Dermatology therapy essentials - part 2 pdf

Arteritis of the aged 65 A Differential diagnosis Cyanosis; diffuse melanosis from meta- static melanoma; hyperpigmentation from other drugs, such as minocycline, gold, or phenothiazine derivative Therapy Discontinuation of exposure to silver; avoidance of sun exposure; chelating agents such as dimercaprol (BAL) References Humphreys SD, Routledge PA (1998) The toxicol- ogy of silver nitrate. Adverse Drug Reactions & To xicological Reviews 17(2–3):115–143 Argyrosis ᭤ Argyria Arrid XX ᭤ Aluminium chlorohydrate Arsenical keratosis Synonym(s) None Definition Punctate keratoses of the palms and soles, occurring after long-term exposure to inorganic trivalent form of arsenic Pathogenesis Inorganic arsenic retained in the body for long periods after exposure, because of poor detoxification mechanisms; affecting many enzymes by combining with sulfhy- dryl groups; acting as a cancer promoter, through its action on chromosomes Clinical manifestation Punctate, non-tender, hard, yellowish, often symmetric, corn-like papules, mainly on the palms and soles; pressure points commonly involved; sometimes coalescing to form large, verrucous plaques Differential diagnosis Keratosis palmaris et plantaris; clavus; wart; nevoid basal cell carcinoma syndrome; porokeratosis; psoriasis of the palms and soles; lichen planus; Darier disease; Bazex syndrome; pityriasis rubra pilaris Therapy Acitretin; destructive modalities such as electrosurgery, liquid nitrogen cryother- apy, and laser vaporization References Ye rebakan O, Ermis O, Yilmaz E, Basaran E (2002) Treatment of arsenical keratosis and Bowen's disease with acitretin. International Journal of Dermatology 41(2):84–87 Arteriovenous malformation ᭤ Vascular malformation Arteritis cranialis ᭤ Te m p o r a l arteritis Arteritis of the aged ᭤ Te m p o r a l arteritis PART1.MIF Page 65 Wednesday, October 29, 2003 4:13 PM 66 Arteritis temporalis Arteritis temporalis ᭤ Te m p o r a l arteritis Arthritis urethritica ᭤ Reiter syndrome Ascher syndrome ᭤ Ascher’s syndrome Ascher’s syndrome Synonym(s) Ascher syndrome; double lip and nontoxic thyroid enlargement syndrome; struma- double lips syndrome; thyroid blepharochalasis syndrome; Fuchs’ syndrome III; Laffer-Ascher syndrome Definition Disorder consisting of blepharochalasis, double lip, and non-toxic goiter Pathogenesis Unknown Clinical manifestation Blepharochalasis (excessive upper lid skin); duplication of the upper lip; euthyroid goiter Differential diagnosis Grave’s disease; angioedema Therapy Surgical correction of excess eyelid skin and lip References Sanchez MR, Lee M, Moy JA, Ostreicher R (1993) Ascher syndrome: a mimicker of acquired angioedema. Journal of the American Academy of Dermatology 29(4):650–651 Ash-leaf macule Definition Sharply circumscribed, round-to-oval area of macular hypopigmentation seen at birth in patients with tuberous sclerosis References Arbuckle HA, Morelli JG (2000) Pigmentary disorders: update on neurofibromatosis-1 and tuberous sclerosis. Current Opinion in Pediatrics 12(4):354–358 Ashy dermatosis Synonym(s) Ashy dermatosis of Ramirez; erythema dyschromicum perstans; dermatosis cenicienta; erythema chronicum figuratum melanodermicum; lichen pigmentosus Definition Eruption of gray-blue macules over the trunk; closely linked to lichen planus Pathogenesis Unknown Clinical manifestation Asymptomatic, gray-blue patches of variable shape and size, distributed symmetri- cally on the face, trunk, and upper extremities; elevated, erythematous border in the early stages; oral cavity and genitals spared Differential diagnosis Lichen planus; lichenoid drug eruption; tuberculoid leprosy; pinta; hemochromato- sis PART1.MIF Page 66 Wednesday, October 29, 2003 4:13 PM Asteatotic eczema 67 A Therapy Clofazimine 100 mg PO every other day if under 40 kg in weight; clofazimine 100 mg every day if greater than 40 kg in weight; ultraviolet exposure; ultraviolet avoidance; antibiotics; antihistamines; psychotherapy References Osswald SS, Proffer LH, Sartori CR (2001) Ery- thema