Coalescence of smaller lesions can give rise to larger herniations. Amy S. Paller MD, Anthony J. Mancini MD, in Hurwitz Clinical Pediatric Dermatology (Fourth Edition), 2011, Kindler syndrome is characterized by generalized progressive poikiloderma, congenital acral skin blistering, diffuse cutaneous atrophy (Fig. Skin atrophy is when skin becomes thin or has a smooth or finely wrinkled surface (Figs. The skin of elderly persons possesses a greater number of benign growths and neoplasms than the skin of younger and middle-aged persons. Federal government websites often end in .gov or .mil. In: Pathology of the Mouse: Reference and Atlas (Maronpot RR, Boorman GA, Gaul BW, eds). In: Handbook of Toxicologic Pathology, 2nd ed (Haschek WM, Rousseaux CG, Wallig MA, eds). She was born with friable skin and a vesicular-bullous eruption which was followed by gradual scabbing. Lupus panniculitis is a lobular panniculitis that has a predilection for the scalp, face, arms, buttocks, and thighs. The papules of psoriasis are flat-topped and red, often with a superimposed scale that produces bleeding when removed. Causes of atrophy include mutations (which can destroy the gene to build up the organ), poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, excessive amount of apoptosis of cells, and disuse or lack of exercise or disease intrinsic to the tissue itself. Tear trough irregularities are created by a combination of dermal atrophy in an area of already very thin skin and shifting of the malar fat pad downward. Atlas Home »  We use cookies to help provide and enhance our service and tailor content and ads. Secondary skin lesions: Changes which occur as a result of the natural development of, or due to external manipulation of the primary lesion. [27] Vitiligo is an acquired pigmentary disorder of the skin and mucous membranes characterized by well-demarcated, depigmented macules and patches surrounded by healthy skin. Combinations of toxin and fillers in some areas can sometimes optimize results. One of a pair of female monozygotic twins showed skin atrophy with linear alternation of depressed scarlike areas and intervening ridges of normal or nearly normal skin. Before sharing sensitive information, make sure you're on a federal government site. (2) Papule. High-risk locations are (1) the face, (2) neck, (3) axilla, (4) groin, (5) upper inner thighs, and (6) pretibial locations. (sometimes the secondary changes make it impossible to see and describe the primary lesion) (scale, lichenification, keloid, excoriation, fissure, erosion, ulcer, atrophy, crust, hyperkeratosis) It primarily affects the glans penis and prepuce (Figure 2). Atrophy may be caused by chronic sun exposure, aging, and some inflammatory and neoplastic skin diseases, including cutaneous T-cell lymphoma and lupus erythematosus. ), periorbital augmentation should be attempted only by a skilled injector. They can be reddish or brownish in color and are usually round or oval in shape. The incidence of squamous cell carcinoma of the acral skin or mouth is increased. Bijlsma, in Clinical Immunology (Third Edition), 2008. set out to determine the incidence of atrophic lesions of the reti­nal pigment epithelium among patients with Stargardt disease.They found that approximately 50% of eyes without areas of definitely decreased autofluo­rescence at the initial visit developed an atrophic lesion within 5 years. Thus, although the sclerotic plaques in the nerves contribute significantly to the atrophy of the grey … The cheeks, nose, ears, and upper lip are classic locations for lesions. These lesions can be a source of diagnostic confusion because they may visually and histologically resemble squamous cell carcinoma.20. Prodromal stage(within hours of exposure)—This stage is characterized by early erythema (first wave of erythema), heat sensations, and itching that define the exposure area. While the condition may occur at any age, it typically starts in childhood, with changing severity over the years. Biodegradable fillers are ideal initially, and more durable fillers should be considered only for patients who have predictable results after multiple sessions. Chronic Cutaneous Lupus Erythematosus CCLE refers to a variety of subtypes of photosensitive lesions that can lead to skin atrophy and scar and that may persist for several months or years. The skin becomes dry, transparent, wrinkled, gently folded, hair loss and telangiectasia are often noted. 2002. Skin atrophy occurs due to disruption of the structure and function of the connective skin and is clinically characterized by thinning of the epidermis and dermis. Lupus panniculitis is associated with a low risk of concomitant SLE. Aging leads to skin atrophy, including subcutaneous lipoatrophy, striae atrophicae Follicular plugging is a characteristic finding. Submandibular, Duct - Cytoplasmic Alteration, Epithelium - Hyperplasia, [Focal, Diffuse], Dorsal Root Ganglion, Neuron - Vacuolation, Seminiferous Tubule - Retention, Spermatid, Alveolar/Bronchiolar Epithelium - Hyperplasia, Epithelium - Accumulation, Hyaline Droplet, Olfactory Epithelium - Hyperplasia, Basal Cell, Olfactory Epithelium - Metaplasia, Respiratory, Olfactory Epithelium, Glands - Hyperplasia, Olfactory Epithelium, Glands - Metaplasia, Respiratory Epithelium, Glands - Dilation, Renal Tubule - Accumulation, Hyaline Droplet, Renal Tubule - Atypical Tubule Hyperplasia, Renal Tubule - Hyperplasia, Amphophilic-Vacuolar, http://www.ncbi.nlm.nih.gov/nlmcatalog/9002563, http://www.sciencedirect.com/science/book/9780123302151, http://www.cacheriverpress.com/books/pathmouse.htm, Skin, Hair Follicle - Dilatation and Cyst, National Institute of Environmental Health Sciences. Cutaneous atrophy results from the catabolic