•autoimmune process associated with vitiligo
• thyroid and endocrine deficiency disorders
•Associated with Down's syndrom
• with emotional stress
•. Hair loss due to systemic disease, e.g.,
after acute febrile illnesses, surgical
•systemic lupus erythematosus,
•low serum iron
•. Toxic alopecia, e.g., with antimitotic drugs,
heparin, thallium, warfarin, overdoses of
•. Overprocessing hair loss from damage by
•Male-pattern baldness is familial; cause un-
•Female-pattern hair thinning in the meno-
pause; baldness rarely in old age
•Scarred alopecia following scar formation
after inflammation and tissue destruction
• Chronic inflammatory skin
disease usually beginning
in' middle age,
papules, and pustules,
especially in center of face
• Diet probably unimportant.
• May be evidence of
• Psychological factors and
menopausal flushing may
• Doubtful significance of
• This is chronic condition
associated with the blockage
of the pilosebaceous duct by
propioni bacterium acnes. It
alter the cell mediated
immune response aid to
stimulate the classical and
• Pro inflammatory mediators
also induced by the organism
on body .Such as the face,
chest and back where
sebaceous glands are most
numerous and active.
• The Principle age of onset is
at puberty when under the
influence of androgenic
hormones, sebaceous lards
undergo hypertrophy and
increased the production of
• Tissue infiltrates with insoluble
proteins or protein-
leading to dysfunction of the
Pathology and Causes
1:Primary (unknown etiology or that
related to multiple myeloma)
• Approximately 70% of cases
• Plasma-cell dyscrasia with
Bence Jones pro-tein
• Tongue, heart, gastrointestinal
tract, muscle, ligaments, and
2:Secondary (associated with
chronic granulomatous diseases
or infections, may also be
hereditary, systemic as with
rheumatoid arthritis or familial
• Involves spleen, liver, kidneys,
and adrenals . Mixed primary
and secondary types occur in
about 30% of cases
Waxy appearance of
deposition around the
CELLULITISCellulitis refers to an infection involving not only the epidermis but
also deeper layers of the skin: the dermis and subcutaneous
tissueGroup A streptococcus and staphylococcus are the most
common of cellulitis-causing bacteria, they are part of the normal
flora of the skin but cause no actual infection until the skin is
broken. Nevertheless other bacteria may cause cellulitis as well.
The symptoms of cellulitis may resemble other dermatologic
Location: Cellulitis frequently occurs on
• exposed ares of the body such as the arms and face, most often
affects the legs.
• Predisposing conditions for cellulitis include insect bite, animal
bite, pruritic skin rash, recent surgery, athlete's foot, swollen skin,
dry skin, eczema, and burns.
• Patients with diabetes or impairment of the immune system are
particularly susceptibile to developing cellulitis.
Symptoms: cellulitis begins as a small area of tenderness,
• swelling, and redness on the skin.
• As this red area begins to spread, the person may develop a fever,
headache, sometimes with chills and sweats, bruising and blisters
on the affected area.
• Lymph nodes near the area of infected skin may become
Erysipelas - also called Saint Anthony's fire - is a form of rather
superficial cellulitis caused by a species of hemolytic
streptococcus; it is characterized by spreading hot, bright red
circumscribed area on the skin with a sharp raised border
accompanied by high fever and a feeling of general illness.
Erysipelas in most cases affects the skin of the face, that is why
when it strikes other parts of the body, it may often be
misdiagnosed. Bacteremia (blood poisoning) and pneumonia are
the most common complications. Erysipelas is a highly
contagious disease that was formerly dangerous to life; however,
it can now be quickly controlled by antibiotic therapy.
• thought to be related to allergies.
• Chronic forms of dermatitis tend to cause thickening, pigmentation, and scaling of
• whereas acute forms are characterized by a red, itching area of blisters and
New research suggests that damage to the protective layer of the skin causes
eczema. Use of a shielding lotion, which will replace this protective layer, is the
best form of eczema treatment
Atopic dermatitis - is a chronic disease affecting the skin, the most common of the
many types of eczema, that is caused by general systemic allergic reactions, as
opposed to contact with an irritant. Atopic dermatitis tends to run in families
susceptible to asthma and hay fever and often occurs together with these
Atopic dermatitis is characterized by itching and inflammation of the skin, causing
scaling, thickening, pigmentation, redness, weeping, crusting and cracking.