dyschromicum perstans: a case report and review. Cutis 68(1):25–28 Ashy dermatosis of Ramirez ᭤ Ashy dermatosis Asteatosis Synonym(s) Dry skin; xerosis; winter itch Definition Irritation caused by lack of moisture in the skin Pathogenesis Physiologic process with aging; seen more often in the winter, with cold air outside and heated air inside causing a decrease in humidity Clinical manifestation Generalized pruritus, often worse after bathing; most common on the lower legs, arms, flanks, and thighs; may be associated with mild erythema and scaliness Differential diagnosis Other causes of generalized pruritus: scabies; atopic dermatitis; drug reaction; obstructive hepatobiliary disease; end-stage renal disease; polycythemia vera; Hodg- kin’s disease; thyroid disease; hyperparathyroidism; psychogenic pruritus Therapy Decreased bathing; use of soap substitutes such as bath gels; application of emollients at least twice daily during the winter months; antihistamines, first generation, for nighttime sedation ᭤ Xerosis References Beacham BE (1993) Common dermatoses in the elderly. American Family Physician 47(6):1445– 1450 Asteatotic dermatitis ᭤ Asteatotic eczema Asteatotic eczema Synonym(s) Asteatotic dermatitis; eczema craquelé; eczema craquelatum; xerotic eczema; eczema hiemalis; eczema fendille; etat craquelé Definition Pruritic, cracked, and fissured skin occurring most commonly on the shins of elderly patients, caused by lack of moisture in the skin Pathogenesis Physiologic process with aging; seen more often in the winter, with cold air outside and heated air inside causing a decrease in humidity; loss of water by stratum corneum causing cells to shrink and creating fine fissures; eczematous changes resulting from patients rubbing and scratching these pruritic areas Clinical manifestation Minimally scaly, red, cracked, and or fissured skin, giving the appearance of a “cracked pot”; most commonly involving PART1.MIF Page 67 Wednesday, October 29, 2003 4:13 PM 68 Ataxia-telangiectasia the pretibial areas, but also the thighs, hands and trunk; generalized pruritus, often worse after bathing Differential diagnosis Ichthyosis; atopic dermatitis; nummular eczema; stasis dermatitis; contact dermatitis; mycosis fungoides; other causes of generalized pruritus: scabies; atopic dermatitis; drug reaction; obstructive hepatobiliary disease; end-stage renal disease; polycythemia vera; Hodgkin’s disease; thyroid disease; hyperparathyroidism; psychogenic pruritus Therapy Decreased bathing; use of soap substitutes such as bath gels; application of emollients at least twice daily during the winter months; mid potency topical corticosteroid ointment; antihistamines, first generation, for nighttime sedation References Beacham BE (1993) Common dermatoses in the elderly. American Family Physician 47(6):1445– 1450 Ataxia-telangiectasia Synonym(s) Louis-Bar syndrome; Boder-Sedgwick syndrome Definition Autosomal, recessive, multisystem disorder characterized by progressive neurological impairment, cerebellar ataxia, variable immunodeficiency, impaired organ matura- tion, x-ray hypersensitivity, ocular and cutaneous telangiectasia, and a predisposition to malignancy Pathogenesis Unclear; possibly associated with dysregu- lation of the immunoglobulin gene super- family, which includes genes for T-cell receptors; abnormal sensitivity to x-rays and certain radiomimetic chemicals, possibly leading to chromosomal abnormalities, infections, and malignancies Clinical manifestation Ocular and cutaneous telangiectasia; neurological abnormalities, mainly ataxia, abnormal eye movements, and chore- oathetosis Differential diagnosis Telangiectatic diseases: hereditary hemor- rhagic telangiectasia; chronic liver disease; benign essential telangiectasia; sun dam- age; neurologic disorders; Friedreich disease; cerebral palsy; familial spinocerebel- lar atrophies; GM1 and GM2 gangliosi- doses; progressive rubella panencephalitis; subacute sclerosing panencephalitis; postinfectious encephalomyelitis; cerebellar tumor Therapy No