Systemic lupus erythematosus. Image illustrates cutaneous involvement of systemic lupus erythematosus (SLE) in the classic butterfly pattern on the face. This macular and intensely erythematous eruption is frequently aggravated by sun exposure and may flare with other symptoms of systemic disease.
Verruca vulgaris. The common wart is a benign growth caused by localized infection with one of the many types of human papillomavirus. These small DNA viruses are part of the papovavirus group. Warts are especially common among children and adolescents and may occur on any mucocutaneous surface. The hands are a particularly frequent location. The typical wart is a roughsurfaced nodule that may be either lighter or darker than the surrounding skin.
Syringoma. These very small papules are adenomas of intraepidermal eccrine ducts. Most commonly, syringomas develop on the eyelids of women during adolescence or early adult life. This image is a good example of the fine papules that occur on the lower eyelids. They have no malignant potential, but the lesions are usually multiple and therefore the cause of cosmetic concern. Syringomas of this type may be delicately removed by electrodesiccation and curettage.
Trachyonychia (twenty nail dystrophy of childhood). Any skin disease that affects the nail matrix may result in an abnormal nail plate. There are children, though, who only manifest dystrophy of the nail without any other cutaneous lesions, a condition that has been termed twenty nail dystrophy of childhood. The nails have a rough, sandpaper-like quality as well as longitudinal ridging and occasional splitting at the distal nail edge. Similar nail changes can be seen in lichen planus and alopecia areata. In many patients the condition spontaneously regresses.
Vascular malformations. These are congenital malformations that consist of capillary, venous, arterial, or lymphatic abnormalities. There are often combined alformations that comprise different types of vessels. Examples of vascular malformations include port-wine stains (capillary malformation), cystic hygroma (lymphatic malformation), and venous malformations. Vascular malformations are present at birth and grow proportionately with the child. Some vascular malformations may not manifest themselves until adolescence or adulthood. These figures represent venous malformations on the hand and foot.
Xerosis. The accentuation of skin markings and fine scale illustrated here are typical of xerosis. The tendency toward dry skin tends to be inherited and is more common in families with a history of atopy. Low humidity, usually related to dry heat during the winter months, is an aggravating factor. Treatment of xerosis is aimed at rehydrating the stratum corneum. Emollients containing urea or alpha-hydroxy acids are particularly effective. Excessive bathing and the use of alkaline soaps must be avoided.