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Leziuni elementare Dermatologie

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    Sunt leziuni individuale, cu aspectemorfolo gice si evolutivecaracteristice;

    Constitue alfabetul prin care seexprima eruptiile cutanate;

    Sunt produse prin diferitemecanisme pato genetice;

    Se descriu 6 grupe de L.. distinctesi un grup neincadrabil;

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    I. L.E. prin modifcari de coloratie;

    II. L.E. solide;

    III. L.E. cu continut lichidian;

    IV. L.E. prin solutii de continuitate;

    V. Deseuri cutanate;

    VI. Sechele cutanate;

    VII. L.E. neincadrabile;

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    !"#$#%#& 'odi(care a culorii tegumentului, Circumscrisa / difuza, Fara modificarea reliefului tegumentar; nepalpabila, nereliefata

    Unii clinicieni utilizeaza denumirea pt. leziuni < 10 mm (5mm, iar altii folosesc termenul pt. leziuni plane de oricemarime

    CL)S#"#C)*& I) Pete discromice: neinamatorii, persistente la diitopresiune, deri!a din modifcari calitati!e" cantitati!e ale procesului

    de melanoene#a; II) Pete !asculo $ sanuine: proli%erare de tesut !ascular, dilatatia calibrului !ascular, sau& e'tra!a#are eritrocitara; III) Pete eritematoase( eriteme): oriine inamatorie, ro# $ rosietice, dispar la diitopresiune, e!olutie !ariabila;

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    ) PE*E +IPE-/E: +exces al productiei de melanina;

    +cafenii+ brune negre;

    a- congenitale si circumscrise nevii pigmentari-

    b- dobindite&

    primitive& + circumscrise& lentiginoza;

    + difuze& Sd. )lbrig/t, Sd. "anconi;

    secundare& + altor dematoze& lic/en plan, si(lidenigricante, pigm. post eruptive;

    + boli sistemice&+ 0. ndocrine )ddison,

    Cus/ing, 1ipertiroidism...- + ciroze /epatice,neoplazii;

    + admin. 'edicamente& cloasma pilulelorcontracep tive, eritem (x medicamentos,;

    + prin depunerea altor pigmenti!Depunerea hemosi - derinei: dermatita

    pigmentar de staza, Argiroze, Arsenic, Tatuaje

    http://www.google.com/imgres?imgurl=http://www.eliterejuvenation.us/Images/Nevus%2520of%2520Ota.jpg&imgrefurl=http://www.eliterejuvenation.us/laserpigmentationbirthmarks.html&usg=__jr0rJNOpWoaMh4OkTqA7cqTP-2w=&h=330&w=200&sz=14&hl=en&start=3&zoom=1&itbs=1&tbnid=HCiv1skC4KebWM:&tbnh=119&tbnw=72&prev=/images%3Fq%3DOTA%2BNEVUS%26hl%3Den%26sa%3DG%26gbv%3D2%26tbs%3Disch:1http://www.google.com/imgres?imgurl=http://www.eliterejuvenation.us/Images/Nevus%2520of%2520Ota.jpg&imgrefurl=http://www.eliterejuvenation.us/laserpigmentationbirthmarks.html&usg=__jr0rJNOpWoaMh4OkTqA7cqTP-2w=&h=330&w=200&sz=14&hl=en&start=3&zoom=1&itbs=1&tbnid=HCiv1skC4KebWM:&tbnh=119&tbnw=72&prev=/images%3Fq%3DOTA%2BNEVUS%26hl%3Den%26sa%3DG%26gbv%3D2%26tbs%3Disch:1http://www.google.com/imgres?imgurl=http://www.eliterejuvenation.us/Images/Nevus%2520of%2520Ota.jpg&imgrefurl=http://www.eliterejuvenation.us/laserpigmentationbirthmarks.html&usg=__jr0rJNOpWoaMh4OkTqA7cqTP-2w=&h=330&w=200&sz=14&hl=en&start=3&zoom=1&itbs=1&tbnid=HCiv1skC4KebWM:&tbnh=119&tbnw=72&prev=/images%3Fq%3DOTA%2BNEVUS%26hl%3Den%26sa%3DG%26gbv%3D2%26tbs%3Disch:1
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    Lentigo malign melanocitar -Lentigo solar (senil)-sunt pete pepiele asociate cu mbtrnirea iexpunerea la radiaiile UV alesoarelui

    Nev onctional!ata mongolica(nev dermic)