Contact dermatitis - is an allergenic reaction, the result of direct contact with an irritant.
• various household chemicals being handled or left on the clothes unrinsed,
• synthetic fibers,
• cosmetics and
• skin-care products,
• nail polish remover,
• As well as wearing rubber gloves,
• unwashed new clothes,
• plated jewelry can also cause contact dermatitis.
• nickel-containing buttons and rivets on clothes(jeans).
• Among plants that may cause allergic reaction are: poison ivy, poison oak and
poison sumac. .
• Perioral dermatitis (muzzle rash) - is a common adult women problem, rarely occuring in men. It mainly affects
persons with the oily skin, most frequently appear around the mouth, as groups of itchy or tender small red spots.
These spots spare the skin bordering the lips, developing on the chin, upper lip and cheeks. The skin surface
becomes dry and flaky. In cases when the skin around the nose and eyes is also involved, the condition is called
periorificial dermatitis. This type of dermatitis may be induced by regular application of the moisturizing face creams,
make-up foundations, sunscreens as well as usage of topical steroid creams to the area bounded by the cheek folds,
chin and around eyes.
Dermatitis herpetiformis (Duhring's disease) - is chronic disease of the skin characterized by severe itching and
eruption of vesicles and groups of papules on the elbows, knees, back, and buttocks. In most cases, it is highly
Dermatitis herpetiformis is frequently associated with sensitivity of the intestine to gluten (a protein found in cereals)
in the diet.
Seborrh(o)eic dermatitis (dyssebacia, pityriasis alba, seborrheic dermatosis) - is a chronic form of dermatitis
characterized by oily scales, crusty yellow patches, and itching. Seborrheic dermatitis occurs primarily on the scalp,
face, upper body, as well as on the genitals, and in skin creases along the nose, under the breasts, and elsewhere,
particularly affecting the sebum-gland rich areas of the skin. It is thought to be caused by a fungal infection caused by
the yeast, Malassezia furfur (aka Pityrosporum ovale) in individuals with decreased immunity and increased sebum
production. Adult seborhheic dermatitis typically affects those between 20 and 40 years old.
Infantile seborrh(o)eic dermatitis (cradle cap) - is a form of seborrheic dermatitis occuring in infants, it commonly
begins sometime in the first 3 months and can affect any baby. Cradle cap is characterized by patchy, greasy, scaly
and crusty skin rash on the scalp that is often prominent around the ear or the eyebrows (when it appears in other
locations, it is called seborrheic dermatitis rather than cradle cap). It apparently doesn't itch and eventually goes away
on its own. Cradle cap is supposed to be caused by hyperactive sebaceous glands in the skin of newborn babies, due
to the mother's hormones still in the baby's circulation, there may also be a relationship with skin yeasts.
Nummular dermatitis (discoid eczema) - is recurrent and chronic form of dermatitis, that may appear at any age, but is
most common in people in their 60's. It is characterized by distinctive coin-shaped red itchy patches, that may affect
any part of the body, but most commonly develop on the legs and buttocks. Flare-ups of the disease are associated
with cold seasons, when the skin is getting dry.
Stasis dermatitis (varicose eczema) - is the result of poor blood circulation in the lower legs, causing pooling of blood,
fluid buildup and edema. This leads to unhealthy skin growth and irritation, especially around the ankles. It can
happen later in life, in people with varicose veins, congestive heart failure, or other conditions.
PARONYCHIA• The nail disease paronychia is an often-tender
bacterial or fungal hand infection or foot infection
where the nail and skin meet at the side or the
base of a finger or toenail. The infection can start
suddenly (acute paronychia) or gradually (chronic
• The cuticle acts as a protective seal but if it's
damaged in any way bacteria can enter the skin
and cause infection. These infections can be
extremely painful as the skin becomes inflamed,
hot, red and throbs continually.
