Dermatology therapy essentials - part 10 pptx

Trench fever 577 T treatment of pustular disorders in the neonate. Pediatric Dermatology 14(2):131–143 Transient neonatal pustulosis ᭤ Transient neonatal pustular melanosis Transient symptomatic zinc deficiency ᭤ Acrodermatitis enteropathica Traumatic alopecia marginalis ᭤ Traction alopecia Traumatic tattoo Synonym(s) Accidental tattoo Definition Localized skin dyspigmentation secondary to deposition of colored material in the skin from a deep dirty abrasion or other pene- trating injury Pathogenesis Deposition of material into dermis, often after high velocity penetration Clinical manifestation Irregular dyspigmentation at site of skin injury Amalgam tattoo variant: punctate gray dis- coloration in oral mucosa secondary to penetration of dental amalgam with dental procedures; some particles may extrude without therapy Differential diagnosis Melanoma; melanocytic nevus; lentigo; drug-induced pigmentation; exogenous ochronosis Therapy Ablation by Q-switched laser; surgical excision; dermabrasion; laser resurfacing; chemical peel References Fusade T, Toubel G, Grognard C, Mazer JM (2000) Treatment of gunpowder traumatic tattoo by Q-switched Nd:YAG laser: an unusual adverse effect. Dermatologic Surgery 26(11):1057–1059 Trenaunay syndrome ᭤ Klippel-Trenaunay-Weber syndrome Trench fever Synonym(s) 5–day fever; quintan fever; shinbone fever; shank fever; His-Werner disease; Wolhynia fever; urban trench fever Definition Blood-borne bacterial infection characterized by fever, systemic signs and symptoms, and an eruption occurring at the onset of the disease Pathogenesis Caused by Bartonella quintana, gram nega- tive bacteria introduced to human host by body louse; inoculation of organism in louse feces through a skin break or a louse bite PART20.MIF Page 577 Friday, October 31, 2003 12:34 PM 578 Trench foot Clinical manifestation Fever, varying from single episode to recur- rent episodes to persistently elevated body temperature for weeks; conjunctivitis; skin eruption most commonly occurring during first fever episode; groups of erythematous macules or papules on abdomen, chest, and back; splenomegaly; hepatomegaly; tachy- cardia Differential diagnosis Babesiosis; bacillary angiomatosis; crypto- coccosis; Lyme disease; relapsing fever; Rocky Mountain spotted fever; HIV infection; tuberculosis Therapy Doxycycline; erythromycin; azithromycin ᭤ Bartonellosis References Ohl ME, Spach DH (2000) Bartonella quintana and urban trench fever. Clinical Infectious Dis- eases 31(1):131–135 Trench foot ᭤ Immersion foot Trench mouth ᭤ Acute necrotizing gingivitis Tretinoin Trade name(s) Retin-A; Retin A Micro; Avita; Renova Generic available Ye s Drug class Retinoid Mechanism of action Gene transcription after membrane receptor binding and intracellular transport; nor- malizes follicular keratinization Dosage form 0.025%, 0.05%, 0.1% cream; 0.04%, 0.1% micro gel; 0.025% gel Dermatologic indications and dosage See table Common side effects Cutaneous: scaling, erythema, blistering, photosensitivity Serious side effects None Drug interactions Benzoyl peroxide; isotretinoin; photosensi- tizing drugs Contraindications/precautions Hypersensitivity to drug class or component References Bershad S (2001) Developments in topical retinoid therapy for acne. Seminars in Cutaneous Medicine & Surgery 20(3):154–161 Triamcinolone ᭤ Corticosteroids, topical, medium potency Trichilemmal cyst ᭤ Pilar cyst PART20.MIF Page 578 Friday, October 31, 2003 12:34 PM Trichilemmal cyst 579 T Tretinoin. Dermatologic indications and dosage Disease Adult dosage Child dosage Acanthosis nigricans Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Acne vulgaris Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Acrokeratoelastoidosis Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Not applicable Acrokeratosis verruciformis Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Actinic elastosis Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Not applicable Actinic keratosis Apply twice daily for up to 3 months Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Bowenoid papulosis Apply twice daily for up to 3 months Not applicable Chloracne Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Epidermolytic hyperkeratosis Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Favre Racouchot disease Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Not applicable