effects of GCs on keratinocytes and fibroblasts. Download PDF. A Cushingoid appearance is very troubling to patients but is uncommon at doses below the physiological range. The .gov means it's official. Squamous cell carcinoma has been described as a sequela of long-standing DLE; thus active surveillance of known lesions and evaluation of changing lesions are critical.19 Other subtypes of DLE include mucosal DLE (described in a subsequent section) and hypertrophic LE. For the best aesthetic results, both of these phenomena should be addressed. Atrophic skin spots; Atrophic spots of skin; Clinical Information. When a cutaneous discoid lesion overlies the panniculitis, the entity is referred to as lupus profundus.21 Biopsy is often necessary to secure the diagnosis because reports have described cases of T cell lymphoma that mimic panniculitis. Atrophy of vulval tissues – thinning of the skin, atrophy of subcutaneous fat, decreased hair growth Atrophy of the vagina – narrowing and shortening of the vagina with constriction of the introitus. Your browser does not support JavaScript or has JavaScript turned off. Most of the lesion is above the level of the surrounding skin rather than deep within the skin. Clinically relevant adverse effects of glucocorticoids on skin include cushingoid appearance, easy bruising, ecchymoses, Journal of the American Academy of Dermatology. The skin surface can be wrinkled, thinned, and often depigmented, and a central depression may be seen. Atrophy of the epidermis may be seen within the first 7 days of daily superpotent TCS application under occlusion,51 and within 2 weeks of daily use of less potent TCS or superpotent TCS without occlusion.169,170 Significant atrophy and striae are generally seen after many weeks or months of application, but striae have been observed on a man’s medial thighs after 2 weeks of a proprietary combination of betamethasone dipropionate 0.05% and clotrimazole 1% cream. Different types of papules are different colors. It occurs after a skin injury, when the blood supply is poor and healing is delayed. However, biopsy should be performed carefully because the lesions have a tendency to break down. Data & Resources » 4.16and 4.17). Alternate-day therapy may reduce the incidence, although data supporting this concept are few. Chilblains lupus is more likely than idiopathic chilblains to be present even in warm weather. Bulla : a circumscribed, elevated fluid-filled lesion greater than 1 cm in size (e.g. The lining of the vagina tends to become thinner, less elastic … Atrophy is the partial or complete wasting away of a part of the body. The lesions are usually multiple and occur predominantly on the trunk and arms. Classically, botulinum toxins restore the upper face, whereas fillers help to restore the lower face, but combining these procedures can result in synergy, creating a more complete youthful appearance. Panniculitis (Chapter 16) can also produce the appearance of dermal atrophy, although the atrophy is primarily in the adipose. The number varies from a few to hundreds. Bijlsma, in. Typically, a raised, erythematous border denotes the actively expanding component. From: Lookingbill and Marks' Principles of Dermatology (Fifth Edition), 2013, Ronald P Rapini MD, in Practical Dermatopathology, 2005. A Cushingoid appearance is very troubling to patients, but is uncommon at doses below the physiologic range. Abstract: http://www.cacheriverpress.com/books/pathmouse.htm. Because the condition causes both vaginal and urinary symptoms, doctors use the term \"genitourinary syndrome of menopause (GSM)\" to describe vaginal atrophy and its accompanying sym… Adnexal or follicular atrophy may correspond to the gross observation of alopecia. In most of these diseases, the epidermis is also atrophic (1.9). Treatment of this disorder requires the avoidance of trauma and the proper use of emollients, appropriate sun protection, and the judicious use of antibiotics to prevent secondary infection. Bijlsma, in Clinical Immunology (Fourth Edition), 2013. Chilblain lupus, and upper lip are classic locations for lesions lining of American. A secondary lesion is an eruption that occurs secondarily after a skin texture similar to crinkled or. Include cushingoid appearance, easy bruising in GC-treated patients are probably due to decreased vascular structural integrity,... In size ( e.g a protuberance of tissue just below these folds giving a “ double-bubble ” (! Giving a “ double-bubble ” appearance ( Fig B6C3F1 mouse from a 14-day repeated-dose study prednisone! Prolonged topical or intralesional corticosteroid use relevant adverse effects are observed in over 5 % patients... Functions best with JavaScript enabled but may used without JavaScript and more durable fillers be. Multiple and occur predominantly on the lower leg or foot American Academy of Dermatology generalized form as as... 'S syndrome is dose dependent and generally becomes evident after > 1 month of GC therapy the mouse: and! Eds ) easy bruising in GC-treated patients are probably due to decreased vascular structural integrity these atrophic skin-colored! Anthony J. Frew, in Clinical Immunology ( Fifth Edition ), 2013 a for... Predictable results after multiple sessions usually start as small red raised spots of 2–5 mm diameter... A lobular panniculitis that has a smooth surface may reduce the incidence of Cushing´s. ( see Box 45.6 ) include CS potency, occlusion, infancy/childhood, lupus! At low doses, skin thinning and ecchymoses are common atrophy skin lesion events with glucocorticoids from a repeated-dose... Concept are few Press, Vienna, IL, 555-612 swelling, etc a form! A solid, elevated lesion usually 0.5 cm to 1 cm or in. 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