmer’s itch

non-human schistosome dermatitis

swimmer’s lupus

AKA fish tank granuloma; Mycobacterium marinum

swimmer’s shoulder

shoulder abrasion by beard during crawl stroke

syndactyly

Russell-Silver s.

synovitis

SAPHO s.

T zone

oiliness of nose, forehead, & central chin in combination skin

target lesion

concentric color change; erythema multiforme

tattoo reactions

granuloma annulare, lupus erythematosus reaction, photoallergy to pigments, sarcoid granuloma

teeth abnormalities

KID s.

teeth, natal

Jackson-Sertoli s.

telangiectasia

actinic damage, adenoma sebaceum, AIDS, angiokeratoma corporis diffusum, angioma serpiginosum, anhidrotic ectodermal dysplasia, ataxia telangiectasia, atrophie blanche, balanitis xerotica obliterans, basal cell carcinoma, blepharocholasis, Bloom’s s., CREST s., carcinoma telangiectaticum, carcinoid, cirrhosis of the liver, Cockayne’s s., dermatomyositis, DLE, essential telangiectasia, Fabry’s d., Goltz’s s., granuloma faciale, hereditary hemorrhagic telangiectasia, hereditary sclerosing poikiloderma, keloids, keratoacanthoma, large plaque parapsoriasis, LE, leprosy, Louis-Bar s., mastocytosis, miscellaneous genodermatosis, NLD, morphea, occupational melanosis, pangeria, poikiloderma, poikiloderma, poikiloderma congenitale, poikiloderma of Civatte, polycythemia rubra vera, pregnancy, prolidase deficiency, PSS, radiodermatitis, rosacea, Raynaud’s d., sarcoid, scleroderma, SCLE, SLE, telangiectasia macularis eruptiva perstans, unilateral nevoid telangiectasia, varicose veins, variegate psoriasis, vinyl chloride, xeroderma pigmentosum, Zinsser-Cole-Engman s.

telangiectasia, chest wall

breast cancer

telangiectasia, facial

Bloom’s s., Fabry’s s., Rothmund-Thomson s.

telangiectasia, many

ataxia-telangiectasia, carcinoid s., Cushing’s s., estrogen, liver disease (alcoholic), PACK s., polycythemia, pregnancy, puberty, rosacea

telangiectasia, matted

PSS

telangiectasia, progressive

adenocarcinoma of bile duct, carcinoid

tennis shoe foot

red, shiny toes & weight-bearing foot, may scale & fissure AKA juvenile plantar dermatosis

tent sign

1) pinching lesion leads to points within lesion; pilomatrixoma 2) medial elevation of nail plate; LP

thickened skin

diabetes (dorsal hands), Donohue’s s., mucopolysaccharidoses, scleroderma

thrombocytopenia

Felty’s s., Griscelli s., Kasabach-Merritt s., Letterer-Siwe d., lupus erythematosus, strawberry angiomas, Wiskott-Aldrich s.

thrombophlebitis

Behçet’s d., cancer of pancreas, prostate, lung, liver, bowel, gallbladder, ovary; lymphoma, leukemia, Mondor’s d.

thromboses

anticardiolipin Ab s., tumors

tinnitus

Ramsay-Hunt s.

tongue, burning

iron-deficiency anemia

tongue, fissured

Cowden’s s., Melkersson’s s.

tongue, painful

Plummer-Vinson s.

translucency

granulomas (sarcoid, deep fungal, tuberculosis, foreign body)

trauma

alpha-1 antitrypsin deficiency, aphthae, desert sore, DLE, dermatofibroma, dystrophia unguim mediana canaliformis, eosinophilic fasciitis, eosinophilic ulcer of the tongue, epidermolysis bullosa acquisita, fibrous epulis, fibrosarcoma, giant cell epulis, herpes simplex infection, Hailey-Hailey d., hereditary angioneurotic edema, keloid, keratoacanthoma, leiomyosarcoma, leg ulcers, leiomyosarcoma, leukonychia, leukoplakia, Mondor’s d., morphea, onychauxis, onycholysis, onychotryphosis, onychoschizia, primary lymphedema (precipitates), PSS, protein C deficiency, psoriasis, pyogenic granuloma (fibroepithelial polyp), reactive perforating collagenosis, SLE, subacute nodular migratory panniculitis, trichorrhexis nodosa, tropical ulcer, yaws

trichrome lesions

dark complexion persons; vitiligo

tricuspid valve prolapse

Ehlers-Danlos s. (type V)

trident hands

hand defect; Seckel’s s.