Fox-Fordyce disease Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Hairy tongue Apply twice daily for up to 3 months Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Idiopathic guttate hypomelanosis Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Not applicable Keratosis pilaris Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Kyrle’s disease Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin PART20.MIF Page 579 Friday, October 31, 2003 12:34 PM 580 Trichilemmoma Trichilemmoma Synonym(s) Tricholemmoma Definition Benign neoplasm with differentiation toward pilosebaceous follicular epithelium Pathogenesis Unknown Clinical manifestation Asymptomatic, slow growing papule and/or plaque on face, ear, or upper extremity; small, flesh-colored papules; small plaques, particularly in the nasolabial fold region; with enlargement, thick hyperkeratotic sur- face suggestive of wart Lamellar ichthyosis Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Melasma Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Nevus comedonicus Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Nevus verrucosus Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Perforating folliculitis Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Photo-aging Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Not applicable Pomade acne Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Postinflammatory hyperpigmentation Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Reactive perforating collagenosis Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Rosacea Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Striae Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Apply once daily, preferably at bedtime; apply 20–30 minutes after washing and drying skin Tretinoin. Dermatologic indications and dosage (Continued) Disease Adult dosage Child dosage PART20.MIF Page 580 Friday, October 31, 2003 12:34 PM Trichoepithelioma 581 T Differential diagnosis Basal cell carcinoma; epidermoid cyst; wart; neurilemmoma; trichoepithelioma; trichofolliculoma; clear cell acanthoma Therapy Shave removal; elliptical excision References Tellechea O, Reis JP, Baptista AP (1992) Desmo- plastic trichilemmoma. American Journal of Dermatopathology 14(2):107–114 Trichoblastoma ᭤ Trichoepithelioma Trichodiscoma Synonym(s) Neurofollicular hamartoma Definition Hamartomatous proliferation of mesoder- mal component of haarscheibe, slowly reacting nerve receptor around hair follicle Pathogenesis Unknown Clinical manifestation Solitary or multiple, discrete, flat-topped papules, usually located on central face Differential diagnosis Trichoepithelioma; trichofolliculoma; angiofibroma; syringoma; basal cell carcinoma; acrochordon Therapy Surgical excision ଙ References Nova MP, Zung M, Halperin A (1991) Neurofollic- ular hamartoma. A clinicopathological study. American Journal of Dermatopathology 13(5):459–462 Trichoepithelioma Synonym(s) Trichoblastoma; epithelioma adenoides cysticum; trichoepithelioma papulosum multiplex; sclerosing epithelial hamartoma; Brooke tumor Definition Benign adnexal tumor with differentiation toward hair follicle epithelium Pathogenesis Autosomal dominant familial form related to a mutation in tumor suppressor gene, located on 9q21 Clinical manifestation Round, skin-colored, firm papule or nod- ule, located mainly on nasolabial folds, nose, forehead, upper lip, and scalp; occa- sional lesions on neck and upper trunk; rare ulceration; multiple lesions in familial form, usually on nasolabial folds; solitary giant trichoepithelioma: large, polypoid tumor, usually in the lower trunk or in glu- teal area Differential diagnosis Basal cell epithelioma; colloid milium; cylindroma; angiofibroma; milium; pilar Trichoepithelioma. Multiple flesh-colored papules in the central facial area PART20.MIF Page 581 Friday, October 31, 2003 12:34 PM 582 Trichoepithelioma papulosum multiplex cyst; syringoma; trichilemmoma; micro- cystic adnexal carcinoma Therapy Solitary tumor: surgical excision or shave removal Multiple tumors: CO2 laser ablation; dermabrasion References Smith KJ, Skelton HG, Holland T (1992). Recent advances and controversies concerning adnexal neoplasms. Dermatologic Clinics 10(1):117– 160 Trichoepithelioma papulosum multiplex ᭤ Trichoepithelioma Trichofolliculoma Synonym(s) Folliculoma; hair follicle nevus Definition Hamartoma of follicular epithelium, typi- cally occurring on the