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Michael Fisher Pearls:
| • | he has only seen cryptococcal cellulitis in patients who are immunocompromised secondary to glucocorticoids (i.e. vs. chemo or AIDS) |
| • | has never seen the lesions of lepromatous leprosy to involve the midline of the back (M. leprae likes cool places); stated otherwise: when presented with a dermal reaction pattern in a patient, you can rule out leprosy if the lesions occur over the spine |
| • | do not see acrosclerosis in sclerodermatous conditions other than PSS; stated otherwise: absence of acrosclerosis argues strongly against progressive systemic sclerosis |
| • | atrophoderma of Pasini and Pierini: classically looks red/brown – most people first think “vascular” --> then think parapsoriasis/MF |
| • | when he sees psoriasiform strange disease, he thinks of erythrokeratoderma variabilis |
| • | "chicken pox" that lingers is PLEVA |
| • | "PR that lingers is small plaque parapsoriasis" |
| • | “BPP with small ulcerations” = cryoglobulinemia |
| • | he has never seen dermatomyositis without periungual telangiectasia |
Alan Halpern:
| • | middle aged women don't get Schamberg’s benign pigmented purpura, therefore in women it is cryoglobulinemia until proven otherwise |
Braverman’s Pearls:
| • | lupus never has pustules (vs. rosacea) |
| • | Raynaud’s: look for pitted scars on fingertips |
| • | scleroderma (PSS only i.e. not CREST) has even follicular re-pigmentation (vs. vitiligo) |
| • | LS&A of the vulva: telangiectasias make the diagnosis |
| • | real “targets” almost never go on to TEN |
| • | SJS-TEN will respond to steroids of caught in the first 48hrs |
| • | Paget’s disease has to involve the nipple (i.e. if only areola, then not Paget’s) ducts à nipple à areola |
AAD Practical Approaches Course:
| • | t. faceii is photosensitive (and often mistaken for LE or rosacea) |
| • | recurrent keratoacanthoma's on legs after multiple Moh's procedures... consider hypertrophic LP (treat with topical steroids) |
Miscellaneous:
| • | Stretch the skin when doing a punch biopsy to leave an ellipse instead of a circle |
| • | Use a needle holder dipped in liquid nitrogen to freeze skin tags (especially close to the eye) |
| • | Inject normal saline into an area of fat atrophy (e.g. after ILK) - seems to speed the resolution |
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