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Chromoblastomycosis 129 C Therapy Cryotherapy; triamcinolone 3–5 mg per ml intralesional; surgical excision; CNH pillow to relieve pressure References Beck MH (1985) Treatment of chondrodermatitis nodularis helicis and conventional wisdom? British Journal of Dermatology 113(4):504–505 Chondrodysplasia punctata ᭤ Conradi disease Chondrodystrophia calcificans congenita ᭤ Conradi disease Choristoma ᭤ Dermoid cyst Christ-Siemens-Touraine syndrome ᭤ Anhidrotic ectodermal dysplasia Chromhidrosis Synonym(s) Ephidrosis tincta; eccrine chromhidrosis Definition Condition characterized by colored sweat, mostly secondary to colored apocrine secretions Pathogenesis Elevated levels of lipofuscins possibly involved; substance P possibly an impor- tant neurotransmitter; extrinsic contribut- ing factors include dyes, chromogenic bac- teria, and chemical contactants Clinical manifestation Turbid, yellow, red, blue, or green apocrine secretion; color accentuated in the pores Differential diagnosis Hyperbilirubinemia; pseudomonas infec- tion; poisoning; alkaptonuria; bleeding dia- thesis (red sweat, hematohidrosis); copper exposure (blue sweat) Therapy Capsaicin 0.025% cream applied 4–5 times per day References Marks JG Jr (1989) Treatment of apocrine chrom- hidrosis with topical capsaicin. Journal of the American Academy of Dermatology 21(2 Pt 2):418–420 Chromoblastomycosis Synonym(s) Chromomycosis; verrucous dermatitis; phaeohyphomycosis; cystic chromomycosis Definition Chronic skin and subcutaneous fungal infection caused by one of multiple fungal pathogens Pathogenesis Inoculation by one of the following: Hor- modendrum pedrosoi, H. compactum, or PART3.MIF Page 129 Friday, October 31, 2003 9:37 AM 130 Chromomycosis Phialophora verrucosa; organisms isolated from wood and soil Clinical manifestation Asymptomatic, verrucous papule, slowly enlarging to large plaque or thick nodule; lesions often ulcerate; satellite lesions pro- duced by autoinoculation Differential diagnosis North American blastomycosis; South American blastomycosis; tuberculosis; leishmaniasis; syphilis; yaws; squamous cell carcinoma; atypical mycobacterial infec- tion; sporotrichosis; nocardiosis Therapy Itraconazole; terbinafine; flucytosine with or without localized hyperthermia; cryo- therapy; surgical excision for small lesions References Rivitti EA, Aoki V (1999) Deep fungal infections in tropical countries. Clinics in Dermatology 17(2):171–190 Chromomycosis ᭤ Chromoblastomycosis Chromophytosis ᭤ Tinea versicolor Chronic actinic dermatitis Synonym(s) Actinic reticuloid; persistent light reactiv- ity; photosensitive eczema; photosensitivity dermatitis; persistent light reaction Definition Persistent eczematous eruption in the sun- exposed areas of greater than 3 months' duration, with abnormal sensitivity to either ultraviolet or visible light Pathogenesis Delayed type hypersensitivity reaction involving a light-induced immune response Clinical manifestation Eczematous and infiltrated plaques that involve mostly exposed skin, but may gen- eralize to erythroderma Differential diagnosis Polymorphous light eruption; allergic con- tact dermatitis; photocontact dermatitis; solar urticaria; actinic prurigo; atopic der- matitis; lupus erythematosus; cutaneous T cell lymphoma Therapy Protection from sunlight; photochemother- apy; azathioprine; hydroxychloroquine sul- fate; cyclosporine References Lim HW, Morison WL, Kamide R, Buchness MR, Harris R, Soter NA (1994) Chronic actinic der- matitis. An analysis of 51 patients evaluated in the United States and Japan. Archives of Der- matology 130(10):1284–1289 Chronic adrenal insufficiency ᭤ Addison’s disease Chronic atrophic acrodermatitis ᭤ Acrodermatitis chronica atrophicans PART3.MIF Page 130 Friday, October 31, 2003 9:37 AM Chronic granulomatous disease of childhood 131 C Chronic atrophic polychondritis ᭤ Relapsing polychondritis Chronic