• Whitlows are common, especially for people who
have to repeatedly wash their hands. Excess
water weakens the seal, while soaps and
detergents remove the protective skin oils leaving
the skin dry and more liable to split. Most often,
trauma to the cuticle allows infection in. Biting or
picking at the cuticle, damage through work and
overenthusiastic manicuring are the usual
culprits. If someone has a cold sore and puts
their finger in their mouth then a herpes infection
whitlow may appear.
• Paronychia may be divided as follows:
• Acute paronychia
• Chronic paronychia
• Alternatively, paronychia may be divided as
• Candidal paronychia
• Pyogenic paronychia
MILIARIA RUBRA• Miliaria (miliaria rubra, sweat rash, heat rash, or prickly heat)
is a skin disease marked by small and itchy rashes. Miliaria is
a common ailment in hot and humid conditions, such as in the
tropics and during the summer season. Although it affects
people of all ages, it is especially common in children and
infants due to their underdeveloped sweat glands.
• Miliaria occurs when the sweat gland ducts get plugged due to
dead skin cells or bacteria such as Staphylococcus
epidermidis a common bacterium that occurs on the skin
which is also associated with acne.
• The trapped sweat leads to irritation (prickling), itching and to
a rash of very small blisters, usually in a localized area of the
• small red rashes-papules, which may itch or more often cause
an intense 'pins-and-needles' prickling sensation
• These may simultaneously occur at a number of areas on a
sufferer's body, the most common including the face, neck,
under the breasts and under the scrotum. Other areas include
skin folds, areas of the body that may rub against clothing,
such as the back, chest, and stomach, etc.
• A related and sometimes simultaneous condition is folliculitis,
where hair follicles become plugged with foreign matter,
resulting in inflammation.
• The symptoms relating to miliaria should not be confused with
shingles as they can be very similar. Shingles will restrict
itself to one side of the body but also has a rash-like
appearance. It is also accompanied by a prickling sensation
and pain throughout the region. Those who suspect they have
shingles and not miliaria should seek medical advice
immediately as the sooner antivirals are taken, the better.
KELOID• A keloid (also known as a "keloidal scar is
a type of scar, which depending on its
maturity, is composed of mainly either type
III (early) or type I (late) collagen. It is a
result of an overgrowth of granulation
tissue (collagen type 3) at the site of a
healed skin injury which is then slowly
replaced by collagen type 1.
• Keloids are firm, rubbery lesions or shiny,
fibrous nodules, and can vary from pink to
flesh-coloured or red to dark brown in
colour. A keloid scar is benign, non-
contagious, and sometimes accompanied
by severe itchiness and pains, and
changes in texture. In severe cases, it can
affect movement of skin.
• Keloids should not be confused with
hypertrophic scars, which are raised scars
that do not grow beyond the boundaries of
the original wound.
• Psoriasis is a skin disease that causes
itchy or sore patches of thick, red skin
with silvery scales. You usually get them
on your elbows, knees, scalp, back, face,
palms and feet, but they can show up on
other parts of your body. A problem with
your immune system causes psoriasis.
In a process called cell turnover, skin
cells that grow deep in your skin rise to
the surface. Normally, this takes a
month. In psoriasis, it happens in just
days because your cells rise too fast
• Things that make them worse include
• Dry skin
• Certain medicines
• Psoriasis usually occurs in adults. It
sometimes runs in families. Treatments
include creams, medications and light
• Scabies is an itchy skin condition
caused by the microscopic mite
Sarcoptes scabei. It is common all over
the world, and it affects people of all
races and social classes. Scabies
spreads quickly in crowded conditions
where there is frequent skin-to-skin
contact between people. Hospitals, child-
care centers and nursing homes are
examples. Scabies can easily infect sex
partners and other household members.
Sharing clothes, towels, and bedding
can also spread scabies. You cannot get
scabies from a pet. Pets get a different
mite infection called mange.
• Symptoms are
• Pimple-like irritations or a rash
• Intense itching, especially at night
• Sores caused by scratching
• Several lotions are available to treat
scabies. The infected person's clothes,
bedding and towels should be washed in
hot water and dried in a hot dryer.
