PositiveDiagnosisinDermatology: ismadeinthebaseofbasicskinlesions;doesntmatterifyouhavethepatientinfrontorifyou havetheimage; thepositivediagnosisismadeinthesameway,nodifferences; whenyouseetheimageyoumustbeclassifiedthelesionsinoneofthegroupsisthebasicskin lesions,andyoumustlookatthelocation;thesearethemostimportantcriteriaformakingthe positivediagnosisintheimage,becausealwaystherearebasicskinlesionsthatare characteristicforthatdisease,itsmeansthatthelocationintheusuallyorcommoneffective areafromthatdisease;andifyourecognizethebasicskinlesionsandifyoumakeaconnection betweenthelesionandtheareawheretheskinlesionislocatedyoucanputthepositive diagnosiswithoutanyproblem; thenextimagesareorderedbythebasicskinlesions,becausethedifferentialdiagnosisismade onthebasicskinlesions,notonthediagnosisofthedisease;

Erythamatouslesions,locatedonthetrunk: ThelesionsthatweseeintheimageareErythamatouslesions,smalllesions(macularlesions; otherchangesintheskinyoucantsee;so:onlyErythamatouslesions,locatedonthetrunk; ifwewillseethewholetrunkwewillnotseebetterthelesions; ArethelesionscharacteristicforLouis,forsecondarysyphilis;andtheyareerythamatous syphilis; Isthefirstlesionthatcanappearinthesecondarysyphilis;

 IrritantContactDermatitis: Alsoerythema,buterythema+edema; thelesionsarewithanimportanterythema(intensered,notpinklikeotherimages); intenseredwithedema,verywelldefined locatedontheneckandontheanteriorpartofthetrunk Thelesionisforurticaria,becauselesionsarenotlocatedinonlyonearea; Thereisadiscussionbetweenthislesionsandalesionincontactdermatitis,but: inthecaseofallergydiseasecanbeerythamatousandedematous,butthemarginsarenot verywelldefined,theyareruptured,theyhyperpigmented; andinthecaseofirritantcontactdermatitisyoucanputthelesionsnearthelesionsof burns,itserythema,edema,bullaorulcerations,butonlyinonearea,wherethecontactis madewiththesubstantthatproducethelesions,notatthedistance;andinthiscasewe canlesionsonthetrunkandalsointhecervicalarea(so:theyaredisseminated,not located); andinthiswaywecaneliminatethediagnoseofirritantcontactdermatitis;remainsthelesions fromallergiccontactdermatitis,buttheyareverywelldefinedorcanbeexanthema(drugs eruption)butalesionofurticarium;

 Sunburnwitherythema: verywelldefinedandthelesionsarelocatedonthetrunk;

 AcuteEczema: Wehavelesionsoferythemaandtheseerythematouslesionsarenotwelldefined,youhavethe fragmentedmarginsofthelesions; erythemawithalotofcrustonthesurfaceoftheerythema butalsoyoucanseealotofscalesonthelesion andalsoyoucanseealotofreddotsontheerythematouslesion;thesereddotsarethelesions oferosions,thelesionthatremainsafterthevesiclesopens; so:notverywellerythemawitherosions,crustandscalesonthesurface=Eczema;andits enough; Eczemacanbefindin: microbialeczema mycoticeczema contactdermatitis mycoticdermatitis others eczemaisenough;becauseinthisimagecantsaytheoriginoftheeczema;so:eczemais enough; ifyouthinkthatthelesionsarelocatedontheshins,youcanthinktomicrobialeczemaor mycoticeczema;buteczemaisenough,becauseyousawacrustsanderosionsontheentire surfaceoftheerythema,youcanthink,therewerealotofvesicles,disseminatedonthis erythematouslesions; So:thediagnoseisacuteeczema;becausethepatienthasexudationandcrust,thismeans acute. chroniceczemaitswithscalesanderythema(notwithcrustandexudation);

 Psoriasis: Erythemaandscales,eventhescalesarenotsoevident,youcantseethewhitelinesonthe surfaceofthelesion; Erythema:round,ovular,polycycliclesions;verywelldefinedasifweputthelesionswithapen onthesurfaceoftheskin;itsalittlebitelevated,butelevationisproducedbythescales;this meansthatthescalesarethickscale; So:Erythemawithscales,verywelldefined;withuniformerythemaonthelesions,isthesame erythemaonthesurfaceofthelesionswithathickscaleonthelesionswhichmeanspsoriasis;