face Pathogenesis May be abortive differentiation of pluripo- tent skin cells towards hair follicles Clinical manifestation Single, flesh-colored or whitish papule, typ- ically on face, most frequently around the nose; central pore or black dot, sometimes draining sebaceous-like material; tuft of white hair sometimes emerges from central pore Differential diagnosis Basal cell epithelioma; colloid milium; cylindroma; angiofibroma; milium; pilar cyst; syringoma; trichilemmoma; micro- cystic adnexal carcinoma; trichoepithelioma; vellus hair cyst Therapy Surgical excision for cosmesis only References Labandeira J, Peteiro C, Toribio J (1996) Hair follicle nevus: case report and review. American Journal of Dermatopathology 18(1):90-93 Tricholemmoma ᭤ Trichilemmoma Trichomalacia Definition Damage to anagen hair root by repeated plucking or other injury, characterized by deformed and twisted bulb, seen mainly with trichotillomania References Walsh KH, McDougle CJ (2001) Trichotillomania. presentation, etiology, diagnosis and therapy. American Journal of Clinical Dermatology 2(5):327–333 Trichomatricoma ᭤ Pilomatricoma Trichomatrioma ᭤ Pilomatricoma PART20.MIF Page 582 Friday, October 31, 2003 12:34 PM Trichorrhexis nodosa 583 T Trichomycosis axillaris and pubis Synonym(s) Trichomycosis nodosa; trichomycosis nodularis Definition Superficial bacterial colonization of the axillary hair shafts, characterized by granu- lar concretions adhering to hair shaft Pathogenesis Caused by several species of the gram-posi- tive diphtheroid Corynebacterium over- growth on hair shafts in moist regions of the body Clinical manifestation Seen more often in tropical climates; sometimes associated with hyperhidrosis; concretions encircling hair shaft, giving it beaded appearance; most common on the central portion of axillary hair (trichomycosis axillaris) or inguinal region, often on scrotum (trichomycosis pubis); red, black, or yellow concretions firmly adhering to hair shaft; yellow color sometimes stains clothes yellow, black, and red Differential diagnosis Pediculosis; piedra; hair casts; soap or deo- dorant remnants Therapy Shaving of affected hair ଙ ; use of antiperspi- rants to prevent recurrence References O'Dell ML (1998) Skin and wound infections: an overview. American Family Physician 57(10):2424–2432 Trichomycosis nodosa ᭤ Trichomycosis axillaris and pubis Trichomycosis nodularis ᭤ Piedra ᭤ Trichomycosis axillaris and pubis Trichophytosis barbae ᭤ Sycosis barbae Trichopoliodystrophy ᭤ Menkes kinky hair syndrome Trichorrhexis invaginata Definition Hair fibers having the shape of bamboo; fibers with focal nodules making them resemble a bamboo shoot; focal defects in the hair fiber, with development of a cup and ball shape; seen in Netherton’s syndrome References Rogers M (1996) Hair shaft abnormalities: Part II. Australasian Journal of Dermatology 37(1):1–11 Trichorrhexis nodosa Definition Defect in the hair shaft characterized by thickening or weak points (nodes) causing the hair to break easily; precipitated by environmental insults in disorders such as argininosuccinic aciduria, Menkes' kinky hair syndrome, Netherton's syndrome, hypothyroidism, or trichothiodystrophy PART20.MIF Page 583 Friday, October 31, 2003 12:34 PM 584 Trichosporosis References Rogers M (1995) Hair shaft abnormalities: Part I. Australasian Journal of Dermatology 36(4):179–184 Trichosporosis ᭤ Piedra Trichostasis spinulosa Synonym(s) None Definition Dark follicular papules, caused by multiple vellus hairs imbedded in follicular orifice Pathogenesis Results from successive production and retention of vellus telogen club hairs from single hair matrix in single follicle Clinical manifestation Dark, follicular plugs or papules, sometimes with tufts or spines of fine hair protu- ding; most common on nose and upper trunk Differential diagnosis Comedonal acne; lichen spinulosus; retained dirt; keratosis pilaris Therapy Depilatory wax or adhesive strips; drainage with comedone extractor References Harford RR, Cobb MW, Miller ML (1996) Trichos- tasis spinulosa: a clinical simulant of acne open comedones. Pediatric Dermatology 13(6):490– 492 Trichothiodystrophy ᭤ Tay syndrome Trichothiodystrophy with congenital ichthyosis ᭤ Tay syndrome Trichotillomania Synonym(s) Chronic hair pulling; morbid hair pulling; compulsive hair pulling Definition Alopecia caused by compulsive pulling and/ or twisting of the hair until