• Pityriasis alba is a common skin disorder
similar to very mild eczema.
• The cause is unknown. The disorder is most
common in children and adolescents --
particularly in children with dark skin.
• Round or oval, colorless patches of skin
appear on the face, upper arms, neck, and
upper middle of the body. There may be flaky
skin, called scales.
• The patches don't tan, but may get red quickly
in the sun.
• Symptoms are treated with moisturizers and
mild topical steroid creams. The patches
usually clear up, but may return.
URTICARIA/nettle rash• Hives are red and sometimes itchy bumps on your
skin. An allergic reaction to a drug or food usually
causes them. Allergic reactions cause your body
to release chemicals that can make your skin swell
up in hives. People who have other allergies are
more likely to get hives than other people. Other
causes include infections and stress
• Hives are very common. They usually go away on
their own, but if you have a serious case, you
might need medicine or a shot. In rare cases,
allergic reactions can cause a dangerous swelling
in your airways, making it hard to breathe - which
is a medical emergency.
BASAL CELL CARCINOMA
• Basal cell carcinoma is the most common
type of skin cancer. It rarely metastasizes
or kills, but it is still considered malignant
because it can cause significant
destruction and disfigurement by
invading surrounding tissues
• Basal cell carcinomas develop in the
basal cell layer of the skin. Sun light
exposure leads to the formation of thymine
dimers, a form of DNA damage. While
DNA repair removes most UV-induced
damage, not all crosslinks are excised. There
is, therefore, cumulative DNA damage
leading to mutations. Apart from the
mutagenesis, sunlight depresses the local
immune system, possibly decreasing
immune surveillance for new tumor cells.
• Seborrheic dermatitis is a common,
inflammatory skin condition that
causes flaky, white to yellowish scales to form
on oily areas such as the scalp or inside the ear.
It can occur with or without reddened skin.
• Cradle cap is the term used when seborrheic
dermatitis affects the scalp of infants.
• Seborrheic dermatitis is thought to be due to a
combination of an over production of skin oil
and irritation from a yeast called malessizia.
• Seborrheic dermatitis appears to run in families.
Stress, fatigue, weather extremes, oily skin,
infrequent shampoos or skin cleaning, use of
lotions that contain alcohol, skin disorders
(such as acne), or obesity may increase the risk.
• Neurologic conditions, including
Parkinson's disease, head injury, and stroke
may be associated with seborrheic dermatitis.
Human immunodeficiency virus (HIV) has also
been linked to increased cases of seborrheic
• . Typically it forms where the skin is oily or greasy.
• Commonly affected areas include the scalp, eyebrows, eyelids, creases
of the nose, lips, behind the ears, in the external ear, and along skin folds
on the middle of the body.
• Seborrheic dermatitis in infants, also called cradle cap, is a harmless,
temporary condition. It appears as thick, crusty, yellow or brown scales
over the child's scalp. Similar scales may also be found on the eyelids,
ear, around the nose, and in the groin. Cradle cap may be seen in
newborns and small children up to age 3 .
• Cradle cap is not contagious, nor is it caused by poor hygiene. It is not
an allergy, and it is not dangerous. Cradle cap may or may not itch. If it
itches, excessive scratching of the area may cause additional
inflammation, and breaks in skin may cause mild infections or bleeding.
• In general, symptoms of seborrheic dermatitis include:
• Skin lesions
• Plaques over large area
• Greasy, oily areas of skin
• Skin scales -- white and flaking, or yellowish, oily, and adherent --
• Itching -- may become more itchy if infected
• Mild redness
• Hair loss
Burns and Scalds
Burns are injuries to tissues caused by heat, friction,
radiation, or chemicals. Scalds are a type of burn caused by a
Burns and Scalds - Description
• A first degree burn causes redness and swelling in the
outermost layers of the skin.
• A second degree burn involves redness, swelling, and
blistering. The damage may extend to deeper layers of
• A third degree burn destroys the entire depth of the skin.
It can also damage fat, muscle, organs, or bone beneath
the skin. Significant scarring is common, and death can
occur in the most severe cases.