effective therapy References Gatti RA (1995) Ataxia-telangiectasia. Dermato- logic Clinics 13(1):1–6 Atheroma ᭤ Epidermoid cyst Athlete’s feet ᭤ Tinea pedis Atopic dermatitis Synonym(s) Atopic eczema; infantile eczema; Besnier's prurigo PART1.MIF Page 68 Wednesday, October 29, 2003 4:13 PM Atrophic parapsoriasis 69 A Definition Disease starting in early infancy and characterized by pruritus, eczematous lesions, dry skin, and an association with other atopic diseases (asthma, allergic rhinitis, urticaria) Pathogenesis Abnormality of T helper type 2 (TH2) cells, resulting in increased production of inter- leukin 4 (IL-4) and increased IgE; stratum corneum lipid defect, leading to increased transepidermal water loss Clinical manifestation Marked pruritus, often starting in the first few months of life; asthma or hay fever or a history of atopic disease in a first-degree relative; dry skin; lichenified plaques with epithelial disruption, occurring on the face in infancy, in the flexural creases, trunk, and diaper area by 1 year of age, and over the distal extremities later in life; scalp involvement, usually after age 3 months Differential diagnosis Seborrheic dermatitis; contact dermatitis; stasis dermatitis; nummular eczema; scabies; mycosis fungoides; dermatophytosis Therapy Mid potency topical corticosteroids ଙ ; pred- nisone for temporary therapy of severe flares; pimecrolimus 1% cream; tacrolimus 0.3% or 1% ointment; azathioprine; cyclo- sporine; antihistamines, first generation, for nighttime sedation UVB phototherapy; photochemotherapy (PUVA); evening prim- rose oil; Chinese herbs; emollients applied at least twice daily, particularly during the winter months References To fte SJ, Hanifin JM (2001) Current management and therapy of atopic dermatitis. Journal of the American Academy of Dermatology 44(1 Sup- pl):S13–16 Atopic eczema ᭤ Atopic dermatitis Atopy Synonym(s) None Definition Predisposition to develop allergic reactions, often genetically determined and involving the production of IgE antibodies References MacLean JA, Eidelman FJ (2001) The genetics of atopy and atopic eczema. Archives of Derma- tology 137(11):1474–1476 Atrofodermia idiopatica progressiva ᭤ Atrophoderma of Pasini and Pierini Atrophic parapsoriasis ᭤ Large plaque parapsoriasis Atopic dermatitis. Lichenified, red plaque with erosions in the antecubital fossa PART1.MIF Page 69 Wednesday, October 29, 2003 4:13 PM 70 Atrophie brilliante Atrophie brilliante ᭤ Confluent and reticulated papillo- matosis Atrophoderma of Pasini and Pierini Synonym(s) Idiopathic atrophoderma of Pasini and Pierini; atrophodermia idiopatica progressiva Definition Asymptomatic atrophy of the skin characterized by single or multiple, defined, depressed areas of skin Pathogenesis Possibly an end result of morphea; possibly related to spirochete infection (in Europe) Clinical manifestation Presenting as asymptomatic, slightly erythematous plaque or plaques on the trunk; lesions developing slate-gray to brown pig- mentation, sharp peripheral border, and central depression Differential diagnosis Morphea; lichen sclerosus; skin atrophy from steroid injection; anetoderma; post- inflammatory hyperpigmentation Therapy Doxycycline; amoxicillin; hyperpigmentation component: Q-switched alexandrite laser References Buechner SA, Rufli T (1994) Atrophoderma of Pasini and Pierini. Clinical and histopathologic findings and antibodies to Borrelia burgdorferi in thirty-four patients. Journal of the American Academy of Dermatology 30(3):441–446 Atrophoderma pigmentosum ᭤ Xeroderma pigmentosum Atrophoderma reticulatum ᭤ Keratosis pilaris atrophicans Atrophoderma vermiculatum ᭤ Keratosis pilaris atrophicans ᭤ Ulerythema ophryogenes Atypical fibroxanthoma Synonym(s) Paradoxical fibrosarcoma; pseudosarcoma; pseudosarcomatous reticulohistiocytoma; pseudosarcomatous dermatofibroma Definition Rapidly enlarging tumor, arising in chroni- cally sun-exposed skin, with histologic features suggesting a malignant connective tis- sue neoplasm, but usually benign clinical course Pathogenesis