    Nev Otta hamartom din melanocite

    dermice dispuse pe ramura otalmica/

    mailara a N!trigemen

    Lentigo" le#iune unica $multipla (lentigine)% pre#ent

    de la nastere sau mai &rec-vent apare prima dat ncopilrie' Lentigo simplexnu este indus de expunereala soare i nu este asociatcu alte boli sau condiii

    este un melanom care a evoluat de la un lentigo malign'l este gasit de obicei pepielea deteriora cronic de soare"&aa i antebraele persoanelor n vrst% Lentigo

    malign este o modi&icare cutanata non-inva#ive considerata a &i un melanom-in-situ%

    http://www.google.com/imgres?imgurl=http://www.eliterejuvenation.us/Images/Nevus%2520of%2520Ota.jpg&imgrefurl=http://www.eliterejuvenation.us/laserpigmentationbirthmarks.html&usg=__jr0rJNOpWoaMh4OkTqA7cqTP-2w=&h=330&w=200&sz=14&hl=en&start=3&zoom=1&itbs=1&tbnid=HCiv1skC4KebWM:&tbnh=119&tbnw=72&prev=/images%3Fq%3DOTA%2BNEVUS%26hl%3Den%26sa%3DG%26gbv%3D2%26tbs%3Disch:1http://www.google.com/imgres?imgurl=http://www.eliterejuvenation.us/Images/Nevus%2520of%2520Ota.jpg&imgrefurl=http://www.eliterejuvenation.us/laserpigmentationbirthmarks.html&usg=__jr0rJNOpWoaMh4OkTqA7cqTP-2w=&h=330&w=200&sz=14&hl=en&start=3&zoom=1&itbs=1&tbnid=HCiv1skC4KebWM:&tbnh=119&tbnw=72&prev=/images%3Fq%3DOTA%2BNEVUS%26hl%3Den%26sa%3DG%26gbv%3D2%26tbs%3Disch:1http://www.google.com/imgres?imgurl=http://www.eliterejuvenation.us/Images/Nevus%2520of%2520Ota.jpg&imgrefurl=http://www.eliterejuvenation.us/laserpigmentationbirthmarks.html&usg=__jr0rJNOpWoaMh4OkTqA7cqTP-2w=&h=330&w=200&sz=14&hl=en&start=3&zoom=1&itbs=1&tbnid=HCiv1skC4KebWM:&tbnh=119&tbnw=72&prev=/images%3Fq%3DOTA%2BNEVUS%26hl%3Den%26sa%3DG%26gbv%3D2%26tbs%3Disch:1http://162.129.70.33/images/Ota_2_040513.jpg
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    Nevi congenitali Lentigine

    &elide

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    *+' NV, NV.L

    *+' !U/0 - 1234*boalgenetica autosomaldominanta caracteri#ata prinde#voltarea de polipi benigni(5amartoame) n tractulgastro-intestinal i macule5iperpigmentate pe bu#e iale mucoasei bucale

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    7elasma

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    Depunerea hemosiderinei: dermatita pimentar0de sta#a

    1riro#e 1rsenicism *atua2e

    +ermatita de sta#a

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    6rsenicism6rgirie

    Argiriare#ulta prin contactul prelungit sauingestia sariurilor de argint!6rgiria secaracteri#ea#a princolorarea gri-neagra apielii si mucoaselor produsa de

    depozitarea argintului!6rgintul poate &idepo#itat in piele prinepunerea industrialsau ca rezultat al medicamentelor care

    contin saruri de argint6rgiria locali#ata la ocicatrice apare secundarcremei cusul"adiazine si argint!

    /atua

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    #$%T#& '%( D%)ANTO*

    A)ANTO+%* N%$%)AN*- )) D%A.#T

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    *d' 86N.N,

    9' 6++,*.N-insu&icientaadrenala cr cu secretiesca#uta de gluco- simineralocorticoi#i

    *d' U*3,N2-tulburare cau#at de un nivel ridicat de corti#ol n snge(5:percortisolism)' cau#at de consumul de glucocorticoi#i saude tumori care produc corti#ol sau 6/3%.be#itate centrala&acies luna plina 5iper5idro#ateleangiecta#ii vergeturiscadere libido'

    este o boal la nivelul tubilor proximali renali n caregluco#a aminoaci#i acid uric &os&at si bicarbonatsunt eliberate n urin n loc de a &i resorbit'6N7,686N.N,"de&ect genetic a unui grup de proteineresponsabile pentru repararea 6+N-ului%; ,NLUL ?.4.N.88

    http://162.129.70.33/images/Woronoff_ring_1_050211.jpg
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    ) PE*E V1S-4L1E: + rosii violacee, + persistente,

    + nein5amatorii,

    + dispar ladigitopresiune;

    a- congenitale& )ngioame plane, Cutis marmoratateleangiect.

    b- dobindite& teleangiectazii din&

    + afect. sist& Cord pulm. cr, Ciroze/ep, L..).!, Sclerodermie;

    + dermatoze& )c. rozacee, L..Cr;

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    6ngiom capilar (*almon) utis marmorata teleangiecta#ica

    6cnee ro#acee 6cnee ro#acee

    T#AN%#)TA+%%

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    6cnee neonatorum @corticoterapie topica @ atro&ie +ermatomio#ita

    piteliom ba#ocelular nodular

    upero#a

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    C1#'78) #n primele oreechimo#a estero9iedatorita o'ihemolobinei, ulterior se pierde o'ien si de!inealbastraculoare ce tine 3&5

    #ile;

    hemolobina se scindea#0 in lobina si hematina iar aceasta dinurma pier#6nd fer se trans%orma in bilirubina care con%er0

    echimo#ei o culoare cafeniela 5&7 #ile de la producere. -uloareca%enie a echimo#ei tine si de o'idarea ferului cu apari8iahemosiderinei.