• hot objects
• a rope burn is caused by friction between the rope and a
person's body. The rope itself is not hot, but the heat
produced by friction is sufficient to cause a burn.
• Chemicals can also cause burns. The chemicals attack
and destroy cells in skin tissue. They produce an effect
very similar to that of a heat burn.
• swelling, and
• pain in the affected area.
• A burn may also trigger a headache and fever.
• The most serious burns may cause shock.
• The symptoms of shock include faintness, weakness,
rapid pulse and breathing, pale and clammy skin, and
bluish lips and fingernails.
• Vitiligo is a chronic disorder that causes
depigmentation in patches of skin. It
occurs when the melanocytes, the cells
responsible for skin pigmentation which
are derived from the neural crest, die or
are unable to function.
Signs and symptoms
• depigmentation of patches of skin that
occurs on the extremities. Although
patches are initially small, they often
enlarge and change shape
• skin lesions occur, they are most
prominent on the face, hands and wrists
• Depigmentation is particularly noticeable
around body orifices, such as the mouth,
eyes, nostrils, genitalia and umbilicus.
Some lesions have hyperpigmentation
around the edges.In regards to
psychological damage, vitiligo can have a
significant effect on the mental health of a
• Psychological stress ,depression &
• Segmental vitiligo
• Segmental vitiligo (SV) differs in appearance
• Non-segmental vitiligo
• In Non-segmental vitiligo (NSV), there is usually some form of
symmetry in the location of the patches of depigmentation. New
patches also appear over time, and can be generalised over large
portions of the body, or localised to a particular area
• Vitiligo is a complex, polygenic disorder characterized by patchy
loss of skin pigmentation due to abnormal melanocyte function. Both
genetic and environmental etiological factors have been proposed
• Vitiligo is sometime associated with autoimmune and inflammatory
diseasescommonly thyroid overexpression and underexpression.
• A wart (also known as a verruca
when occurring on the sole of the foot
or on toes) is generally a small, rough
tumor, typically on hands and feet but
often other locations, that can
resemble a cauliflower or a solid
blister. Warts are common, and are
caused by a viral infection,
specifically by the human
papillomavirus (HPV) and are
contagious when in contact with the
skin of an infected person. It is also
possible to get warts from using
condoms or other objects used by an
infected person. They typically
disappear after a few months but can
last for years and can recur.
Leprosy( hansen’s diseases)
Leprosy is an infectious disease that has been known since
biblical times. It is characterized by disfiguring skin
sores, nerve damage, and progressive debilitation.
• Leprosy is caused by the organism
Mycobacteriumleprae. It is not very contagious (difficult
to transmit) and has a long incubation period (time before
symptoms appear), which makes it difficult to determine
where or when the disease was contracted. Children are
more susceptible than adults to contracting the disease.
• Leprosy has two common forms, tuberculoid and
lepromatous, and these have been further subdivided.
Both forms produce sores on the skin, but the
lepromatous form is most severe, producing large,
disfiguring lumps and bumps ( nodules).
• All forms of the disease eventually cause nerve damage
in the arms and legs, which causes sensory loss in the
skin and muscle weakness. People with long-term
leprosy may lose the use of their hands or feet due to
repeated injury resulting from lack of sensation.
• Skin lesions that are lighter than your normal skin color
– Lesions have decreased sensation to touch, heat, or
– Lesions do not heal after several weeks to months
• Numbness or absent sensation in the hands, arms, feet,
• Muscle weakness
• Hyperhidrosis is a medical condition in which a person sweats excessively
and unpredictably. People with hyperhidrosis may sweat even when the
temperature is cool or when they are at rest
• Sweating is physiological process n occur excessivly when one is nervous,
angry, embarrassed, or afraid or after exercise
• Those with hyperhidrosis appear to have overactive sweat glands. The
uncontrollable sweating can lead to significant discomfort, both physical and
• When excessive sweating affects the hands, feet, and armpits, it's called
primary or focal hyperhidrosis. Primary hyperhidrosis affects 2 - 3% of the
population, yet less than 40% of patients with this condition seek medical
advice. In the majority of primary hyperhidrosis cases, no cause can be
found. It seems to run in families.