Solar radiation and prior X-irradiation possible predisposing factors Clinical manifestation Firm, solitary, eroded or ulcerated papule or nodule on sun-exposed skin, particularly the ear, nose, and cheek; most common in elderly patients PART1.MIF Page 70 Wednesday, October 29, 2003 4:13 PM Atypical mole syndrome 71 A Differential diagnosis Squamous cell carcinoma; pyogenic granu- loma; melanoma; basal cell carcinoma; Merkel cell carcinoma; cutaneous metasta- sis; leiomyosarcoma; dermatofibrosarcoma protuberans Therapy Mohs micrographic surgery ଙ ; elliptical excision; destruction by electrodesiccation and curettage References Davis JL, Randle HW, Zalla MJ, Roenigk RK, Brodland DG (1997) A comparison of Mohs micrographic surgery and wide excision for the treatment of atypical fibroxanthoma. Dermato- logic Surgery 23(2):105–110 Atypical lipoma ᭤ Liposarcoma Atypical lipomatous tumors ᭤ Liposarcoma Atypical melanocytic nevus ᭤ Atypical mole Atypical mole Synonym(s) Active junctional nevus; atypical melanocytic nevus; B-K mole, Clark's nevus; atypical mole syndrome; dysplastic mole; dysplastic nevus Definition Benign melanocytic growth, possibly shar- ing some of the clinical or microscopic features of melanoma, but not a melanoma Pathogenesis Genetic component in some patients (melanoma-prone families; familial atypical mole syndrome); sunlight exposure possibly a factor Clinical manifestation Va r i a b le features, with some or all of the following: asymmetrical conformation; irregular border which can fade impercepti- bly into the surrounding skin; variable col- oration, with shades of tan, brown, black; and red; diameter > 6 mm; elevated center and feathered, flat border, giving the lesion the appearance of a fried egg Differential diagnosis Melanoma; compound nevus; seborrheic keratosis; dermatofibroma; wart Therapy Avoidance of excessive sun exposure; use of sunscreen with a sun protective factor of 15 or greater; evaluation of other family mem- bers for evidence of atypical moles; base- line photographs of entire skin surface, if possible References Slade J, Marghoob AA, Salopek TG, Rigel DS, Kopf AW, Bart RS (1995) Atypical mole syndrome: risk factor for cutaneous malignant melanoma and implications for management. Journal of the American Academy of Dermatology 32(3):479–494 Atypical mole syndrome ᭤ Atypical mole PART1.MIF Page 71 Wednesday, October 29, 2003 4:13 PM 72 Audry’s glands Audry’s glands ᭤ Fordyce’s disease Auranofin Trade name(s) Ridaura Generic available No Drug class Anti-rheumatic Mechanism of action Inhibition of complement and lysosomal enzymes; normalization of defective Lang- erhans cell antigen presentation Dosage form 3 mg tablet Dermatologic indications and dosage See table Common side effects Cutaneous: skin eruption, stomatitis, pruritus, glossitis Gastrointestinal: diarrhea, abdominal pain Laboratory: anemia, leukopenia, proteinuria Neurologic: change in taste sensation Ocular: keratitis Serious side effects Bone marrow: agranulocytosis Neurologic: seizures Pulmonary: pneumonitis Renal: renal failure, nephrotic syndrome Drug interactions Atovaquone/proguanil Auranofin. Dermatologic indications and dosage Disease Adult dosage Child dosage Cicatricial pemphigoid 3 mg PO twice daily Initial: 0.1 mg per kg daily in 1–2 divided doses; usual maintenance: 0.15 mg/kg/day in 1–2 divided doses; maximum: 0.2 mg/kg/day in 1–2 divided doses Epidermolysis bullosa acquisita 3 mg PO twice daily Initial: 0.1 mg per kg daily; usual maintenance: 0.15 mg/kg/day in 1–2 divided doses; maximum: 0.2 mg/kg/day in 1–2 divided doses Lupus erythematosus 3 mg PO twice daily Initial: 0.1 mg per kg daily in 1–2 divided doses; usual maintenance: 0.15 mg/kg/day in 1–2 divided doses; maximum: 0.2 mg/kg/day in 1–2 divided doses Pemphigus vulgaris 3 mg PO twice daily Initial: 0.1 mg per kg daily in 1–2 divided doses; usual maintenance: 0.15 mg/kg/day in 1–2 divided doses; maximum: 0.2 mg/kg/day in 1–2 divided doses PART1.MIF Page 72 Wednesday, October 29, 2003 4:13 PM Aurothioglucose 73 A Contraindications/precautions