bullous dermatosis of childhood ᭤ Linear IgA dermatosis Chronic bullous disease of childhood ᭤ Linear IgA dermatosis Chronic cutaneous lupus erythematosus ᭤ Lupus erythematosus, discoid Chronic erythema nodosum ᭤ Subacute nodular migratory pan- niculitis Chronic granulomatous disease Synonym(s) Chronic granulomatous disease of child- hood; fatal granulomatosis of childhood; progressive septic granulomatosis; X-linked chronic granulomatous disease Definition Inherited disorder of phagocytic cells, lead- ing to recurrent, life-threatening bacterial and fungal infections Pathogenesis Failure of phagocytes to generate sufficient quantities of reactive oxygen species; molecular defect represents a mutation in the gene encoding the b subunit of cyto- chrome b558 (CYBB), located on the X chro- mosome Clinical manifestation Early onset of severe recurrent bacterial and fungal infections, often involving the skin; lungs most common site of infection; other involved sites include gastrointesti- nal tract, lymph nodes, liver, and spleen Differential diagnosis Bruton agammaglobulinemia; common var- iable immunodeficiency; severe combined immunodeficiency; HIV infection; comple- ment deficiency; leukocyte adhesion defi- ciency; Wiskott-Aldrich syndrome Therapy Prophylaxis of bacterial infections with tri- methoprim-sulfamethoxazole 5 mg per kg per day PO divided into 2 doses; bone mar- row transplantation ଙ References Goldblatt D, Thrasher AJ, Chronic granulomatous disease. Clinical & Experimental Immunology 122(1):1–9 Chronic granulomatous disease of childhood ᭤ Chronic granulomatous disease PART3.MIF Page 131 Friday, October 31, 2003 9:37 AM 132 Chronic hair pulling Chronic hair pulling ᭤ Trichotillomania Chronic papulopustular facial dermatitis ᭤ Perioral dermatitis Chronic superficial dermatitis ᭤ Small plaque parapsoriasis Chrysiasis Synonym(s) Chrysoderma Definition Development of a blue-gray pigmentation in skin and mucous membranes, caused by exposure to gold compounds Pathogenesis Deposition of gold salts in the dermis; increased melanin production in the epi- dermis Clinical manifestation Blue-gray or violaceous hue to sun-exposed skin and sclerae; mucous membranes spared; pigmentation usually permanent; occurs only after a cumulative dose of at least 50 mg per kg Differential diagnosis Argyria; other drug-induced pigmentation (e.g. minocycline; amiodarone); Addison’s disease; hemosiderosis; jaundice; carotene- mia; hemochromatosis Therapy No effective therapy References Smith RW, Cawley MI (1997) Chrysiasis. British Journal of Rheumatology 36(1):3–5 Chrysoderma ᭤ Chrysiasis Churg-Strauss disease ᭤ Churg-Strauss syndrome Churg-Strauss granulomatosis syndrome ᭤ Churg-Strauss syndrome Churg-Strauss syndrome Synonym(s) Allergic granulomatosis; allergic angiitis and granulomatosis; eosinophilic granulo- matous vasculitis; Churg-Strauss granulo- matosis syndrome; granulomatous vasculi- tis with asthma Definition Disorder characterized by asthma, tran- sient pulmonary infiltrates, eosinophilia, and systemic vasculitis Pathogenesis Activated eosinophils possibly pathogenic PART3.MIF Page 132 Friday, October 31, 2003 9:37 AM Ciclopirox 133 C Clinical manifestation Cutaneous findings: red papules and mac- ules; palpable purpuric papules and plaques; cutaneous and subcutaneous papules and nodules Respiratory tract findings: allergic rhinitis; asthma; transient pulmonary infiltrates Vasculitis target organs: kidney, heart, cen- tral nervous system, gastrointestinal tract Differential diagnosis Henoch-Schönlein purpura; lupus ery- thematosus; bronchopulmonary aspergillo- sis; lymphoma; Loeffler syndrome; lympho- matoid granulomatosis; polyarteritis nodosa; rheumatoid arthritis Therapy Prednisone ଙ ; steroid-sparing agents: meth- otrexate; azathioprine 100–150 mg PO per day; cyclosporine; cyclophosamide pulse therapy 0.6 gm per m 2 IV monthly for up to 1 year References Gross WL (2002) Churg-Strauss