    Prin o'idarea bilirubinei mai ales la peri%eria #onei echimotice 9i%ace apari8ia bili!erdina care reali#ea#0 aici o culoareverzuie.

    /ai tar#iu sub ac8iunea %aocitelor si a en#imelor tisulare

    echimo#ele se resorb, persistand uneori un timp de pimentare, :ntreaga evoluie in? zile.

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    !urpura posttraumatica (c5imo#a)

    !urpura 3enoc5 -

    *c5onlein

    !urpura trombocitopenica

    autoimuna

    !urpura senila

    !urpura teleangiecta#ii

    (7+4.L)

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    c5imo#a

    0etesii 6N2,.+47,/6 !,27N/646(*/606 VN.6*6)

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    !urpura petesiala

    Vibice

    c5imo#a

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    L''*'- !urpura necrotica3ematom

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    7rigine in5amatorie, *oz rosietice !ispar la digitopresiune volutie variabila;

    @- *#%' '7*0#L#"7*'& +*u2eola, *ozeola;

    >- *#%' SC)*L)%#$#"7*'& +Scarlatina, *as/uri postmedic. A- *#%' )*7L)*& "oliculite super(ciale,

    B- *#%' "#D*)%& rEt/ema gEratum repens,rit.centrifug !arier

    F- *#%' $*)L#8)%*#%*7!'#)-& enodermatoze& ritrodermia i/tioziforma; #nfectii cutanate& ritrodermia streptococica; !ermatoze preexistentegeneralizate& czema

    eritrodermica, 3soriazis eritrodermic, Limfoame 'g. cu celule%& 'icozis fungoid, Sd. SezarE,

    Leucoza limf. cronica;

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    ritem morbili&orm - rueola

    4o#eole si&ilitice

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    4as5 morbili&orm

    ritem areolar

    ritem morbili&orm

    ritem ro#eoli&orm

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    ritem &igurat r:t5ema g:ratum repens

    ritem centri&ug

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    Eritem al intreului teument

    Se asocia#a cu alte semne cutanate: infltrat !i#ibil si

    palpabil dat de un edem cutanat pro%und,descuamatie, modifcari ale %anerelor

    Semne enerale asociate: %ebra, alterarea stariienerale

    1denopatii superfciale E'.

    dermato#e cronice enerali#ate (psoria#iseritrodermic, ec#ema ertrodermi#ata),

    in%ectii (eritrodermia streptococica), postmedicamentos,

    lim%oame cutanate,(Sd. Se#ar, /ico#is %unoid,Leuco#a lim%atica cr.)

    enodermato#e (Eritodermia ihtio#i%orma))

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    Eritem al intreului teument Se asocia#a cu alte semne cutanate: infltrat !i#ibil

    si palpabil dat de un edem cutanat pro%und,descuamatie, modifcari ale %anerelor

    Semne enerale asociate: %ebra, alterarea stariienerale

    1denopatii superfciale

    E'. dermato#e cronice enerali#ate (psoria#is,

    ec#eme), in%ectii, postmedicamentos, lim%oamecutanate, enodermato#e (ihtio#a)

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    *d' *e#ar: ritr' sta&ilococica

    ,c5tio#a lamelara

    celulele a&ectate sunt celulele / care aucantiti patologice de mucopoli#a5aride'9oala lui *e#ar: este uneori considerata un

    stadiu avansat de m:icos:s &ungoides culim&adenopatie

    &%)O*%* '1NO%D- lim"om cutanat mg! cu celuleTcelule

    tumorale mici,cere2ri"orme

    !*.4,60,* 4,/4.+47,

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    Pitiriasis rubrapilar

    ritroderm' !ostmedic';Ae&alexin

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    Depunerea hemosiderinei: dermatita pimentar0de sta#a

    1riro#e

    1rsenicism

    *atua2e

    +ermatita de sta#a

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    6rsenicism6rgiro#a

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    Culoare 1istopatologie !iagnosticposibil

    eru /elanina, necro#a /elanom,purpura%ulminanta,calcifla'ie

    1lbastru Piment in dermulpro%und, +b redusa,tatua2e, medic.

