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Dermatology
Dermal Hypertrophies
Built from Dermatology, 5th Edition
What’s inside
6 sections · 90 slides
Overview
- What this topic covers
Hypertrophic Scars and Keloids
Two patterns of abnormal wound healing
- Three ways a wound can heal
- Normal wound healing has three phases
- Fetal skin heals without scarring
- Differences in adult versus fetal wound healing.
- Who develops hypertrophic scars and keloids
- Risk factors for abnormal scarring
- Genetic syndromes linked to keloids
- Chemical messengers that drive scarring
- TGF-beta isoforms play opposite roles
- How a keloid differs from a hypertrophic scar
- Keloids on the trunk, neck, and shoulder
- How fast do these scars appear and change
- A hypertrophic scar after a knife injury
- Comparing the three scar types side by side
- Clinical features of conventional scars, hypertrophic scars, and keloids.
- Scoring a scar objectively
- Vancouver Scar Scale.
- What the pathologist looks for
- Hypertrophic scar under the microscope
- Keloid under the microscope
- Histologic features side by side
- Staining tests do not fully separate the two
- Further hypertrophic scar histology
- Other diseases that look like a keloid
- Nodular morphea mimicking a keloid
- Tumors that look like a scar under the microscope
- Keloids without an obvious cause
- Multiple keloids from acne
- Extensive spontaneous keloids
- Claw-like keloid of the flexor arm
- Keloid at an earlobe piercing site
- Treatment starts with prevention
- First-line injected and topical treatments
- Other injectable options
- Evidence-based treatment options
- Surgical and physical treatments
- Pulsed dye laser before and after treatment
Dupuytren Disease
Thickened palm fascia that bends the fingers
- A disease known for over two centuries
- Who gets Dupuytren disease
- What drives the fascia thickening
- How the contracture develops
- Variable finger involvement
- Complications of longstanding disease
- What the tissue looks like under the microscope
- Conditions that can mimic Dupuytren disease
- Treatment ranges from injections to surgery
- Treatment options for Dupuytren disease.
- Newer and investigational approaches
Cutis Verticis Gyrata
Folded, ridged skin of the scalp
- Ridged skin on the scalp
- How primary cutis verticis gyrata looks
- Primary versus secondary cutis verticis gyrata
- Cutis verticis gyrata - disease associations.
- Cutis verticis gyrata - disease associations. (continued)
- What a scalp biopsy shows
- Pachydermoperiostosis mimics cutis verticis gyrata
- Other look-alikes to rule out
- Treatment is rarely needed
Hyaline Fibromatosis Syndrome
A rare genetic disorder with glassy skin nodules
- One gene, two severities
- First described 150 years ago
- How the mutation causes fibrosis
- Where the nodules appear
- Clinical features of hyaline fibromatosis syndrome.
- Clinical features of hyaline fibromatosis syndrome. (continued)
- What the biopsy shows
- Severe disease with large nodules and contracture
- Other genetic diseases that look similar
- Differential diagnosis of hyaline fibromatosis syndrome.
- Treatment options remain limited
Elastic Tissue-Related Disorders
When elastic fibers, not collagen, build up in the skin
- A confusing but distinct group
- Focal disorders of elastic tissue
- Elastoderma: lax, sagging skin
- Elastofibroma dorsi: a deep chest-wall mass
- Elastoma and elastosis perforans serpiginosa
- Pseudoxanthoma elasticum: a systemic disorder
- Sun damage also increases elastic tissue
- Disorders characterized by increased elastic tissue fibers.
- Disorders characterized by increased elastic tissue fibers. (continued)
- Key points to remember
- References
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- References (continued)
- Dermatology, 5th Edition (2-Volume Set)