• If the sweating occurs as a result of another medical condition, it is called
secondary hyperhidrosis. The sweating may be all over the body, or it may
be in one area. Conditions that cause second hyperhidrosis include:
• Anxiety conditions
• Carcinoid syndrome
• Certain medications and substances of abuse
• Glucose control disorders
• Heart disease
• Lung disease
• Parkinson’s disease
• Spinal cord injury
• Tuberculosis or other infections
Bromidrosis• Body odor, often abbreviated as B.O., or bromhidrosis (also called
osmidrosis and ozochrotia and known alternatively as Apocrine
bromhidrosis, Bromidrosis, Fetid sweat, Body smell, Malodorous
sweating, and Osmidrosis) is the smell of bacteria growing on the body.
• These bacteria multiply rapidly in the presence of sweat, but sweat itself is
almost completely odorless to humans Body odor can smell pleasant and
specific to the individual, and can be used to identify people, though this is
more often done by dogs and other animals than by humans. An
individual's body odor is also influenced by diet, gender, genetics, health
and medication. Propionic acid (propanoic acid) is present in many sweat
samples. This acid is a breakdown product of some amino acids by
propionibacteria, which thrive in the ducts of adolescent and adult
sebaceous glands. Because propionic acid is chemically similar to
acetic acid with similar physical characteristics including odor, body odors
may be identified as having a vinegar-like smell by certain people.[citation
needed] Isovaleric acid (3-methyl butanoic acid) is the other source of
body odor as a result of actions of the bacteria Staphylococcus epidermidis
,which is also present in several strong cheese types
• Body odor is largely influenced by major histocompatibility complex (MHC)
molecules. These are genetically determined and play an important role in
immunity of the organism. The vomeronasal organ contains cells sensitive
to MHC molecules in a genotype-specific way. Experiments on animals
and volunteers have shown that potential sexual partners tend to be
perceived more attractive if their MHC composition is substantially different
• Onychatrophia is very common nail diorder. Onychatrophia
is an atrophy or wasting away of the nail plate which causes it
to lose its luster, become smaller and sometimes shed
entirely. Injury or disease may account for this irregularity.
• Onychatrophia Symptoms
• Here are the list of symptoms of Onychatrophia
• skin lesion located in the skin around the nail, often at the
cuticle or at the site of a hangnail or other injury
• onset sudden (bacterial) or gradual (fungal, mixed infection)
• may persist (fungal, mixed infection)
• may be acute or chronic
• redness, localized
• swelling , localized
• pus-filled blisters (especially with bacterial infection)
• swelling of the finger or the cuticle
• nail changes
• distorted shape
• A cut refers to a skin wound with separation of the
connective tissue elements. Unlike an abrasion (a wound
caused by friction or scraping), none of the skin is
missing the skin is just separated. A cut is typically
thought of as a wound caused by a sharp object (such as
a knife or a shard of glass).
• The term laceration implies a torn or jagged wound.
Lacerations tend to be caused by blunt trauma (such as
a blow, fall, or collision). Cuts and lacerations are terms
for the same condition
• Cuts or Lacerations Symptoms
• Although it can be obscured by blood, a cut is one of
the easiest medical conditions to diagnose.
• A deep cut, may reveal underlying tissues such as
fat, tendon, muscle, or bone.
• Some people faint at the sight of their own blood
(this is a neurological reaction in which a reflex
slowing of the heart causes a low blood pressure
called vasovagal syncope). Physicians need to
distinguish this common faint from people who pass
out from loss of blood (hemorrhagic shock).
Cracks of skin• * A crack goes all the way through the skin
on your hand or foot.
• * A cracked area feels warm or sore, is
swollen or red or discharges pus or fluid.
• * The skin on your lower legs starts to
resemble fishlike scales or alligator skin.
• Cracks in the skin
• Dry skin is common. It happens more often
in the winter when cold air outside and
heated air inside cause low humidity.
Forced-air furnaces make skin even drier.
• The skin loses moisture and may crack and
peel, or become irritated and inflamed.
Bathing too frequently, especially with harsh
soaps, may contribute to dry skin. Eczema
may cause dry skin.