    >e! albastru,melasma

    1ramiu Inamatie cuplasmocite

    Siflis secundar

    Verde +emosiderina In%ectie cu

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    Culoare 1istopatologie !iagnosticposibil

    Violaceu Inamatie,!asodilatatie in dermulpro%und

    Le#iuni e!oluti!ede mor%ee(marini),dermatomio#ita

    Portocaliu Inam.?ranulomatoasa cuhistiocite

    @antoranulomul2u!enil

    Perlat Proli%erare epidermica

    neacoperita deAeratina

    -arcinom

    ba#ocelular

    o# Inamatie acuta,!asodilatatiesuperfciala

    Ec#ema

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    Culoare 1istopatologie !iagnosticposibil

    o#

    somon

    Inamatie cu a%ectarea

    epidermului,!asodilatatie, inamatiecu edem

    Pitiria#is rubra

    pilar, psoria#is,urticarie

    Violet +emoraie, hemosiderina

    pro%unda, inamatielichenoida

    Lichen plan,

    sarcom Baposi

    1lb educerea sau absentasinte#ei de melanina,

    postinamator

    Pitiria#is!er#icolor,

    albinism,!itilio

    ?alben In%ectie superfcialastaflococica sau

    streptococica; amestecde celule Aeratini#ate,

    Impetio,'antoame,

    hiperpla#iesebacee,

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    3)3DL 3#!*'#C, !*'#C, !*'7 +3#!*'#C, "7L#CDL)*-

    %D0*CDL# LD3#C, S#"#L#%#C, L3*)-

    $7!DL, $7!78#%)%

    7') S#"#L#%#C), %D0*CDL7)S), )C%#$7'#C7%#C),S37*7%*#C178)-

    L#C1$#"#C)*)

    4%)%#)

    %D'7*) 0$#$), ')L#$)-

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    *idicaturi circumscrisetegumentare

    Consistenta ferma #n epiderm si dermul super(cial

    )- 3)3DL 3#!*'#C& 1iperplazie circumscrisa

    epidermica, Culoare teg normal cafeniu

    bruna, xemple& + 4eruci plane 2uvenile,

    + 4eruci plantare;

    Veruci plantare

    Veruci plane

    uvenile

    http://162.129.70.33/images/wart_flat_6_050308.jpghttp://162.129.70.33/images/wart_flat_1_050308.jpg
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    0- 3)3DL !*'#C

    @- 3apula edematoasa&edem circumscris al corpuluipapilar;

    + Drticarie, ritempolimorf eritemato+ papulos;

    >- 3. 3rin in(ltrat celular&in(ltrat limfocitar siplasmocitar perivascular;

    + Sif. ##, Sif. cong. precocesi(lida papuloasalenticulara-

    A- 3apula dismetabolica&degenerescente speci(ce

    + )miloidoze cutanate,'ucinoza papuloasa

    6miloido#a

    Urticarie

    *i&ilide papuloase

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    67,L.,+.06 U/6N6/6 (!6!ULN.+UL,)

    7U,N.06 !6!UL.6*6 (*L4. >7BC+7)

    0 A 0 1 #

    7U,N.06 !6!UL.6*6 (*L4.-7BC+7)

    http://162.129.70.33/images/scleromyxedema_1_040407.jpghttp://162.129.70.33/images/scleromyxedema_3_040407.jpghttp://162.129.70.33/images/scleromyxedema_5_040407.jpghttp://162.129.70.33/images/nodular_amyloid_1_050115.jpg
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    C- 3)3DL !*'7 3#!*'#C&1+plazie epidGin(ltrat in5.cr, in dermulpapilar

    + Lic/en plan !- 3)3DL "7L#CDL)* &

    1iper plazie disHeratozafoliculara G in(ltrat in5am.perifolicular speci(c nespeci(c&

    + 3itiriazis rubra pilar

    + 'al. !arier

    + Si(lide foliculare

    + Lic/en scrofulosorum + Lic/en plan folicular

    CL#$#C& ridicaturi perifolic.acuminate, ferme; senz. degranitare;

    Lic5en ruber plan

    L,3N !L6N 8.L,UL64

    http://162.129.70.33/images/Lichen_1_020319.jpg
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    0%T%$%A*%* $1.$A 0%A$ ; 4646% 6U0NUN.*U/%

    -!L6,!L664+ 4,-/76/.*U67.6*

    [email protected] !6!UL8.L,UL64 3,!4D46/.0,

    http://162.129.70.33/images/Pityriasis_rubra_pilaris_1_031116.jpghttp://162.129.70.33/images/pityriasis_rubra_pilaris_1_040726.jpghttp://162.129.70.33/images/pityriasis_rubra_pilaris_3_040726.jpghttp://162.129.70.33/images/pityriasis_rubra_pilaris_2_050112.jpghttp://162.129.70.33/images/pityriasis_rubra_pilaris_1_050112.jpg
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    *,8,L,+ 8.L,UL64

    L,3N !L6N 8.L,UL64 !,/,4,6*,* 4U946 !,L64

    L,3N 67,L.+.*U*

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    http://162.129.70.33/images/keratosis_follicularis_5_070304.jpghttp://162.129.70.33/images/keratosis_follicularis_4_050307.jpg
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    3#$ATO+A 0%A$A

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    L.E solida, Infltrat inamator cr. specifc, ranulomatos, C decit papula, cicatrice: sclero#a interstitiala " ulceratie; Dermul mi2lociu si pro%und; %#3D*#&