 TineaFaciei: Almostthesame,thedifferencesaretwo: Thecenterofthelesionispale Andthescalesarethin=thismeansTinea,becausethelesionsarelocatedontheface, almostallthelesions;hereisnottheface,isfromtheneck;butalmostallthelesionsareon theface(TineaFaciei); Ifthelesionsarelocatedonthetrunk,oronthelowerlimbs,orupperlimbs:itsTineacorporis+ thelocationofthelesion;thelocationisapartofpositivediagnosis=>TineaFaciei; Themarginofthelesionisalittlebetelevated,becauseitserythema;itsaninflammation;its notedemaandonthismarginwecanseealotofpostureslocated,thisisacharacteristicaspect ofTinea;

 Purpura: Purpuriclesions Itsnotonlypetchiallesion,wecanalsoseebullouslesion(filledwithliquid); wecanalsoseelesionthatareelevated(palpablekindofpurpurapurpuricpapuleonthe lesion); alsowecanseesomelesionthatareulceratedandtheyarecoveredwithahematiccrust;

Purpurawithlinearlesion: hereisalsopurpurawithpetechiallesion,butwithlinealdistributionofthelesion; vebixorvebitis:dependsifyouhaveonelineorlotofline;theseareonlypetechiallesion; youcantsee:popularlesion,ulceratedlesion,bullouslesion;nothing;onlypetechiallesion;

 Ecchymosis: lesionwithacolorchangesoftheskin;

CongenitalNevilesion: colorchangesoftheskintwolesionofplanedlesion,buttheotherareonlyalittlebitelevated (theyarecompoundkindsofnevi);alotofthecellsarelocatedinthedermis;so:thelesionsare elevated,notonlyplanedformofnevi; Types:inthelesionofforehead:therearetwolesion: Dermalchanges:withplanedaspect(colorchanges); Epidermischanges:areelevatedandpairsonthe(notveryevidenthairs); Neviscanbeinthe: Epidermis(junctionarea) Orinthedermis someofthemarecompoundwithchangesinalltheareawherethegroupofnevalcellscanbe;

 Melanoma: twohyperpigmentedlesion,withblackcolor(itsnotuniformincolor),withnochangeonthe surfaceonthelesions,becausethecolorisblack; ifyouseelesionlikethisontheskin:thefirststepistomakethedermatoscopyofthelesion; andiftheaspectofthedermatoscopygivesyoucluetomelanoma,isbettertothepatient toputthediagnoseofMelanoma,tosendittothesurgeryandtoremovethelesion;andto makethehistopathologyofthelesionandthehistopathologisttotellyouthatthisisnota melanoma;itsgoodfortonotpassnearamelanoma; inthecaseofmelanomaisbettertoexaggeratethemtostepthemnearandletthemthere;

Melasma: ifthelesionsappearsintheperiodofpregnancy,thenameisChloasma; ifthelesionappearsontheperiodofpregnancyandtheyremainontheskinafterthebirth:the nameisMelasma(notChloasma=hyperpigmentationoftheskinofthefaceonlyintheperiod ofthepregnancy); Melasma:usuallyappearsinthecaseofdrugreaction(anticonceptionaldrugs)andinpatients withdiseasesofthyroid;

 Vitiligo: Hyperpigmentedlesions,disseminated,butthelesionsareveryverywelldefined,someofthem havelikearingattheperipheryofthelesion,asweremovethemelanocytefromthearea hyperpigmentationandsendthemtotheperipherylesion; Itsnotadiffusemargin,itsverywelldefinedinthecaseofVitiligolesions; Ifwetookapenwecandrawthemarginsofthelesionsontheskin;