Hypersensitivity to drug class or component; pulmonary fibrosis; bone marrow aplasia; caution with impaired liver or renal function References Papp KA, Shear NH (1991) Systemic gold therapy. Clinics in Dermatology 9(4):535–551 Auriculotemporal syndrome Synonym(s) Frey’s syndrome; Baillarger's syndrome; Dupuy's syndrome; salivosudoriparous syndrome; sweating gustatory syndrome; gustatory sweating Definition Gustatory sweating secondary to auriculotemporal nerve injury Pathogenesis Misdirection of parasympathetic fibers, which migrate into the postganglionic sym- pathetic fibers to innervate the sweat glands Clinical manifestation Flushing or sweating on one side of the face when certain foods are eaten Differential diagnosis Gustatory sweating from diabetic neuropa- thy or post-herpetic neuralgia; Horner’s syndrome; lacrimal sweating; harlequin syndrome Therapy Surgical: tympanic neurectomy for severe symptoms; perineural alcohol injection Medical: scopolamine 3–5% cream applied twice daily; aluminium chloride ᭤ Gustatory sweating References Kaddu S, Smolle J, Komericki P, Kerl H (2000) Au- riculotemporal (Frey) syndrome in late child- hood: an unusual variant presenting as gustatory flushing mimicking food allergy. Pediatric Dermatology 17(2):126–128 Aurothioglucose Trade name(s) Solganol Generic available No Drug class Anti-rheumatic Mechanism of action Inhibition of complement and lysosomal enzymes; normalization of defective Lang- erhans cell antigen presentation Dosage form Intramuscular injection Dermatologic indications and dosage See table Common side effects Cutaneous: stomatitis, glossitis, skin eruption, pruritus Gastrointestinal: diarrhea, abdominal pain, dyspepsia, change in taste sensation Laboratory: proteinuria, anemia, leukopenia Neurologic: change in taste sensation Ocular: keratitis Serious side effects Laboratory: agranulocytosis Neurologic: seizures Pulmonary: pneumonitis Renal: renal failure, nephrotic syndrome Drug interactions Atovaquone/proguanil PART1.MIF Page 73 Wednesday, October 29, 2003 4:13 PM 74 Auspitz sign Contraindications/precautions Hypersensitivity to drug class or component; pulmonary fibrosis; bone marrow aplasia; caution with impaired liver or renal function References Papp KA, Shear NH (1991) Systemic gold therapy. Clinics in Dermatology 9(4):535–551 Auspitz sign Definition Bleeding points appearing when overlying scale removed physically from a lesion of psoriasis References Bernhard JD (1997) Clinical pearl: auspitz sign in psoriasis scale. Journal of the American Acade- my of Dermatology 36(4):621 Autoeczematization ᭤ Id reaction Autoerythrocyte sensitization ᭤ Autoerythrocyte sensitization syndrome Aurothioglucose. Dermatologic indications and dosage Disease Adult dosage Child dosage Cicatricial pemphigoid 25–50 mg IM once weekly Initial – 0.25 mg per kg per dose first week; increment at 0.25 mg per kg per dose increasing with each weekly dose; maintenance – 0.75–1 mg per kg per dose weekly, not to exceed 25 mg per dose Epidermolysis bullosa acquisita 25–50 mg IM once weekly Initial – 0.25 mg per kg per dose first week; increment at 0.25 mg per kg per dose increasing with each weekly dose; maintenance – 0.75–1 mg per kg per dose weekly, not to exceed 25 mg per dose Lupus erythematosus; pemphigus vulgaris; cicatricial pemphigoid; epidermolysis bullosa acquisita 25–50 mg IM once weekly Initial – 0.25 mg per kg per dose first week; increment at 0.25 mg per kg per dose increasing with each weekly dose; maintenance – 0.75–1 mg per kg per dose weekly, not to exceed 25 mg per dose Pemphigus vulgaris 25–50 mg IM once weekly Initial – 0.25 mg per kg per dose first week; increment at 0.25 mg per kg per dose increasing with each weekly dose; maintenance – 0.75–1 mg per kg per dose weekly, not to exceed 25 mg per dose PART1.MIF Page 74 Wednesday, October 29, 2003 4:13 PM [...]