    %D0*CDLDL LD3#C LD37'DL- %D0*CDLDL S#"#L#%#C %D0*CDLDL !#$ L3*) 3*70 CL#$#C&

    4itropresiunea modi(care culorii; Stiletul butonat stabilirea consistentei;

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    #n LD3DSDL 4DL)*, *osu violaceu, Consistenta moale, *ecidiveaza in cicatrice

    4ireaza culoarea

    galbui brun-

    http://162.129.70.33/images/atypical_mycobacteria_1_051010.jpg
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    #n S#"#L#S %*%#)*,S#"#L#S C7$.%)*!#4;si(lide tu berculoaseuscate sau ulceroase;

    *osu aramiu,

    Consistenta ferma, $u recidiveaza in

    cicatrice $u+si modi(ca culoarea;

    *%'%%* T#$T%A$

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    0run rosietic, $u+si vireaza culoarea, Consistenta ferma, $u recidiveaza in

    cicatrice;

    Lepra tuberculoida

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    L.. solida, circumscrisa, #n(ltrat in5am.

    perivascular G alterariale peretilor vasc.

    I tubercul, modi(cari ale reliefului

    si culorii teg.supraiacent,

    #n !*'DL 3*7"D$! S#1#+ 37!*';

    $7!78#%)% nodul Iboaba de fasole;

    #$& EI*E/ >DS EI*E/ I>D41* =1I>, V1S-4LI*E -4*1>1*E;

    rit' nodos!aniculita nod'

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    #$%T#& NODO*

    4A*)1%TA NOD1A$A 50AN%)1%TA6

    #$%T#& %ND1$AT .A+%N

    http://www.dermnetnz.org/common/image.php?path=/bacterial/img/s/eryth-induratum.jpghttp://162.129.70.33/images/nodularvasculitis_1_030306.jpghttp://162.129.70.33/images/cutaneous_crohns_disease_5_050505.jpg
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    $odozitate 1#37!*'#C) 47LD%# & Cruditate *amolitie Dlceratie Cicatrizare; #$& SIILIS III *4=E-4L1 -4*1>1*1 1-*I>/I-1 SP*I-1

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    #n S#"#L#S %*%#)*!70#$!. S#"#L#S C7$.%)*!#4;

    4L-E1*I1: 'argini regulate,

    *otunde ovalare, #n(ltrate,

    *osii aramii,

    "undul ulcer& curat

    'argini& abrupte

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    #n SC*7"DL7!*'); 4L-E1*I1:

    'argini neregulate, Consistenta moale, "undul murdar secretii

    ce+ nusiu purulente

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    onion, ome grupate; faze

    evoluti ve diferite, 'ici concretiuni in puroi, *eactie con2unctiva

    perigomoasa. I consist. dur

    lemnoasa !g. dif.

    + Sarcom

    + piteliom spinocelular

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    #n lungul unui traiectlimfatic

    ta2ate, Sirag margele,

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    )ccentuare circumscrisaa cadrila2ului normaltegum.

    I pseudopapule, 3laca reliefata,

    Cenusie rata2 prurit- PI/I*IV1:

    $D*7!*'#%) SE-4>D11

    ( derm.pruriin)

    Ec#ema lichenifcata

    Psoria#is lichenifcat,

    *inea cruris lichenifcata;....

    N#1$OD$&%TA

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    +erm' contact- Ni

    +erm'atopica

    *cabie

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    xcrescenta cut. (liforma conopidiforma,

    Consist. variabila, PI/I*IV1: 3apiloame, 4egetatii

    vener. SE-4>D11: #nf. cronice& %0C verucoasa

    vegetanta Si(lide vegetante

    3iodemita vegetanta, Candidoze vegetante; 3rocese secretante cr.& 3em(gus vegetant; Vegetatie (&loare)

    Veruco#itate(Eerato#a)

    http://162.129.70.33/images/warts_2_030521.jpg
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    http://162.129.70.33/images/Condyloma_accuminata_1_070703.jpghttp://162.129.70.33/images/Condyloma_accuminata_2_070703.jpg
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    0A0%OA!6!.V6V,4U*U4, 3!V (3U76N !6!,L.76 V,4U*)

    http://www.dermnetnz.org/common/image.php?path=/lesions/img/s/tag6.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/tag5.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/s/tag4.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/tag3.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/tag2.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/tag1.jpg
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    #0%T#%O&

    .A+O)#1A$

    !,/L,.7*!,N.LUL64

    7L6N.7 76L,2N

    L,!.7

    376N2,.7

    D46/.66N/.7

    !,L.76/4,.7

    http://www.dermnetnz.org/common/image.php?path=/lesions/img/pilomatricoma.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/ka3.jpghttp://www.dermnetnz.org/common/image.php?path=/vascular/img/haeman1.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/lip3.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/melanoma/img/s/nm5.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/mel4.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/scc3.jpghttp://www.dermnetnz.org/common/image.php?path=/lesions/img/bcc1.jpg
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    48#CDL); 0DL&o + SD3*"#C#)L

    o + '#JL7C## ')L3#1#$-o + 3*7"D$! !*'7 3#!*'#C-

    3DS%DL&o + "7L#CDL)*

    o + $"7L#CDL)*

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    !"#$#%#& colectie lic/idiana epiderm. @ F mm,