syndrome: up- date on recent developments. Current Opinion in Rheumatology 14(1):11–14 Cicatricial pemphigoid Synonym(s) Benign mucous membrane pemphigoid; scarring pemphigoid; mucosal pemphigoid Definition Autoimmune vesiculobullous disease pre- dominately affecting mucous membranes Pathogenesis IgG antibodies against antigens in base- ment zone; major antigens associated are BPAG2 and epiligrin (laminin 5); immune reaction causes loss of adhesion at the der- mal-epidermal junction and blisters Clinical manifestation Persistent, painful erosions on mucous membranes, often healing with scarring; ocular involvement: pain or the sensation of grittiness in the eye; conjunctival inflam- mation and erosions; keratinization of the conjunctiva and shortening of the fornices; entropion with subsequent trichiasis; skin: tense vesicles or bullae, sometimes hemor- rhagic, sometimes healing with scarring or milia; scalp involvement leads to alopecia Differential diagnosis Bullous pemphigoid; linear IgA dermatosis; erythema multiforme; Stevens-Johnson syndrome; epidermolysis bullosa; epider- molysis bullosa acquisita; dermatitis herpe- tiformis; impetigo; pemphigus foliaceus; pemphigus vulgaris; herpes simplex virus infection; herpes zoster Therapy Limited disease: mid potency topical corti- costeroid gel for mucous membranes Extensive disease: prednisone, dapsone; cyclophosphamide; azathioprine References Fleming TE, Korman NJ (2000) Cicatricial pem- phigoid. Journal of the American Academy of Dermatology 43(4):571–591 Ciclopirox Trade name(s) Loprox; Penlac Generic available No Drug class Topical antifungal agent Mechanism of action Affects synthesis of fungal cell wall PART3.MIF Page 133 Friday, October 31, 2003 9:37 AM 134 Ciprofloxacin Dosage form 0.77% cream, gel, lotion; 8% nail lacquer Dermatologic indications and dosage See table Common side effects Cutaneous: burning, itching, redness, swell- ing Serious side effects None Drug interactions None Contraindications/precautions Hypersensitivity to drug class or compo- nent References Gupta AK, Baran R (2000) Ciclopirox nail lacquer solution 8% in the 21st century. Journal of the American Academy of Dermatology 43(4 Sup- plement):S96–102 Ciprofloxacin Trade name(s) Cipro Generic available No Drug class Fluoroquinolone antibiotic Mechanism of action Inhibition of bacterial DNA gyrase, which results in interference with DNA replication Dosage form 100 mg, 250 mg, 500 mg, 750 mg tablet; 250, 500 mg per 5 ml for intravenous infusion Dermatologic indications and dosage See table Common side effects Cutaneous: photosensitivity, urticaria, or other vascular reaction Gastrointestinal: nausea and vomiting, diarrhea, abdominal pain Neurologic: agitation, confusion, insomnia, headache, dizziness, restlessness Serious side effects Gastrointestinal: pseudomembranous coli- tis Neurologic: toxic psychosis, seizures Drug interactions Antacids; caffeine; calcium salts; clozapine; oral contraceptives; cyclosporine; glybu- ride/metformin; iron salts; non-steroidal anti-inflammatory drugs; olanzapine; phenytoin; probenecid; theophylline; warfa- rin Ciclopirox. Dermatologic indications and dosage Disease Adult dosage Child dosage Onychomycosis Apply Penlac once daily for up to 48 weeks Apply Penlac once daily for up to 48 weeks Tinea corporis Apply Loprox twice daily Apply Loprox twice daily Tinea cruris Apply Loprox twice daily Apply Loprox twice daily Tinea faciei Apply Loprox twice daily Apply Loprox twice daily Tinea nigra Apply Loprox twice daily Apply Loprox twice daily Tinea pedis Apply Loprox twice daily Apply Loprox twice daily White piedra Apply Loprox twice daily Apply Loprox twice daily PART3.MIF Page 134 Friday, October 31, 2003 9:37 AM Clarithromycin 135 C Contraindications/precautions Hypersensitivity to drug class or compo- nent; safety not established for patients < 18 years old; caution in those with impaired renal or liver function; caution in