 ProliferatedlesionontheskinproducedbyHPV(planedwarts): Thesurfaceoftheskinismodified,itsplaneandlittlebitelevatedontheareaofthelesion Andallthelinesoftheskinarestockatthemarginsatthatlesion Thesurfaceisplainandparallelwiththeskinnearthelesions Andthelocationisonthedorsumofthehand(notonthedorsumofthefinger); ThelesionsproducedbyHPV(warts); Inthecaseofvegetation:vegetationarethelesionsontheanugenitalwartsorthelesions locatedonthedorsumofthefingersontheplantararea,butbecausethesevegetationlesion onthedorsumofthefingers,ontheareaofthepalmsandsoleshaveimportanthyperkeratosis onthem,thenameisnotvegetation:itsvaricosity; Hereisaplanepapula,coloroftheskin; Thelinesarestockingonthemarginsothelesions,thismeansthelesionisputthere(itsnotan elevationoftheskinbecauseandedemaorinfiltrationinsidetheskin); HereisaproliferatedlesionontheskinproducedbyHPV(planedwarts); usuallyaffectschildren

 Louis,syphiliswithpopularlesion: arepopularlesions,butthesurfaceisdomeshape(convex); thecoloriscopperred andlocatedonthetrunk Louis,syphiliswithpopularlesioninthiscase;thecolorisspecific; thedimensionarebiggerthanotherpopularlesions;

 Lichenplanus: theleftimage:firstlythedetail;becauseonthedetailwecanseethatthepopularlesionslook thatareformattedbythelinesofthesin(theaspectisgeometricalaspect,theyarenotround likeinplanewarts);thelesionsarepolygonallesions;thecolorisnotthecoloroftheskin,its violet; inthebigimageinright:someofthemsparklinginthelieinsomeincidence; thelocation:wecantdistinguishthelocationhere;butwecanseethatalotoflesionsare isolatedlesions,andotherlesionsconfideandformsplaques; so:thediagnoseis:Lichenplanus; inthebigimage:Wecanalsoseethatontheplaquesthatareformedtheyarescales,butfine, thinscales,adherentfromthesurfacefromthelesion;

 UrticariaorExanthema: Erythematousandedematouspopularlesion,withoutscalesorwithoutanyotherchanges; ThiscanbeanUrticariaoranExanthema;

 Urticaria: Erythamatousandedematouslesion; Onsomeofthelesion,thecenterofthelesionisalittlebitpalethanthemarginofthelesion; Thisaspectcanbefindinsomecasesofurticariawheretheedemainthemiddleofthe lesionisveryimportant; Wecanseethatsomeofthemhaveamoreimportantredonthemarginsonthelesion,this aspectandalsolesionsthatlookslikethelesioninTineawithaerythematousmargins(pale center)canbefindinthatcaseofpatientofurticaria,becausesometimestheedemainthe middleofthelesion;itssoimportantpalecenterofthevessels,themarginsappearsred;thisis aparticularclinicalaspectinthecaseofurticaria;

 Erythemanodosum: profoundlesionswiththecolorchangeoftheskinthatcoverthisnodules Thechangeislikeinecchymoticlesions; Dontmixwitherythemamultiformiwhichmeansinthesamelesionwehavedifferentkindof lesions,becausecanbeerythematousandpapularlesionsandthelesionsaredistributedin concentriccirclelikeatargetsign;canbelesionwitherythematouslesionsandlesionsfilled withliquid; Butthesearenodules(palpable),thelesionsareelevatedandmodifiedincolor; Erythemamultiformihasdifferentaspectofthelesionsinthesamelesion;

 Keratoacanthoma: Itsanodulewithhyperkeratoticlesionwithanerythematousandtranslucentaspectinthe periphery,likearingontheperiphery; Inthemiddleofthatcolorisblack,becauseofthehemorrhage; Nowitsconsideredcytobasalcellcarcinoma;

 CongenitalTertiarysyphiliswithGuma: Itsalsoannodularlesion,butwithinflammationonthetopofthelesion; Thelesionislocatedontheface Itsatertiarysyphiliswithgumawithastageofalmostulceration,thecolorisalittlebitispale; Thelesionopenandthechaseomcontentofthenodulewillgoout; Wecanfeelthatitsanodulebecauseitselevatedandthelesionisround(itsnotlikein urticariawhereyouhavearoundplaquewhichisflat);hereitsaroundlesionandconvexofthe surfacewitherythema,andtheerythemaisonlyontheareaoftheelevation,itsnotadiffuse erythemawithsomeelevationonthesurface(itsanodularlesion); Buterythemanodosumdontappearthere;othererythematypesthatwecanfindinTBofthe skin,orCarcinoma,doesntlooklikethisanddoesntappearinagirlandwiththisclinical aspect; So:becauseoftheaspectofthelesion:nodularlesionwithinflammationonthesurfaceofthe skinthatcoverthatnodule,andthelocationofthelesiononacralpartofthebodyofthatcase, canbediagnosedlikecongenitalsyphiliswithalesionthatlookslikeagumaintertiarysyphilis; ThestartoflesionincongenitalLouislookslikethelesionsthatcanappearintertiarysyphilisin anadult;