    Continut serocitrin tulbure purulent;

    )S3C% 47C)%7)*& 1erpes simplex, 8ona 8oster, !ermatita /erpetiforma polimorfa, czema,

    !is/idroza czema dis/idrotica- %inea cruris;

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    +476/,/6 34!/,8.476+U34,N2

    076

    /,N6

    /,N6

    D%*7%D$O+A

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    +EPES VI4S +/I>I; *IP 1D>; VEI-4LE EE/EE, ?4P1*E I>=4-+E* EI4>I D4E1SE -4 ->*4 PLI-I-LI-; 7 &FILE;

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    +EPES VI4S V1I-ELL1E; PD/ D4ES & 7 ILE E4P*IEDE/1*/1L1: =4-+E* DELEI4>I P1P4L& VEI-4L1SE, >DEI*E/1*S, EI4>I, -4S*E, -I-1*I-I, LE. 1-/I-E"

    +IPEPI?/E>*1*E; *1IE-* >EV SE>I*IV S14 /[email protected]*; 1DE>P1*IE S1*ELI*1

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    5G& HG 1>I, E4P*IE PLI/1: >D EI*E/1*&EDE/1*S, 4*I-1I/ VEI-4L&=4LE /I-I, ?4P1*E +EPE*I/; SI/P*/E S4=IE-*IVE PE/>I*II ; EI>ILIES1>?4I>1 SI I> LI-+D =4L1;

    I>*LE1>*1 : ?L4*E>, L1-*1*E, +1L?E>I

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    4#+%)1A #0%D#$& *10#$%O$

    http://162.129.70.33/images/dermatitis_herpetiformis_6_070429.jpghttp://www.dermis.net/bilder/CD058/550px/img0070.jpg
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    DE/1*1 1LE?I-1 P4I?I>1S1; PLI/IS/ LEI>1L:EI*E/VEI-4LEE/4IES-41/& -4S*E; +P:

    SP>?I1 VEI-4L1*IE I>*1/1LPI?+I1>1

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    -au#a este necunoscuta, dar sunt date care suerea#a inter!entia urmatorilor %actori: *ulburarile de secretie alandelor sudoripare, Stres&ul neuropsihic, Iritantii primari si anumite substante de tip crom, cobalt, neomicina,nichel, eactie alerica la un %ocar in%ectios (micotic sau bacterian) aat la distanta, de e'emplu *inea pedis.

    Le#iuni !e#iculo&buloase, cu un continut clar, care pot f asociate cu reactii eritematoase sau eritemato&scuamoase. Locali#area le#iunilor este stricta la ni!el palmo&plantar,

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    /I-1 -4*1>1*1; VEI-4LE VII=ILE L1 PEIEIE; EVL4*IE-E>*I4?1; P4I*;

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    !"#$#%#& )lterare a coeziunii intercelulare, I cliva2 si cavitati lic/idiene serocitrine, I decit

    vezicula, Spargere eroziuni rotund ovalare G fran2 epit.

    periferic; CL)S#"#C)*& SD3*"#C#)L& exotoxine microbiene acantoliza;

    #'3%#7 0DL7S S%*3%7C7C#C S%)"#L7C7C#C, S!.LKLL#$")$%#L, 3'"#DS "7L#)CD;-

    '#JL7C##& acantoliza 3'"#DS 4DL)*- 3*7"D$! !*'73#!*'#C-& 3#!*'7L#8L 0DL7)S J7$C%#7$)L G !*'7L#%#C; *#%'DL 37L#'7*" 0DL7S; 37*"#*##L CD%)$)%; Sd. LKLL 37S%'!#C)'$%7S;

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    +U!6 F= 6N,% 68/64 U/6N.- 7U.6*6% +9U/ 84V' 6V' 9U6L6% /2U7N/6!64N/ *6N6/.*" ,N,/,6L 7.N.7.48!.L,7.48 (9UL4.0,UN,4U*/!,/L,064!/ 3,!44.7)% 66N/.L,06" ,/.+2 ' /06ND *' NB.L*DB

    http://162.129.70.33/images/pemphigus_2_050502.jpg
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    http://162.129.70.33/images/pemphigus_3_050507.jpg
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    0or"irie

    0#&'%O%D .1O*

    #ritem polimor" veziculo -

    2ulos#pidermoliza 2uloasa

    distro"ica

    0#&'%O%D 0A$AN#O0A+%)