those with seizures References Sadick N (2000) Systemic antibiotic agents. Der- matologic Clinics 19(1):1–21 Circumscribed neurodermatitis ᭤ Lichen simplex chronicus Circumscribed scleroderma ᭤ Morphea Clam digger’s itch ᭤ Cercarial dermatitis Clarithromycin Trade name(s) Biaxin Generic available No Drug class Macrolide antibiotic Mechanism of action Inhibits protein synthesis of sensitive bacte- rial organisms Dosage form 250 mg, 500 mg tablet Dermatologic indications and dosage See table Common side effects Cutaneous: skin eruption, vaginitis Gastrointestinal: nausea, vomiting, abdom- inal pain, diarrhea, anorexia Serious side effects Cutaneous: anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis Gastrointestinal: pseudomembranous coli- tis, cholestatic jaundice Ciprofloxacin. Dermatologic indications and dosage Disease Adult dosage Child dosage Cellulitis 250–500 mg PO twice daily for 7–21 days, depending on response Not indicated Chancroid 500 mg PO twice daily for 3 days Not indicated Malakoplakia 250–500 mg PO for 7–14 days Not indicated Mycobacterium marinum infection 500 mg 1–2 times daily for 4–6 weeks Not indicated Rhinoscleroma 250–500 mg PO twice daily for months to years Not indicated Rickettsialpox 250–500 mg PO daily for 5 days Not indicated Salmonellosis 500 mg IV twice daily, then switch to PO when tolerated for a total course of 10–14 days Not indicated PART3.MIF Page 135 Friday, October 31, 2003 9:37 AM 136 Clark’s nevus Drug interactions Amiodarone; antacids; budesonide; bus- pirone; carbamazepine; clozapine; oral con- traceptives; cyclosporine; digoxin; ergot alkaloids; methadone; phenytoin; pimoz- ide; protease inhibitors; quinidine; statins; tacrolimus; theophylline; valproic acid; vinca alkaloids; warfarin Contraindications/precautions Hypersensitivity to drug class or compo- nent; caution in those with impaired liver function; do not use concomitantly with terfenadine or astemizole References Alvarez-Elcoro S, Enzler MJ (1999) The mac- rolides: erythromycin, clarithromycin, and azi- thromycin. Mayo Clinic Proceedings 74(6):613– 634 Clark’s nevus ᭤ Atypical mole Classic typhus ᭤ Epidemic typhus Clavus Synonym(s) Callus; callosity; corn, heloma, callous Definition Thickening of the skin due to intermittent pressure and frictional forces Pathogenesis Inappropriate distribution of pressure onto a specific site, producing increased fric- tional forces and reactive skin thickening Clinical manifestation Thickened skin, with retained skin derma- toglyphics, most commonly on the foot; occasional secondary maceration and fun- gal or bacterial infection Clarithromycin. Dermatologic indications and dosage Disease Adult dosage Child dosage Atypical mycobacterial infection 500 mg PO twice daily for 6–12 weeks after clinical remission > 45 kg weight; 7.5 mg per kg PO twice daily for 6–12 weeks after clinical remission Bacillary angiomatosis 250 mg PO twice daily for 3 weeks > 45 kg weight; 7.5 mg per kg PO twice daily for 3 weeks Bartonellosis 250 mg PO twice daily for 3 weeks > 45 kg weight; 7.5 mg per kg PO twice daily for 3 weeks Cellulitis 250 mg PO twice daily for 5–7 days > 45 kg weight; 7.5 mg per kg PO twice daily for 5–7 days Ecthyma 250 mg PO twice daily for 5–7 days > 45 kg weight; 7.5 mg per kg PO twice daily for 5–7 days Erythrasma 1 gm PO for 1 dose > 45 kg weight; 7.5 mg per kg PO for 1 dose Impetigo 250 mg PO twice daily for 5–7 days > 45 kg weight; 7.5 mg per kg PO twice daily for 5–7 days Mycobacterium marinum infection 500 mg PO twice daily for 6–12 weeks 15 mg per kg PO divided into 2 doses daily for 6–12 weeks PART3.MIF Page 136 Friday, October 31, 2003 9:37 AM Clindamycin, systemic 137 C Differential diagnosis Wart; gout; lichen planus; interdigital neu- roma; lichen simplex chronicus; palmo- plantar keratoderma; keratosis punctata; porokeratosis plantaris Therapy Mechanical pressure redistribution: orthot- ics; well-fitted shoes; protective pads on