Goodhearts Photoguide To Common Skin Disorders – Herbert P Goodheart

• It becomes especially common in persons who are older than 65 years of age (FIG. 16.1). Pathogenesis • The reasons why the skin becomes—or appears to become—dry are not well understood. It has been proposed that xerosis may be secondary to diminished production of sebum (asteatosis), as well as to reduced eccrine gland activity.

However, other biochemical factors related to aging skin have also been implicated. • Popular folklore and the lay literature often blame xerosis on inadequate water ingestion, but there is no scientific basis for this claim. Asteatotic Eczema See also FIGURE 2.52. • Asteatotic eczema (winter eczema) is caused by a relative loss of water from the skin through evaporation, a lack of normal desquamation, and, possibly, a decline in the pro- duction of sebum (the skin’s natural lubricant and sealant).

• Most often seen on the shins, with seasonal recurrences dur- ing the winter months, this form of eczema is a common, sometimes pruritic, low-grade dermatitis. Early on, the affected skin feels and looks dry (FIG. 16.2); later, an inflam- matory dermatitis may evolve. 16.1 Xerosis. Dry skin tends to be most apparent on the hands and lower legs.

This elderly patient’s legs are dry and scaly. 16.2 Asteatotic eczema. Xerosis and subtle changes con- sisting of exaggerated skin markings are seen in this patient. Chapter 16 • Xerosis: The “Dry” Patient • Occurring exclusively in adults, lesions most commonly appear on the shins, arms, hands, and trunk (see Chapter 2, “Eczema”). Because the eruption often resembles the sur- face of a cracked porcelain vase, it is often referred to as erythema craquelé. It is also likened to the appearance of a dry riverbed (FIG.

16.3). • A clinical variant consists of small, square, scaly plaques that are often mistaken for tinea corporis (ringworm) or pso- riasis and treated as such (FIG. 16.4).

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No part of this book may be reproduced in any form or by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S.

government employees are not covered by the above-mentioned copyright. Printed in China Library of Congress Cataloging-in-Publication Data Goodheart, Herbert P. Goodheart’s photoguide to common skin disorders : diagnosis and management / Herbert P. Goodheart. — 3rd ed. p. ; cm. Includes index. ISBN-13: 978-0-7817-7143-6 ISBN-10: 0-7817-7143-9 1. Skin—Diseases—Handbooks, manuals, etc. 2. Skin—Diseases—Atlases. I. Title. II. Title: Photoguide to common skin disorders.

[DNLM: 1. Skin Diseases—diagnosis—Atlases. 2. Skin Diseases—therapy—Atlases. WR 17 G652g 2008] RL74.G66 2008 616.50022’2—dc22 2008024074 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editor, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication.

Application of this information in a particular situation remains the professional responsibility of the practitioner. The authors, editor, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication.

However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice.

10 9 8 7 6 5 4 3 2 1 To my family, who have provided immense support and encouragement throughout. What the mind does not know, the eyes cannot see. ANCIENT PROVERB Contents Contributors ix Foreword by Warren R.

This is a short excerpt from the opening of “” by Unknown, quoted for review and introduction purposes. All rights belong to the copyright holders.

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