it breaks off Pathogenesis Impulse control disorder, often with under- lying emotional problem; become habitual once behavior is established, regardless of initial emotional problem Trichotillomania. Alopecic plaque with broken hairs in the scalp PART20.MIF Page 584 Friday, October 31, 2003 12:34 PM Trimox 585 T Clinical manifestation Incomplete nonscarring alopecia, in rela- tively localized sites; geometric shapes of involved area, with broken hair; occurs most frequently in scalp, but sometimes involves eyebrows or eyelashes Differential diagnosis Alopecia areata; tinea capitis; androgenetic alopecia; syphilis; lupus erythematosus; monilethrix; traction alopecia; pili torti; temporal triangular alopecia Therapy Selective serotonin reuptake inhibitors in patients unable to control impulse after understanding nature of disorder References Hautmann G, Hercogova J, Lotti T (2002) Tri- chotillomania. Journal of the American Acade- my of Dermatology 46(6):807–821 Trichrome vitiligo ᭤ Vitiligo Triglyceride storage disease ᭤ Chanarin-Dorfman syndrome Trimethoprim- sulfamethoxazole Trade name(s) Bactrim; Septra Generic available Ye s Drug class Antibiotic Mechanism of action Inhibition of enzymes involved in bacterial tetrahydrofolic acid synthesis Dosage form DS capsule Dermatologic indications and dosage See table Common side effects Cutaneous: urticaria or other vascular reac- tion, photosensitivity Gastrointestinal: anorexia, nausea, vomiting, diarrhea Neurologic: dizziness Serious side effects Bone marrow: aplastic anemia, agranulocy- tosis Cutaneous: Stevens-Johnson syndrome, toxic epidermal necrolysis Gastrointestinal: hepatitis, hepatic necro- sis, pseudomembranous colitis Renal: interstitial nephritis Drug interactions Oral contraceptives; dapsone; MAO inhibitors; metformin; methotrexate; phenytoin; probenecid; procainamide; sulfonylureas; warfarin Contraindications/precautions Hypersensitivity to drug class or component; folate deficiency; G6PD deficiency References Smilack JD (1999) Trimethoprim-sulfamethoxazole. Mayo Clinic Proceedings 74(7):730–734 Trimox ᭤ Amoxicillin PART20.MIF Page 585 Friday, October 31, 2003 12:34 PM 586 Tropical anhidrosis Tropical anhidrosis ᭤ Miliaria Tropical anhidrotic asthenia ᭤ Acquired generalized anhidrosis Tropical jungle foot ᭤ Immersion foot Tropical phagedenic ulcer Synonym(s) Vincent’s ulcer; tropical sloughing phagedena; ulcus tropicum Definition Acute, painful, destructive skin ulceration occurring in presence of fusiform bacilli and spirochetes Pathogenesis Multiple contributing factors, including protein deficiency, presence of fusiform bacilli and spirochetes, and minor trauma to affected site Clinical manifestation Papule or vesicle at site of minor trauma, often on lower extremity; rapid evolution of necrotic, purulent, putrid ulceration often down to fascia, tendon, and bone; chronic stage with indolent, non-purulent ulceration Differential diagnosis Leishmaniasis; bacterial pyoderma; pyoderma gangrenosum; cutaneous diphthe- ria; gummatous syphilis; yaws; leprosy; chromomycosis; squamous cell carcinoma; venous stasis ulcer; atypical mycobacterial infection; venomous sting or bite Therapy Acute stage: Benzathine penicillin G ଙ ; tet- racycline; metronidazole: 400 mg PO 3 times daily until healing Chronic stage: no specific antibiotic therapy References Robinson DC, Adriaans B, Hay RJ, Yesudian P (1988) The clinical and epidemiologic features of tropical ulcer (tropical phagedenic ulcer). Trimethoprim-sulfamethoxazole. Dermatologic indications and dosage Disease Adult dosage Child dosage Granuloma inguinale DS capsule twice daily for at least 3 weeks Not established Melioidosis DS capsule twice daily until ulceration heals Not established Mycetoma DS capsule twice daily until ulceration heals Not established Mycobacterium marinum infection DS capsule PO twice daily for 4–6 weeks after clincial resolution Not established Nocardiosis DS capsule twice daily for at least 3 weeks Not established South American blastomycosis DS capsule twice daily for 2–3 years Not established PART20.MIF Page 586 Friday, October 31, 2003 12:34 PM [...]