pressure points; skin-surface paring for symptomatic lesions References Freeman DB (2002) Corns and calluses resulting from mechanical hyperkeratosis. American Family Physician 65(11):2277–2280 Clear cell acanthoma Synonym(s) Clear cell acanthoma of Degos; Degos’ acanthoma; acanthome à cellules claires Definition Skin tumor with accumulation of clear, gly- cogen-containing cells Pathogenesis Unknown Clinical manifestation Solitary, dome-shaped papule or nodule, with a peripheral scale; occurring most commonly on the lower extremities Differential diagnosis Histiocytoma; seborrheic keratosis; lichenoid keratosis; pyogenic granuloma; amelanotic melanoma Therapy Surgical excision ଙ References Degos R, Civatte J (1970) Clear-cell acanthoma. Experience of 8 years. British Journal of Der- matology 83(2):248–254 Clear cell acanthoma of Degos ᭤ Clear cell acanthoma Clear cell adenoma ᭤ Eccrine acrospiroma Clear cell hidradenoma ᭤ Eccrine acrospiroma Clear cell myoepithelioma ᭤ Eccrine hidradenoma Climatic bubo ᭤ Lymphogranuloma venereum Clindamycin, systemic Trade name(s) Cleocin Generic available Ye s Drug class Lincosamide antibiotic Mechanism of action Binds to bacterial 50S ribosomal subunit, interfering with protein synthesis PART3.MIF Page 137 Friday, October 31, 2003 9:37 AM 138 Clostridial myonecrosis Dosage form 75 mg, 150 mg tablet; intramuscular prepa- ration; solution for intravenous injection Dermatologic indications and dosage See table Common side effects Cutaneous: skin eruption, pruritus Gastrointestinal: nausea, vomiting, diarrhea, abdominal pain, jaundice Serious side effects, Bone marrow: thrombocytopenia; granulo- cytopenia Cutaneous: anaphylaxis, Stevens-Johnson syndrome Gastrointestinal: pseudomembranous coli- tis, esophagitis Drug interactions Oral contraceptives; neuromuscular block- ers Contraindications/precautions Hypersensitivity to drug class or compo- nent; history of ulcerative colitis; caution with renal or hepatic impairment References Weingarten-Arams J, Adam HM (2002) Clin- damycin. Pediatrics in Review 23(4):149–150 Clostridial myonecrosis ᭤ Gas gangrene Clouston’s disease ᭤ Hidrotic ectodermal dysplasia Clubbing of the nails Definition A broadening and thickening of the fingers or toes, with increased lengthwise curva- ture and curvature of the tip of the nail, and flattening of the angle between the cuticle and nail References Collins KP, Burkhart CG (1985) Clubbing of the fingers. International Journal of Dermatology 24(5):296–297 Cobb syndrome Synonym(s) Cutaneomeningospinal angiomatosis Clindamycin, systemic. Dermatologic indications and dosage Disease Adult dosage Child dosage Acne vulgaris 150 mg PO 2–3 times daily Not indicated Gas gangrene 15 mg per kg IV daily divided into 3 doses 10 mg per kg daily IV divided into 3 doses Necrotizing fasciitis 600–900 mg IV every 6–12 hours 25–40 mg per kg IV divided into 3–4 doses daily Paronychia, acute 150 mg PO 3 times daily for 7–10 days Not indicated Streptococcal toxic shock-like syndrome 600–900 mg IV every 6–12 hours 25–40 mg per kg IV divided into 3–4 doses daily PART3.MIF Page 138 Friday, October 31, 2003 9:37 AM [...]... diagnosis Gardner’s syndrome; Peutz-Jeghers syndrome; Bandler syndrome; Ménétrier disease; familial polyposis Therapy No therapy for cutaneous manifestations; close follow-up for gastrointestinal problems References ᭤ Niemann-Pick disease Finan MC, Ray MK (1989) Gastrointestinal polyposis syndromes Dermatologic Clinics 7 (3) :419– 434 Crocker-Farber syndrome ᭤ Niemann-Pick disease Crotch rot ᭤ Tinea cruris... WH, Lautenschlager S (2001) Cowden syndrome-Diagnostic skin signs Dermatology 202(4) :36 2 36 6 Cowden syndrome ᭤ Cowden disease Cowden’s syndrome ᭤ Cowden disease Cowden/Bannayan-RileyRuvalcaba overlap syndrome ᭤ Bannayan-Riley-Ruvalcaba drome syn- C 158 Creeping eruption Creeping eruption ᭤ Cutaneous larva migrans Crocker syndrome ᭤ Niemann-Pick disease Crocker's syndrome fuse