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    ?enodermato#a ; 1uto#omal dominant " recesi!; bule de la nastere, mari,asce &C cicatrici atrofce, %u#iune diitala, mani%estari e'tra cutanate:bolta oi!ala, steno#a eso%aiana, etc

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    DE/1*1 >E1-1>*LI*I-1; PES*E HG 1>I; E-V. P11>EPL1I-1. DE=4*: E4P*IE

    4*I-1I/1 " E-E/1*1S1 " *E? 1P1E>* S1>1*S

    =4LE /1I, S4= *E>SI4>E, LI-+ID-L1 "+E/1?I-, LE =4-1LE 1E, S*1E ?E>E1L1 1L*E1*1; -LIV1< P4>D, DE/&EPIDE/I-;

    0#&'%O%D 0A$AN#O0A+%)

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    I>IL*1* -EL4L1 />" PLI&/: >E4*ILE, EI>ILE,LI/-I*E

    !.+6U6 9UL,

    http://162.129.70.33/images/bullous_pemphigoid_1_060313.jpghttp://162.129.70.33/images/bullous_pemphigoid_1_060313.jpghttp://162.129.70.33/images/bullous_pemphigoid_1_060313.jpghttp://162.129.70.33/images/bullous_pemphigoid_1_060313.jpg
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    1-*IV . DEI-. 1 4PII>?E>& [email protected] +EP1*I-E; *@I-E, L VI4S +EP1*I*I- C;*SE>SI=ILI*1*E, =4LE *4>DE" V1L1E, ->*I>4* SE-I*I> " +E/1?I- -I-1*I-E1*I-1" PI?/E>*1*IE EID41L1; 1?ILI*1*E -4*1>1*1, +IPE*I-+1 /1L11

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    D#$&

    #0%D#$&

    http://162.129.70.33/images/handblisters_5_011107.jpghttp://162.129.70.33/images/handblisters_5_011107.jpghttp://162.129.70.33/images/handblisters_5_011107.jpg
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    !"#$#%#& Colectii lic/idiene primitiv purulente, xocitoza cu polimorfo+nucleare neutro(le; CL)S#"#C)*& "7L#CDL)*& centrata de un (r de par; "7L#CDL#% S%)"#L7

    C7C#C, cu germeni *)' $)%#4#, '#C7%#C#candida,

    ag. zoo(li- $"7L#CDL)*& afectiuni grave; potential letal; continut

    S%+ *#L 0)C%*#7L7#C pustuloze amicrobiene& 4)*#7L), #'3%#7 1*3%#"7*' 3S7*#)8#S 3DS%DL7S

    Sd. *#%* )C*7!*')%#%) SD3D*)%#4) 1)L73)D;

    01*T1# 'O%)1A$# 01*T1# N#'O%)1A$#

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    Acrodermatita supurativa

    7AO0#A1

    0soriazis pustulos palmar'oliculita super"iciala

    3erion )elsi

    01*T1# 'O%)1A$# 01*T1# N#'O%)1A$#

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    V64,L6

    %mpetigo herpeti"orm

    *d! $eiter

    *d! $eiter

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    ,V)L''!4

    ,N*.LU

    /,,+

    -.N/,NU,/6/

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    MC7*#)%#)& 3ierdere de substanta super(ciala

    %raumatica #ntereseaza epidermul si virful papilelor dermice; #$& SC)0#, !*')%78 C*. 3*D*##$7)S,

    3*D*#%D*# $!7$ 0. 17!N#$, !#)0% 8)1)*)%,C)$C* 4#SC*)L, LDC78 L#'")%#C C*7$#C-;

    *78#D$) MDLC*)%#)-& 3ierdere de substanta super(ciala,

    3atologica, 4indecare fara cicatrice #$& S#"#L#S primar, )"%, evolutia 48#CDL, 0DL,

    3DS%DL;

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    ro#iun, postbul% !78,2U* SIFILOM

    AFTE

    xcoriatii

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    DLC*)%#)& 3ierdere de substanta mai profunda cicatrice

    DLC* ulceratii atone;

    C)*)C%*& margini (delimitare,subminata"nu), adincime(pro%unda, superfciala), aspect suprafata (curata,secretii,ranulare), zona perilezionala, localizare

    C)D8)& #$"C%#7)S)& D. %D0*CDL7S; D.S#"#L#%#C;

    $73L)8#C)& C)*C S3#$7CLDL)*; '%)S%)8 CD%)$)%; 4$7)S)& D.Cr.37S%%*7'07%#C; D.4$7S; )*%*#)L)& )*%*#%) )*%*#7SCL*7%#C); %*7'0)$#%)

    70L#%*)$%);

    %*7"#C $*47)S)& %)0S, S#*#$7'#L#, L3*), )C*73)%#)DLC*7 + 'D%#L)$%)

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    MAL PERFORANT -LEPRA

    ULCER GOMA TBC ULCERATA

    EPITELIOM BAZOCEL. ULCERAT

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    "#SD*) *))!)-& 3ierdere de substanta super(ciala, Liniara, Comisuri mucoase pliuri cutanate;