 Vegetation: TheyarealsoproducedbyHPV Butthesurfaceofthelesioniswithacolorredorinacaseoflesionwherethelesionconfluence andlocatedonthemucosa; canappearerosionsonthesurfaceofthelesionwithsufferinginfection;

 Varicosity(particularyvegetationcommonwartswithhyperkeratosisonthetop): itsalsocausedbyHPV;butanothertypeofvirus; thelesionsarelocatedonthedorsumofthefingerthistime,thistimethelocationisonthe joint; butthesurfaceofthelesioniswithhyperkeratosis;looklikeavegetation,butwith hyperkeratosis; itsavaricosity;thiskindofparticularyvegetationwithhyperkeratosisonthetop; thenameofthebasicskinlesionisVaricosity andthenameofthediseaseofthelesioniscommonwarts; thelocationisusuallyonthedorsumofthefinger,nearthenails,onthepalms,andonthesoles (palmar,plantarsoleswarts); thecolorcanbegray,white,black,brown;dependonwhatthepatientputonthelesion;but usuallytheyarewhite; wecanpalpateit;itsavaricosity,itsaproliferatedlesion;

Commonwartswithhyperkeratosis: thisaspectlikeinavegetation theetiologyforthisisHPV;alltypesofwartscausedbydifferenttypesofHPV;

 Lichenificationofthechroniceczema: chronickindofeczemaisanerythematousplaque,butthistypeiswelldefinedfromthe surroundingarea; onthesurfaceoftheskinlesionwecanweescales,itsadrylesion,wedontseealotofcrust, wecantseeerosions,butwecanseeexcoriation,becausetheyarelinear(lossesof substances); thismeansthatthelesionhavesymptoms,itsapruriticlesion,becausewehaveexcoriationon thesurfaceofthelesion; andbecauseoftheaspectonthepartoftheplantarareaofthelesion,thisisalichenificationof thechroniceczema; so:inthiscaseitsachroniceczema,becauseweseethescales,erythema inthecaseofchroniceczemathelesionarenotwithfragmentedmargins,theyarewelldefined fromthesurroundingarea; itsnotalichenplanus,because: lichenhasthebasicskinlesionofPapule;andwhenthepapularlesionsgoesonenearthe other,remainsneartheflat,isolatedlesions; andherewecantseeisolatedlesions,wecanseeonlybigplaqueontheskinsurfaceon lesion,butinthesamelesionwecanseescalesandexcoriation;inthiscasethelesionsare old,becauseofthelichenificationinapartofthelesion,thescalesontheotherpartofthe lesion;itsaneczema; andthecoloristhelastthatwecantputindiscussion:hereitsred; inthecaseoflichenplanusitsalittlebitisviolet;andinacaseoflichenplanus,usual lesionsappearsanddisappears,andappearsagainanddisappears; andalmostalwayslichenplanuslesionshealshyperpigmentedlesion;andherewecantsee hyperpigmentedlesionsontheareathatsurroundsthelesion; anotherdifferentdiagnoseisthelocation:itsausualareaforchroniceczema;butitsnot usualareaforlichenplanus;

 Nodularkindofbasalcellcarcinoma: thevesselfromthesurfaceputthediagnose:

Pirlandprofoundulceratedformofbasalcellcarcinoma: edematousPerlontheperipheryofthelesionformsthelesionlikearing,andwillbecyto inducedsuperficialulceration(butitsnotacorrectterm,becauseulcerationmeansaprofound lossofsubstance); butinthiscaseweseethatitsanulceration,itsbrownscales,thismeansthatthebasal membraneisdestroyed,buttheulcerationdoesntgoverydeep;remainsonthesurfaceonthe skin;andinthiscaseitsaprofoundkindofulceration,Icanttellthatitsasuperficialkindof basalcellcarcinoma;itsprofound,itsanendophytickind(terapanthkind)ofbasalcell carcinoma;

