Erythematous

Juvenile dermatomyositis (JDM) is perhaps the most uniform, in terms of clinical and histopathological features, of the whole PM/DM disease complex. Presentation may be before 5 years of age with peak incidence between 8 and 12 years. The disease may remit and recur until well into young adult life. The skin lesions include a facial rash in butterfly distribution across nose and cheeks. Erythematous skin changes are seen over extensor surfaces of joints, especially knees, knuckles and elbows. Muscle involvement is generally evident some time later and takes the form of weakness and stiffness, particularly affecting shoulder and pelvic musculature. Proximal muscles are often worse affected than distal muscles and extensors worse than flexors. In the absence of prompt and effective treatment contractures may occur at elbows, ankles, knees, and hips. Subcutaneous calcification and skin ulceration may be found calcification of deeper-lying connective tissue may be apparent on X-ray. 

Actinic keratoses are the most common epithelial precancerous lesions which occur primarily on sun-exposed skin of middle-aged and elderly people as multiple erythematous macules or papules with a dry adherent scale (Figs. 12.1, 12.2 and 12.3). 

Fig. 12.1. Erythematous maculo-papules localized on the dorsum of the nose...

Erythematous macules with a dry adherent scale localized on the forehead... 

Actinic keratoses are persistent, easily palpable, rough, usually erythematous patches that range in size between pinpoint to over 2 cm in diameter (Fig. 12.4a, b) ... 

Actinic keratosis treated with imiquimod 5% cream. Clinical presentation after 15 days of treatment vesicles on an erythematous base... 

Topical 5% vitamin C preparations have recently been evaluated in the erythematous stage of rosacea [8]... 

Simpson JK, Brockow K, Turner ML, et al Generalized erythematous macules and plaques associated with flushing, repeated syncope, and refractory anemia. J Am Acad Dermatol 2002 46 588-590. Caplan RM The natural course of urticaria pigmentosa. Arch Dermatol 1963 87 146-157. 

The further allergologic workup is recommended should be performed within 6 months after the reaction [13]. Both delayed IDTs and patch tests are frequently positive, when read after 48 and 72 h (in case of local pruritus or erythematous plaques optionally at other time points, e.g. 24 h, 96 h). Since some patients tested positive with only one of these tests, it is recommended to use both tests in parallel to enhance test sensitivity (table 3). Patch tests should be conducted with undiluted RCM, whereas 10-fold diluted products in physiologic saline had been recommended when performing delayed IDTs. IDTs and late readings with undiluted RCM may be discussed in non-severe reactions to increase sensitivity, however this has not been evaluated in a sufficient number of controls. A panel of several different RCM should be tested to identify skin test-negative substances. 

Pustular psoriasis may be localized or generalized and may be an acute emergency requiring systemic therapy. Generalized pustular psoriasis is characterized by disseminated deep-red erythematous areas and pustules, which may merge to become "lakes of pus."... 

FIGURE 62-1. A spectrum of acne lesions is seen on the face of a 1 7-year-old male comedones, papules, pustules, and erythematous macules and scars at the site of resolving lesions. The patient was successfully treated with a 4-month course of isotretinoin there was no recurrence over the next 5 years. 

A 45-year-old female presents to a pharmacy with complaints of itching and wants a recommendation to treat it. Upon visual examination you see that she has erythematous papules on both legs. After further questioning, you learn that she has recently spent a great deal of time outside at a family picnic. She states that the picnic was in a wooded area near her home and that she and several others went on a short hike that day. She states that she was wearing shorts and "probably" came into contact with the grasses and weeds that lined the hiking trail. The rash appeared the same day as the picnic and she says that it seems to have spread since it first developed. From the information she has presented, you conclude that she has been exposed to poison ivy. 

Folliculitis presents as small, pruritic, erythematous papules. Location of the lesions and a good patient history are often all that are required in the diagnosis of folliculitis. While the papules may be cultured and Gram stains or potassium hydroxide stains done to help determine causative agent, it is not generally required because folliculitis often resolves spontaneously within a few days. 

Early Skin is erythematous, edematous, and warm the clinical presentation is similar to that of cellulitis. 

Sigmoidoscopic examination may reveal a nonspecific diffuse or patchy erythematous colitis without pseudomembranes. 

Affected area will likely become erythematous and painful within 48 hours of application. 

Four to seven days after infection, a tender, erythematous papule usually develops and subsequently progresses to the pustular stage.37 The pustules often rupture after 2 to 3 days. 

A 35-year-old woman presents to your clinic complaining of "burning and soreness in my mouth" along with a metallic taste and "this funny white stuff." On initial examination, she has white patches on her tongue, gums, and buccal mucosa. These patches are easily removed, revealing erythematous tissue underneath. 

White patches on tongue, gums, or buccal mucosa removal of patches reveals erythematous and bloody tissue ability to remove patches distinguishes OPC from oral hairy leukoplakia... 

Precursor of invasive SCC (actinic keratosis) scaly erythematous macule or papule on areas of chronic sun exposure... 

Infected catheter sites may be erythematous and tender to the touch. 

Despite adequate precautions, midway through her doxorubicin administration, JM complains of intense burning around the catheter site, and the site appears to be swollen and erythematous. 

Erythematous Flushing of the skin caused by dilation of the capillaries. It is often a sign of inflammation and infection. 

Comedo (pi. comedones) Dermatitis Dermatitis herpetiformis Plug of dried sebum in the sebaceous duct blackhead Inflammation of the skin Dermatitis marked by grouped erythematous, papular, vesicular, pustular, or bullous lesions occurring in varied combinations... 

On examination, joint swelling may be visible or may be apparent only by palpation. The tissue feels soft and spongy and may appear erythematous and warm, especially early in the course of the disease. Chronic joint deformities commonly involve subluxations of the wrists, metacarpophalangeal joints, and proximal interphalangeal joints (swan-neck deformity, boutonniere deformity, ulnar deviation). 

Psoriasis is a common chronic inflammatory disease characterized by recurrent exacerbations and remissions of thickened, erythematous, and scaling plaques. 

Lesions are characterized by sharply demarcated, erythematous papules and plaques often covered with silver-white fine scales. Initial lesions are usually small papules that enlarge over time and coalesce into plaques. If the fine scale is removed, a salmon-pink lesion is exposed, perhaps with punctate bleeding from prominent dermal capillaries (Auspitz sign). 

The word dermatitis denotes an inflammatory erythematous rash. The disorders discussed in this chapter include contact dermatitis, seborrheic dermatitis, diaper dermatitis, and atopic dermatitis. Drug-induced skin disorders have been associated with most commonly used medications and may present as maculopapular eruptions, fixed-drug eruptions, and photosensitivity reactions. 

Seborrheic dermatitis typically occurs around the areas of skin rich in sebaceous follicles (e.g., the face, ears, scalp, and upper trunk). In infants with involvement ofthe scalp, the condition is commonly referred to as cradle cap. Diaper dermatitis results in erythematous patches, skin erosions, vesicles, and ulcerations. Although commonly seen in infants, it can occur in adults who wear diapers for incontinence. 

Lesions should be inspected for color, texture, size, and temperature. Areas that are oozing, erythematous, and warm to the touch may be infected. 

Allergic reactions are rare and usually occur within 8 weeks of initiating therapy. They manifest as maculopapular, erythematous, or pruritic rashes. Drug discontinuation and topical steroids are recommended when they occur. 

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