tripe palm

rugose pattern of palmar skin; acanthosis nigricans, carcinoma (stomach, lung), Gardner’s s., KID s. AKA stippled keratoderma

triple response of Lewis

normal reaction to firm stroking of skin; wheal, flare, erythema

turban tumors

cylindroma of scalp

ulcer

arteriosclerosis obliterans, Arthus’ reaction (purpura fulminans), brown recluse spider bite, cryoagglutinins, cryofibrinogenemia, cryoglobulinemia, decubitus ulcer, deep fungi, embolus, ergot poisoning, factitial, macroglobulinemia, MAGIC s., neoplasms, polyarteritis, polycythemia, PG, Raynaud’s d., sepsis, syphilis, TB, thrombosis, TTP, Wegener’s granulomatosis, yaws

ulcer, leg

hematologic: cryoagglutinins, cryofibrinogenemia, cryoglobulinemia, hypercoagulable states, leukemia, polycythemia vera, sickle cell anemia, thalassemia

infectious: acid-fast bacteria, actinomycosis, anthrax, atypical mycobacteria, blastomycosis, coccidioidomycosis, cryptococcus, ecthyma, histoplasmosis, leishmaniasis, leprosy, lues, Madura foot, pinta, Pasteurella, Pseudomonas, sporotrichosis, syphilis, tularemia, yaws

miscellaneous: acrodermatitis chronica atrophicans, drugs, erythema induratum, Felty’s s., neuropathic ulcers, nodular vasculitis, panniculitis, PG

neoplasia: angiosarcoma, BCC, KS, melanoma, metastasis, MF, SCC

physical: arthropod assault, burn, chemical, factitious, pressure, radiation, trauma

vascular: atrophie blanche, arteriosclerosis obliterans, pernio, septic emboli, thromboangiitis obliterans, vasculitis, venous stasis

ulcer, painful

necrobiosis lipoidica, gout, calcinosis cutis, calciphylaxis, arteriosclerosis, thromboangiitis obliterans, atrophie blanche, hypertensive, pyoderma gangrenosum, Raynaud’s d., vasculitis

umbilication

central depression in papule; molluscum contagiosum, sarcoid, sebaceous hyperplasia, varicella; AKA dell

upper respiratory infection

erythema nodosum, hypersensitivity angiitis, idiopathic thrombocytopenic purpura, IgA deficiency s., polyarteritis nodosa, purpura fulminans, scleredema, Sweet’s s.

urethritis

Reiter’s s.

urticaria

antigen sensitivity (allergens, caterpillar, drug, food, helminths, Hymenoptera), atopy, autoimmune, drugs, erythropoietic protoporphyria, familial Mediterranean fever, hyper IgE s., idiopathic, infection, Muckle-Wells s., NERD s., NERD s., physical urticaria, serum sickness, transfusion, urticarial vasculitis

UVA induced

PMLE, actinic prurigo, Henoch-Schönlein purpura, hydroa vacciniforme (hydroa estivale), phototoxicity, photoallergy, persistent light reactor, solar urticaria

UVB induced

PMLE, actinic prurigo, solar urticaria, hydroa vacciniforme

uveitis

Behçet’s d., cobalt sensitivity, Heerfordt s., necrobiotic xanthogranuloma, psoriatic arthritis (juvenile), Reiter’s s., sarcoidosis, vitiligo, Vogt-Koyanagi s.

varices

Klippel-Trenaunay-Weber s.

vascular malformations

von Hippel-Lindau d.

velvety skin

Williams s.

venous malformations

Maffucci’s s.

vermiculation

worm-like movements; smooth muscle hamartoma

verruga peruana

vascular papules & nodules developing in crops; Carrion’s d. AKA Peruvian wart

vertigo

Ramsay-Hunt s., Vogt-Koyanagi-Harada s.

vesicles, hemorrhagic

gonococcemia, herpes zoster, HSV, meningococcemia

vesicles, neonate

candidiasis (congenital), erythema toxicum neonatorum, HSV (congenital), impetigo, incontinentia pigmenti, miliaria crystallina, miliaria rubra, scabies, syphilis (congenital)

volcanic border

raised, indurated lesion border; leishmaniasis

vomiting

Vogt-Koyanagi-Harada s.

wable

painful, swollen subdermal cavity containing a botfly larva; myiasis (Dermatobia hominis)

warmth

arthritis, cellulitis, erysipelas, hyperthyroidism, Paget’s d. (of bone), sunburn

web neck

fetal hydantoin s., Klipper-Feil s., Noonan’s s., Turner s.

white dermographism

stroking skin produces white line without red phase; atopic patient

wood grain

alternating bands of skin; erythema gyratum repens

wrinkling, premature

DeBarsy’s s.

xanthoderma

yellow skin color; carotenemia, jaundice, quinacrine, xanthoma planum

xerophthalmia

dry eyes; Sjögren’s s.

xerosis, congenital

Basan’s s., Clouston’s s., Sabinas s.

xerostomia

HIV infection, Sjögren’s s.

yellow nails

lymphedema, smokers

yellow skin

carotenemia, diabetes mellitus, liver d.

zebra-like

alternating dark and light skin bands; erythema gyratum repens

zosteriform distribution

breast carcinoma (metastatic), connective tissue nevi, Darier’s d., eccrine spiradenoma, epidermal nevi, herpes zoster, lichen planus, neurofibromas, nevus spilus, porokeratosis, zebra-like hyperpigmentation