Melanoma, warning signs — remember the ABCDEs — Asymmetry, Border irregularity, Color variation, Diameter, Evolving/changing/growing over time ………. Cytological layers of epidermis, superficial to deap— Californians love gorillas in string bikinis — corneum, lucidum, granulosum, spinosum, basalis ………. Lichen planus, descriptors — 6 P’s — Purple, Polygonal, Planar, Papules, Plaques, Pruritic ………. Generalized hyperpigmentation, differential—no skin SPARED — Pregnancy, Addison’s disease, Renal failure, Excess iron, or Drugs (e.g., amiodarone, minocycline). ………. Papulosquamous eruption, differential—5L’s + 5P’s = a ten! — Lupus, Lichen planus (and other lichenoid reactions), Lichen simplex chronicus (LSC), Lichen nitidus, Lues (an antiquated name for Syphilis), Psoriasis, Pityriasis rosea, Pityriasis lichenoides et varioliformis acuta (PLEVA)/pityriasis lichenoides chronica (PLC), Parapsoriasis, Pityriasis rubra pilaris (PRP), Seborrheic dermatitis, Adverse drug reaction, Tinea, Eczema/erythema annulare centrifugum (EAC) and Neoplasm (e.g., MF). ………. Persistent red face, differential — Dr. McLeap — Dermatomyositis, rosacea, Mastocytosis, carcinoid, Lupus erythematosis, autoimmune connective tissue disease or polycythemia vera ………. White skin patch, differential — vitiligo PATCH — vitiligo, Pityriasis alba/Post-inflammatory hypopigmentation, Age-related hypopigmentation (e.g., idiopathic guttate hypomelanosis), Tinea versicolor/Tuberous sclerosis (ash-leaf macules), Congenital birthmark (e.g., Hypomelanosis of Ito) or Hansen's disease (leprosy). ………. Painful cutaneous nodule, differential — BENGAL DOCS — Blue rubber nevus, Eccrine spiradenoma/erythema nodosum, Neurilemmoma/neuroma, Glomus tumor/granular cell tumor, Angiolipoma/angioleiomyoma/angiosarcoma/arthopod bite, Leiomyoma, Dercum's disease/dermatofibroma, Osler's node/osteoma cutis, Calcinosis cutis/cutaneous endometriosis and Sweet's Syndrome ………. Small blue cell tumor, differential — LEMONS — Lymphoma, Ewing’s Sarcoma, Merkel cell carcinoma and Melanoma, Oat cell carcinoma of the lung, Neuroblastoma, Small cell endocrine tumor ………. Exfoliative dermatitis, differential — RED MAN — Radiation, Eczema/psoriasis, Drugs, Malignancy (MF, lymphoma), Autoimmune (rare DM), No cause found ………. Exfoliative dermatitis, differential — SCALP ID — Seborrheic dermatitis, Contact dermatitis, Atopic dermatitis, Lymphoma/leukemia, Psoriasis, Idiopathic (possibly most common) and Drug allergy. Note, the layers of scalp can be remembered by the acronym SCALP: Skin, Connective tiss- vue, Aponeurosis (epicranial), Loose areolar connective tissue and Periosteum. ………. Black eschar, differential — CAGES — Clostridium, Aspergillus (deep fungal e.g., fusarium)/Anthrax, Group B strep, Ecthyma gangrenosum (i.e., pseudomonas) --- or possibly a Spider bite! ………. Behcet’s syndrome, presenting symptoms— ROSE Path — Recurrent genital ulceration, Oral ulceration*, Skin lesions (e.g., erythema nodosum, subcutaneous thrombo- phlebitis, cutaneous hypersensitivity), Eye lesions (e.g., iridocyclitis, chori- oretinitis) and a positive pathergy test (*Oral ulceration is a central criterion for diagnosis) ………. Transient acantholytic dermatoses, features — MAPS — Men, Acantholysis, Pruritic, Sun-exposed sites ………. Drug rash with eosinophilia and systemic symptoms, features — DRESS — Due to anticonvulsants, sulfonamides or allopurinol. Skin signs usually begin with a Rash beginning on the face with sterile folliculitis. Eosinophilia is almost always present and Systemic manifestations are common, particularly of the liver. In addition, there can also be evidence of Sensitization previously (even with contactants). ………. Subepidermal split w neutrophils in dermal papillae, causes — PLAID — Pemphigoid (bullous), Lupus (i.e., bullous SLE), Acquista (Epidermolysis Bullosa Acquista), IgA linear and Dermatitis herpetiformis ………. Spindled cells against epidermis, differential — SLAM — Spindle cell squamous cell carcinoma (Keratin+), Leiomyosarcoma (SMA+), Atypical fibroxanthoma* (CD68+, Vimentin+, CD99+, Procollagen-1) or Melanoma (S100+) *note; atypical fibroxanthoma is a diagnosis of exclusion. ………. Albright syndrome, symptoms — GAME OF — Giant melanosomes, Alopecia, Macules (e.g., café au lait spots), End crine dysfunction, Osteomas and Fibrous dysplasia ………. Waardenburg Syndrome types 1-4, associated genes — pack your mittens, pack your SOX — PAX3 (type I), MITF (type II), PAX3 (type III), SOX10 (type IV). ………. Spongiotic dermatitis w epidermal eosinophils, differential — HAPPIED —Herpes gestationis, Arthropod/Allergic contact, Pemphigus, Pemphigoid, Incontienta pigmenti, Erythema toxicum, or a Drug reaction ………. Spongiotic dermatitis w dermal eosinophils, differential — DID A CAN —Dermatophytes, Id reaction, Drug reaction, Arthropod bite, Contact dermatitis, Atopia and Nummular dermatitis on the differential …………. Source
