Em rede | Reticulada
- Oclusão da arteríola ascendente cutânea → reprodução do plexo venoso subpapilar
- Cutis Rhomboidalis Nuchae
- Devido às pregas de flexão/extensão
- Dermatitis from heaters
Serpiginoso
- Colisão de lesões anulares gradualmente a abrir
- Pili migrans (pelo ou cabelo na camada subcornea)
- Supravenous serpiginous dermatosis
Geométrico
- Reminescente da causa
- Cicatrizes circunferenciais ou quadrangulares
- Em estrela
- Angioma stellate
- Em árvore
- Branched lividity
- Striated lichenoid keratosis
Em halo
Sutton Halo NevusFenómeno de Meyerson → halo de eczema em torno de uma lesão melanocítica ou não melanocítica
- Corresponde a uma resposta de eczema a antigénios novos expostos em células epidermicas transformadas (ex. nevo, queratose actínica, etc.)
Dermatoses lineares
Fatores exógenos
Sherrington’s line (axial lines)
- Specific lines on the limbs that mark the boundary between dermatomes supplied by non-consecutive spinal nerves (e.g., a transition from C5 to C8).
- They represent a developmental gap where adjacent spinal segments do not overlap
- Line A: anterior surface of the arm and pectoral region
- Line B: inner thighs
- Some vitiligo cases may follow these lines
- Sometimes evident in morbilliform eruptions - “drug line”, due to differential pigmentary or inflammatory responses on either side of the line
Fuchter-Voigt’s “demarcation” line
- represent a remanent of embryology
- Vertebrates have ventral face lighter pigmented than dorsal
- Less pigmentation on the anterior-internal side of the arm compared to the posterior-external area → more visible in pigmented subjects
- Wallace line
- Forms the anatomical boundary between skin with dermatoglyphs and skin with normal anatomical structure
- Between the palm and back of the hand, and the sole and back of the foot
- Contribute to demarcation of acquire inflammatory dermatoses
- Correspond the fact that lymphatic drainage is different on either side of these lines (different dorsal and ventral system)
- Palmoplantar keratoderma can be Transgradient if extend beyond Wallace lines to dorsal suface of the hands and feet
Blaschko Lines
- Traces of the migration of primordial ectoderm cells during embryogenesis
- Queratinócitos derivam da ectoderme de superfície
- Melanócitos derivam da crista neural
- Reflect genetic mosaicism: Invisible in healthy individuals, become visible if a dermatosis results in abnormaly mifgrated primordial clone
- Isolated VS. Syndromic
- More extensive = more likely systemic involvement
- Early mutations can involve CNS, msk, ophtho, cardiac tissues
- DDx
- Isolated
- Hypomelanosis of Ito
- Nevus depigmentosus
- Linear and whorled nevoid hypermelanosis
- Sindromic
- Síndromes associadas a nevo epidérmico
- McCune Albright
- Lichen Striatus | Blaschkite | BLAISE (Blaschko Linear Acquired Inflammatory Skin Eruption)Nevo/Hamartoma Epidérmico
- Incontinentia Pigmenti
Flagellate dermatosis
- Chemotherapy
- Bleomycin (++)
- Relative deficiency of bleomycin hydroxylase in the skin, which causes the product to accumulate in situ, resulting in local inflammation and subsequent pigmentary incontinence (controversial)
- Taxanes
- Shiitake Dermatitis (Flagellate Mushroom Dermatitis)
- Autoimmune
- Fitofotodermatitis
Annular dermatoses | Eryhtema Gyratum
Synonym: erythema gyratum
Mechanism:
- Involves 2 elements
- Spontaneous resolution (central healing)
- Due to consumption and depletion of the factors necessary for the inflammatory reaction
- Centrifugal progression into healthy skin
- Progression of Infectious agents
- Unknown in non-infectious agents
- Dermatoses Figuradas definidas por um padrão anular
- São dermatoses é que a apresentação clínica é o critério de diagnóstico principal Erythema Annulare CentrifugumErythema Marginatum RheumaticumErythema MigransErythema Gyratum Repens | Gammel Syndrome
- Dermatoses que adotam geralmente um padrão anular
Eritema Anular Secundário (há autores que consideram um padrão de reação)
- Infeções: TB, apendicite, ascariasis, virus
- Malignancy: Hodgkin, thrombocytopenia
- Medications
- Various general disease, Hashimoto thyroiditis, relapsing polychondritis, thymoma
Na tabela, falta o eritema anular do Sjogren