 Endophytickindwithadestructionoftheprofoundtissue(basalandsquamouscellcarcinoma): thebasalcellcarcinomacantappearonthemucosa,buthereonthepassingbetweentheskin andthemucosa,itsapartofsemimucosa,wherebasalcellcarcinomacanappear;andthey cangofromtheskintothemucosa;itsametatypickindofcarcinoma; whenwemakethehistopathologicalexambybiopsy,wecanfindpartofbasalcellcarcinoma andpartofsquamouscellcarcinoma; inthiscaseitsaendophytickindwithadestructionoftheprofoundtissue;

Vegetatedandulceratedkindofsquamouscellcarcinoma: itslookslikeavegetationwitherosionsandulcerationsonthetopofthelesions; coveredwithcrust,andthecrustisyellowbrown,likeapuswhenitsdry; so:itssquamouscellcarcinomabecausethisisaclinicalaspectthatusuallyfindinsquamous cellcarcinoma; andthelocationalsoisusuallytypicalforsquamouscellcarcinoma; so:itsanvegetatedandulceratedkindofsquamouscellcarcinoma;

 Melanoma: thathavethebothkindofgrowing: Onthesurface:fromwhereweknowthesurface?=>becausethelesionsisnotwiththe samecolorofthesurfaceoftheplaqueandontheprofoundpartoftheskin,because appearsnodularlesiononthesurfaceofthetumor; butalsoonthedepths;

 HerpesSimplexType1oftheupperlip(leftsideoftheupperlip): Itsnotabulla;itsagroupofvesicle Wecanseetheseptalareainsidethepseudobullaisformed,becausethevesiclelesionslocated onebeyondtheother; Anditsherpessimplextype1oftheupperlip; Herpessimplexcanbetype1orcanbetype2onthelip,ontheface,onthetrunk,ontheupper limb,onthelowerlimp;anywhere;

ThoracobrachialHerpesZoster:

 AcuteEczemaontheaxillararea/allergiccontactdermatitis: Erythema,edema,vesiclesdisseminatedonthesurfaceoftheerythematousandedematous plaque,withfragmentedmargins; Itsacuteeczemaontheaxillararea; Wehavesaythatitsacontactdermatitis;usuallyinthatarea,thediagnoseinthiscaseis contacteczemaandappearstothecosmeticsthatthepersonuse; andlivewiththisremainsofdermatology:nevereczemaorurticariaorexanthemaappearstoa newproduct;alwaysforproductsthatthepersonuseintime;nevereverforsomethingnew; andafterthattothenextcontactappearsthelesion; inthecaseofnewintroduceddrug,neverthelesionsappearinthefirstdayofadministration; onlyafewdrugscanproducethiskindoflesions;theyproducedthelesionsbydestroyingthe mastoidcellandhistamine; butusuallyifitsanewdrugandappearslesionsofeczema,orurticaria,theyappearaftera coupleofdaysofusingofthedrug; AcuteEczemaontheaxillararea; ifyouwantyoucansay:allergiccontactdermatitis,acuteform(duetotheexudationvesicles)

 Pemphigusvulgaris:(erosions,ulceration,lineonthesurfaceoftheskin,pressurearea) pemphigusisabullousdisease; thelesionsarebulla,locatedonnormalskin,withoutanyotherchangesontheskin,onlythe bulla,withoutanysymptomsthatcanbeontheskin,beforethelesionappearsontheskin; after,yes,appearsomesymptoms; ontheliquidonthebullausuallyfirstlesionsaresmallbulla; thatswhywecantsayfromthebeginningiftheyareflatlesionorflaccidbullaoriftheyare tensebulla; whenappearslesionbigger,wecanseethattheliquidinsideisinasmallquantityorbig quantityandsaytensebulla;inthiscasewehaveflaccidbulla; onthebiglesions(ontheabdomen),whenthepatientsstay,theliquidgoesdownlikeanbag; usuallypemphigusischaracterizedonthefragilityoftheskin,thatswhy; alwayswhenyoulookontheskinofthepatientwithpemphigus,youcantfindlesionsthatare coveredwithhematiccrust,becausewhenthepatientcalltheassistantorthedoctorputa pressureontheskinofthepatient,thelesionsgoesdownintheprofoundpartoftheskin; so:youdontfindonlysuperficialbullaanderosion;youcanonlyfindulcerationonthesurface ofthelesions; itsdoesntmeanthatthebullaisprofound,becauseprofoundbullaarecharacteristicfor pemphigoidandherpeticformdermatitis; flaccidbullawiththeskin,withnormalaspectonthenikolskysign,putthediagnoseof pemphigusvulgaris; andothersignthatwecanfindwhenwediscusswiththepatient,notwhenwelooktothe picture,istheinvolvementofthemucosa;firstisthemucosamembranethatareeffected;and afterthattheskin;butintheimagewehavesmalllesions,flaccidlesions,erosions;andwesaw onthesuperiorpartoftheabdomen,thatlesionsthatareputtedinaline,likeanikolskysign,; alesionsthatappearonthepressureontheskin(afterthepatientremoveshisclothes);lookto thelocationofthelesion,anddontmakeanewnikolskysignbyputtingpressureontheskin;