hyperpigmentation, including... Congenital self-healing histiocytosis (Hashimoto-Pritzker) International Journal of Dermatology 38 (9):6 93 696 Definition Inflammation or infection of the membrane lining the eyelids References Congenital self-healing Langerhans cell reticulohistiocytosis Shields SR (2000) Managing eye disease in primary care Part 2 How to recognize and treat common eye problems Postgraduate Medicine 108(5): 83 86, 91–96... kyphoscoliosis Differential diagnosis Nevus flammeus; infantile hemangioma; Sturge-Weber syndrome; Wyburn-Mason syndrome; Klippel-Trenaunay-Weber syndrome; angiokeratoma corporis diffusum Therapy Neurosurgical evaluation References Shim JH, Lee DW, Cho BK (1996) A case of Cobb syndrome associated with lymphangioma circumscriptum Dermatology 1 93( 1):45–47 Coccidioidomycosis Synonym(s) Valley fever, San Joaquin Valley... poison ivy: understanding allergic contact dermatitis in children Pediatric Annals 30 (4):2 03 206 Moore DE (2002) Drug-induced cutaneous photosensitivity: incidence, mechanism, prevention and management Drug Safety 25(5) :34 5– 37 2 Wakelin SH (2001) Contact urticaria Clinical & Experimental Dermatology 26(2): 132 – 136 Contact eczema ᭤ Contact Clinical manifestation Acute contact stage: red and edematous... necrosis of the newborn; sclerema neonatorum; poststeroid panniculitis; erythema infectiosum; atopic dermatitis; cellulitis Therapy None References Ter Poorten JC, Hebert AA, Ilkiw R (1995) Cold panniculitis in a neonate Journal of the American Academy of Dermatology 33 (2 Pt 2) :38 3– 38 5 C 142 Cold urticaria Cold urticaria Synonym(s) None Collagenoma perforant verruciforme ᭤ Reactive Definition Physical... cyst; syndrome of Favre-Racouchot; sebaceous hyperplasia; xanthoma; tuberous sclerosis; porphyria cutanea tarda Therapy Cryotherapy; dermabrasion References Touart DM, Sau P (1998) Cutaneous deposition diseases Part I Journal of the American Academy of Dermatology 39 (2 Pt 1):149–171 Colloid degeneration of the skin ᭤ Colloid degeneration Colloid milium ᭤ Colloid degeneration 1 43 Colloid pseudomilium... absence of heparin anticoagulation Cowden/Bannayan-Riley-Ruvalcaba overlap syndrome Differential diagnosis Other coagulopathies; heparin necrosis; spider bite reaction; pyoderma gangrenosum; vasculitis; cutaneous anthrax; traumatic ulceration; calciphylaxis; necrotizing soft tissue infection Therapy Medical therapy: continued coumarin therapy Surgical therapy: hydrocolloid dressings; skin grafting if... of Dermatology 29(7):472–476 Conradi Hunermann syndrome ᭤ Conradi disease Constricting bands of the extremities ᭤ Ainhum Consumptive thrombocytopenia ᭤ Kasabach-Merritt syndrome Pathogenesis Unknown; X-linked dominant trait Clinical manifestation Sparse, coarse scalp hair; thickening, dryness, and scaling of the skin; mild-to-moderate growth deficiency; disproportionate shortening of long bones, particularly... posterior hairline, underdeveloped orbital arches, anteverted nares, down-turned angles of the mouth, thin lips, low-set ears, depressed nasal bridge, micrognathia; hypertrichosis; micromelia; behavioral abnormalities Differential diagnosis Fetal alcohol syndrome; Coffin-Siris syndrome Therapy No specific therapy References Opitz JM, Brachmann-de Lange syndrome (1994) A continuing enigma Archives of Pediatrics . into 3 4 doses daily PART3 .MIF Page 138 Friday, October 31 , 20 03 9 :37 AM Coccidiosis 139 C Definition Association of spinal angiomas or arteriov- enous malformations with congenital cuta- neous. epidermolysis bul- losa acquisita Therapy None References Mehregan DR, Daoud M, Rogers RS 3 rd (1992) Coma blisters in a patient with diabetic ketoac- PART3 .MIF Page 1 43 Friday, October 31 , 20 03 9 :37 AM 144. weeks PART3 .MIF Page 136 Friday, October 31 , 20 03 9 :37 AM Clindamycin, systemic 137 C Differential diagnosis Wart; gout; lichen planus; interdigital neu- roma; lichen simplex chronicus; palmo- plantar