... Bacillary angiomatosis 500 mg PO on day 1; 25 0 mg PO on days 2 5 Bartonellosis 500 mg PO on day 1; 25 0 mg PO on days 2 5 Cellulitis 500 mg PO on day 1; 25 0 mg PO on days 2 5 Chancroid 1 gm PO for 1 dose Ecthyma 500 mg PO on day 1; 25 0 mg PO on days 2 5 Furuncle 500 mg PO on day 1; 25 0 mg PO on days 2 5 Impetigo 500 mg PO on day 1; 25 0 mg PO on days 2 5 Trench fever 25 0-5 00 mg PO for 4 weeks Child dosage Not... daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 4–8 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks... and hemangiomas for cosmetic purposes only References Fargnoli MC, Orlow SJ, Semel-Concepcion J, Bolognia JL (1996) Clinicopathologic findings in the Bannayan-Riley-Ruvalcaba syndrome Archives of Dermatology 1 32( 10): 121 4– 121 8 Bannayan-Zonana syndrome ᭤ Bannayan-Riley-Ruvalcaba syndrome Barber's itch ᭤ Sycosis barbae Barber-Say syndrome Synonym(s) Say syndrome Definition Disease entity consisting of hypertrichosis,... function; 2 3 mg per kg PO daily 2 3 mg per kg PO daily Corticosteroid sparing function; 2 3 mg per kg PO daily 2 3 mg per kg PO daily Corticosteroid sparing function; 2 3 mg per kg PO daily Corticosteroid sparing function; 2 3 mg per kg PO daily Corticosteroid sparing function; 2 3 mg per kg PO daily Corticosteroid sparing function; 2 3 mg per kg PO daily 2 3 mg per kg PO daily 2 3 mg per kg PO daily 2 3... hair B ᭤ Trichorrhexis invaginata Bancroftian filariasis ᭤ Filariasis Bannayan syndrome ᭤ Bannayan-Riley-Ruvalcaba syndrome Bannayan-Riley-Ruvalcaba syndrome Synonym(s) Bannayan-Zonana syndrome; Riley-Smith syndrome; Ruvalcaba-Myhre syndrome; Ruvalcaba-Myhre-Smith syndrome; Bannayan syndrome; Cowden/Bannayan-RileyRuvalcaba overlap syndrome; PTEN hamartoma tumor syndrome; macrocephaly; pseudopapilledema;... References References Berman DA, Roenigk HH, Green D (19 92) Autoerythrocyte sensitization syndrome (psychogenic purpura) Journal of the American Academy of Dermatology 27 (5 Pt 2) : 829 –8 32 Autoimmune alopecia ᭤ Alopecia areata Wainer S (20 02) A child with axillary freckling and cafe au lait spots Canadian Medical Association Journal 167(3) :28 2 28 3 Azathioprine Trade name(s) Imuran A 76 Azathioprine Azathioprine... in weight; 500 mg PO on day 1; 25 0 mg PO on days 2 5 Not indicated in those < 45 kg in weight; 500 mg PO on day 1; 25 0 mg PO on days 2 5 Not indicated in those < 45 kg in weight; 500 mg PO on day 1; 25 0 mg PO on days 2 5 Not indicated in those < 45 kg in weight; 20 mg per kg PO for 1 dose Not indicated in those < 45 kg in weight; 500 mg PO on day 1; 25 0 mg PO on days 2 5 Not indicated in those < 45... Corticosteroid sparing function; reaction 2 3 mg per kg PO daily Polyarteritis nodosa Corticosteroid sparing function; 2 3 mg per kg PO daily Pyoderma Corticosteroid sparing function; gangrenosum 2 3 mg per kg PO daily Relapsing 2 3 mg per kg PO daily polychondritis Sarcoidosis 2 3 mg per kg PO daily Sulzberger-Garbe 2 3 mg per kg PO daily syndrome Weber-Christian 2 3 mg per kg PO daily disease Wegener’s... infection Differential diagnosis Lawrence-Seip syndrome; progressive partial lipodystrophy; post-traumatic partial lipodystrophy Therapy Dietary fish oil supplementation; acitretin References Seip M, Trygstad O (1996) Generalized lipodystrophy, congenital and acquired (lipoatrophy) Acta Paediatrica Suppl413 :2 Berardinelli-Seip-Lawrence syndrome ᭤ Berardinelli-Seip syndrome Bergamot phototoxicity ᭤ Berloque... weeks Apply twice daily for 2 4 weeks Apply twice daily for 4–8 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Apply twice daily for 2 4 weeks Contraindications/precautions Hypersensitivity to drug class or component; caution . Bannayan-Riley-Ruvalcaba syndrome Bannayan-Riley-Ruvalcaba syndrome Synonym(s) Bannayan-Zonana syndrome ; Riley-Smith syndrome ; Ruvalcaba-Myhre syndrome ; Ruvalcaba-Myhre-Smith. MC, Orlow SJ, Semel-Concepcion J, Bo- lognia JL (1996) Clinicopathologic findings in the Bannayan-Riley-Ruvalcaba syndrome. Ar- chives of Dermatology 1 32( 10): 121 4– 121 8 Bannayan-Zonana syndrome . per day for 7 days PART2 .MIF Page 82 Wednesday, October 29 , 20 03 4 :21 PM Bannayan-Riley-Ruvalcaba syndrome 83 B Definition Chronic, progressive, sclerosing, inflammatory dermatosis of