 Irritantcontactdermatitis: erythema,edema,verywelldefinedfromthesurroundingarea,withsmallandbigtensebulla onthesurfaceofthelesion; theyareblusters,thatarelocatedonlyontheknee(erythematous,edematouslesion); thislesionsappearsbecausethepatientputtedSwedishbutterontheskinbecausehavepain ontheknee;andsomeonetoldhimtoputthisbutterontheskintohealthepain,itshealedthe painontheknee,butproducedthisontheskin; irritantcontactdermatitisisachemicalburnontheskin;itsproducedexactlylikeaburn;

Bullouspemphigoid: Bluster,bigBullaonthesurfaceoftheskin butsomeofthemareerythematouslesions,andsomeofthemareonnormalskin; thatswhywecalleditbullouspemphigoid(pemphigoidmeansurticarialikelesionsand bluster); itsappearonnormalskin,orerythematousskin(likeurticaria);

 SuperficialFolliculitis: beattentivetothedimensionofthelesionsandcomparethelesionwiththesurroundingskin, hereisasmalllesion; ontheabdomenweshouldhavevellushairs(checkwithamagnifyglass); evenonthisvelluskindofhairs,canappearfollicularlesionsproducedbystaphylococcus infection; so:itsasuperficialfolliculitis(postureandalittleerythemalikearing); theyhealincoupleofdays;theydryanddisappear; butthiskindofsuperficiallesions,canthavepainonhim; differentbetweenacne: acneappearsinmanyarea(notontheabdomen);andinacnethelesionarenotpustule, theyarepopularpustulelesions;thepustuleisonthetopofthepopularlesion; ifyouseeonthefaceoronthetrunkofthepatientapapulewithoutanyerythema,or edema,orinflammationunderthepapule:thenthisisnotacne;thisisasuperficialinfection withstaphylococcus;orifitsunderthetrunkwithvictorioushormone;otherkindfollicular lesions;butnotacne;

 Generalizedformofpostularkindofpsoriasis: erythematouslesion,withadiffuseerythema,orlikeinerythroderma; withscalesandcrust,butalsoalotofpostularlesion;thismeanspostularkindofpsoriasis; butageneralizedformofpostularkindofpsoriasis,notaformwithanormalplaque,orwith locationonlyonthepalmsofsoles; itsathreateninglifedisease; usuallycantbecontrolledveryeasy;

 DiffuseHerpesSimplex: butwecantsayinthiscaseupperliporlowerlip,itsadiffuse diffuse=thatsmeanthattheyarenotonlyoneortwoorthreegroupsofvesicles,theyarealot ofgroupofvesicles; usuallyherpessimplexhaveafewgroupsoflesions(hereifsdiffuseform,whichmeansthe immunitystatusisverylow);