... keratosis Therapy No effective therapy Therapy Alpha hydroxy acids; emollients; urea References References Tosti A, Bardazzi F, Piraccini BM, Fanti PA (1994) Idiopathic trachyonychia (twenty-nail dystrophy): a pathological study of 23 patients British Journal of Dermatology 131(6):866–872 Cohen PR, Kurzrock R (1995) Miscellaneous genodermatoses: Beckwith-Wiedemann syndrome, Birt-Hogg-Dube syndrome, familial... disease Therapy None References Ruiz-Maldonado R, Tamayo L, Fernandez-Diez J (1978) Universal acquired melanosis The carbon baby Archives of Dermatology 114(5):775– 778 Unna-Thost palmoplantar keratoderma Synonym(s) Diffuse nonepidermolytic palmoplantar keratoderma; Thost-Unna disease; palmoplantar keratoderma diffusa circumscripta; congenital keratoderma of the palms and soles; hereditary palmo-plantar... Varicella 100 0 mg PO twice daily for 10 days Not established 500 mg -1 00 0 mg PO daily for up to 1 Not established year 2000 mg PO twice daily for 1 day Not established 100 0 mg PO 3 times daily for 7 days 100 0 mg PO 3 times daily for 7 days Not established Not established 600 Valley fever References Baker DA (2002) Valacyclovir in the treatment of genital herpes and herpes zoster Expert Opinion on Pharmacotherapy... cellulitis, and ulceration Differential diagnosis Thrombophlebitis; cellulitis; Osler-WeberRendu syndrome; stasis dermatitis Therapy Small or superficial vein disease: support hose; intermittent leg elevation; weight loss; chemical sclerosis (sclerotherapy); transcutaneous laser therapy; intense-pulsed-light (IPL) therapy Large and deep vein disease: ligation of saphenofemoral junction with vein stripping;... allergic cutaneous vasculitis; erythema multiforme Therapy Antihistamines, second generation; recalcitrant disease: colchicine; hydroxychloroquine; dapsone; systemic disease: prednisone U 598 Uveoencephalitis References Black AK (1999) Urticarial vasculitis Clinics in Dermatology 17(5):565–569 ᭤ Vogt-Koyanagi-Harada Uveoencephalitis ᭤ Vogt-Koyanagi-Harada Uveomeningoencephalitic syndrome syndrome syndrome... nodosa; Churg-Strauss syndrome; antiphospholipid antibody syndrome; serum sickness; septic vasculitis; systemic lupus erythematosus; sarcoidosis Therapy Symptomatic hyperviscosity: plasmapheresisଙ; lymphoma: chemotherapy; splenectomy References Alexanian R, Weber D (2001) Recent advances in treatment of multiple myeloma and Waldenström's macroglobulinemia Biomedicine & Pharmacotherapy 55( 9-1 0):550–552... corneal ulcerations and subsequent scarring Neurologic findings: mental retardation; self-mutilating behavior; fine coordination disturbances Differential diagnosis Other forms of focal palmo-plantar keratoderma, such as Wachter syndrome and Howel-Evans syndrome; epidermolysis bullosa; Spanlang-Tappeiner syndrome Therapy Low tyrosine, low phenylalanine diet, such as Mead Johnson 3200 ABଙ; acitretin References... and auditory abnormalities Pathogenesis May be a post-viral syndrome, perhaps secondary to Epstein-Barr virus; possibly an autoimmune disorder; susceptibility related to presence of HLA-DR4 antigen and DRB*0405 allele Clinical manifestation Prodromal stage: non-specific symptoms, including headache, vertigo, nausea, nuchal rigidity, vomiting, and low-grade fever Meningoencephalitis phase: generalized... dysgenesis; autoimmune thyroiditis; XY gonadal agenesis syndrome Therapy No specific therapy References ᭤ Nail-patella syndrome Turner phenotype syndrome Cunniff C (2002) Turner syndrome Adolescent Medicine State of the Art Reviews 13(2):359–366 Turner-like syndrome ᭤ Noonan’s ᭤ Noonan’s syndrome syndrome Turner syndrome Synonym(s) Bonnevie-Ullrich syndrome; gonadal dysgenesis Definition Disorder in women... neurofibromatosis Pathogenesis Autosomal dominant trait; may be associated with NF-1 gene mutation Clinical manifestation Café-au-lait macules; axillary freckling; Lisch nodules; pulmonary stenosis; low intelligence; short stature Differential diagnosis Neurofibromatosis; Noonan’s syndrome; Turner’s syndrome Therapy No effective therapy References Conway JB, Posner M (1994) Anaesthesia for caesarean section . autis- tic behavior; and attention-deficit hyperac- tivity disorder Miscellaneous findings: cardiac rhabdomy- omas; aortic aneurysm; renal angiomyol- ipoma and renal cysts; pulmonary lym- phangiomatosis. arsenical keratosis Therapy Alpha hydroxy acids; emollients; urea References Cohen PR, Kurzrock R (1995) Miscellaneous genodermatoses: Beckwith-Wiedemann syndrome, Birt-Hogg-Dube syndrome, familial. disease; bronze baby; Schilder’s disease Therapy None References Ruiz-Maldonado R, Tamayo L, Fernandez-Diez J (1978) Universal acquired melanosis. The carbon baby. Archives of Dermatology