 Syphiliticchancre: Erosionwithsurfacethatsparkle(hasserosityonthesurface); Verywelldefined itsasyphiliticchancre; itsthefirstlesionthatappearinacaseofsyphilis; allthelesionsinsyphilisareasymptomaticlesions; thelesionshealswithoutthepatientknowsthatthelesionsarethere; Howyouknowthattheselesionsarelesionsofsyphilis? Inthiscase,thisaspectasweputalackonthesurfaceofthelesions,andverywelldefined formofthelesion; Ifyouhaveapatientinfront,youputthehandonthelesion,andthebaseisnotsoft;its notelasticbase;itslikeyouwanttoputbetweenyourfingerapaper; itsainfiltratedbase,butitsnotveryhardlikeinacaseofpopularanderosionlesion;and thisinfiltrationontheskinoronthemucosa,remainsacouplesofdaysaftertheerosions heals,andyoucanputthediagnoseeventhelesiondisappearfromtheskinorfromthe mucosa;afterthischancredisappears,appearlymphnodesonthatarea;andthe adenopathycanbeunilateralbilateral,becausethelesionscanbelocatedeverywhere,not onlyonthegenitalia;canbelocatedonthefinger,onthelip;andwemustmakethe differentialdiagnose;

 ErosionsinthecaseofEczema: erythematouslesions,smallerosions(12mm)andbigerosions;

SubacuteEczema: hereisalsoeczema,butitsasubacutekindofeczema; weseealsoscales,crust,butinthesameproportion,wecantsaythattheexudativelesions,or thescalesarepredominantonthelesion(itsansubacute);

 PemphigusVulgaris: butwithalotoferosions,fewbullafilledwithliquidinside; Inpemphigusnewlesionsappearseveryday; Ifyoutreatthediseasewithadoseofcorticosteroidandoutthecorrectdiagnose,thisisthe signthatnotappearnewlesionontheskin,whichmeanthatitsgood; Corticosteroid:takestime,slowlythannormal;theydontimprovethehealingontheskin;

 Chronicvenousdisease(ulcer)onthelowerlimbs: Itsachroniculcerationontheskinwithsclerosisontheskin; Therestisdescribedlikeso:dermohypodermitis:erythematous,violaceousplaqueswith sclerosisontheskin;

 Tuberculosis:

ChronicEczema: withfissureonthesurfaceoftheerythematousplaque;

 IntertrigoTineaPedis: Intertrigo:meansthattheinflammationiffootdoesntmatterwherethefoldislocated; Ifitslocatedonthefeet,usuallytheinflammationisproducedbydermatophyticinfection; Ifitslocatedunderbreastsfold,itcanbeinfectedbyCandidaorstreptococcalinfection; IftheCandidaiswithwhitedepositandscaleontheperipherythenitsanstreptococcus infection(erythematous,edematousplaquewithfissureinthedepthofthefold); Thesearethedifferencesbetweenthem;Intertrigoareallofthem,dependsonthelocationto putthediagnose;whichkindofinfectionproducethismodificationonthefold; Inthiscase:dermatophyticinfection Underthebreasts:usuallyCandidaorstreptococcalinfection Ontheear:streptococcalinfection

 Tineacorporis: Thescalesarebetterseen Butalsothatmoreintenseerythematousmargin Itsnotpsoriasis,becausethescalesarethin(notthick); Ontheplaquethecenteriswhite;

Psoriasis: Thelocationisontheknee(isthecommonaffectedareainpsoriasis); Erythema,thickscales,weseethefoldsthattheskinmakesonthetopofthelesions(its importantscaleonthesurface);

 Psoriasis: Thesame,butthescaleismoreimportant; Weseealsotheprofoundfissurethatappearonthesurfaceofthelesion; Weseethehemorrhagethatappearonthehematiccrust;

 Streptococcal(nonbullous)Impetigo Producedbystreptococcalinfection,becausewesawonlythecrusts,wecantseethebulla; Usuallyinthestreptococcalinfectionthebullareatthesurfaceoftheskin,underthehorney layer,thatswhywecallitnonbullous,becausethebulladriesveryquickandseeonlythecrust;

AcuteEczema:

 ErythemaMultiforme: Withlesionslocatedontheface,onthetrunk,butonthemucosaofthemembranes Onthelips:becausetheinflammationappearsprofoundfissurewithhematicandnecroticcrust, whenthepatientwanttotalk,wanttoeat;

LeftIntercostalNecroticHerpesZosterwithvaricelleformreaction: Itsnotacommonaspectoftheherpeszoster; withvaricelleformreaction,weseealotofisolatedlesionsontheskin(morethan1020 isolatedlesions); ifwedontlooktothelesionsofherpeszoster,itslookslikethepatienthavevaricella;

 Gangrene:

KeloidAcne: itsonlyinmen itsproducedbystaphylococcalinfection