    #$& 3*LS S%*3%7C7C#C& 3*LS L4D*#C; S#"#L#!) 3)3DL7)S) 3*#C7'#SD*)L);

    !4L* */4!/..,

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    PERLES LEVURIC

    PERLES STREPTOCOCIC

    INTERTRIGO STREPTOCOCIC

    SIFILIDA PAPULOASA PERI -COMISURALA

    http://www.dermnetnz.org/common/image.php?path=/bacterial/img/bull-impet.jpghttp://www.dermnetnz.org/common/image.php?path=/bacterial/img/impet3.jpghttp://162.129.70.33/images/Thrush_1_041024.jpg
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    SCD)')& 1iper paraHeratoza I exfolieretegumentara;

    o SC. 3#%#*#)8#"7*'& 'ici, furfuracee, taritoase #$& 3#%#*#)8#S S#'3LM )L 3#L## 3)*7)S ) C)3DLD#;

    '#C*7S37*#;o SC. 3S7*#)8#"7*'& '. mari, lamelate, side(i, strati(cate; #$& 3S7*#)8#S, S#"#L! 3S7*#)8#"7*';

    o SC. #$ L)'07D*#& 'ari #$& SC)*L)%#$); *)S1D*# 37S%'!#C)'$%7)S;

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    FURFURACEE

    ICHTIOZIFORMA

    PSORIAZIFORMA LAMELARA

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    C*DS%)& Dscarea unor secretii cutanate, #$& evol. L.. cu continut lic/id sol. de

    continuitate;o C*DS%) 'L#C*#C)&

    Culoare galben+ aramie ceara de albine- #$& S%*3%7!*'##, C8', 48#CDL SD3*)#$"C%)%

    SCD$!)*;

    o C*DS%) 7S%*)C*D3#)-& Culoare brun+ neagra, Strati(cata coc/ilie melc-; #$& S#".'g.3*C7C, 3S7*#)8#S MD!)%#4;

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    SIFILIS MALIGN PRECOCE ( RUPIA)HERPES (HEMATICA)

    IMPETIGO STREPTOCOCIC

    (MELICERICA)

    http://www.dermnetnz.org/common/image.php?path=/bacterial/img/s/impet6.jpg
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    SC)*) S")CLDL- 3ierdere circumscrisa si acuta a tro(citatii

    cutanate; Cauze& 4asculara $ervoasa; CL#$#C& 3laca circumscrisa +neagra, uscata galbui+

    slaninoasa, umeda; !etasare I& ulceratie; )$*$)& escara G infectie locala;

    #$& .!#)0%#C), . )*%*#%#C), ")SC#%)$C*7%#C), . "D+ !*7#)$%) ) 7*)$L7* $#%)L;

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    /rombangeita obliteranta

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    6N/46C

    !646!L2,

    UL4 !.*/46U76/,

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    FAGEDENISM GANG. FOURNIER( fasc nec!"#ca)

    Fasce#"a nec!"#ca

    P!s" a$%&"a"#e

    ARTERITA

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    C#C)%*#C)& *estaurare vicioasa tegumentara care nu mai

    reproduce struc+ tura si functia antelezionala;o 7') S#"#L#%#C) DLC*)%) cicatrice&

    $eteda, rotunda, depigmentata central, 1iperpigmentata

    periferic;o 7') %D0*CDL7)S) ,)C$) C7$L70)%) cicatrice&

    4iolacee, reliefata, neregulata, bride, punti (broase;

    o C#C)%*#C) C1L7#!#)$)&

    *elifata, voluminoasa, violaceee; G+ fenomene

    subiective;

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    *,8,L,* /4/,64 *4.8UL.2.76

    6N .N2L.96/6 6N 3L.,+,6N6

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    )%*7"#)& Subtiere a epidermului, stergerea reliefului cutanat; 'odi(cari (bre elastice si colagen *etea vasculara vizibila, CL#$#C& C7$$#%)L) +circumscrisa& )C*7*# +difuza& 3*7*#; !70#$!#%)

    + primitiva&+ circumscrisa )$%7!*'#; L#C1$SCL*7)%*7"#C, )%*7"7!*'#) 3)SS#$#;

    + difuza & )C*7!*')%#%) C*. )%*7"#)$%); + secundara& +af. in5amatorii& L..Cr, 3#!.0DL.

    J7$C%#7$)L;

    + af. tumorale& 0.*CNL#$1)DS$;

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    !rogeria sau *indromul 3utc5inson- 2il&ord este cau#atade o mutatie sporadica la nivelul genei L7N6 ce codi&ica oproteina (lamin 6) care &urni#ea#a sc5eletul molecular alnucleilor celulari' Lipsa proteinei duce la instabilitatenucleara a divi#iunii celulare inclusiv la moartea timpurie atuturor celulelor organismului

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    6netodermia este o a&eciune benign cu pierderea&ocala de tesut elastic pielii care apare ca un sac &lascsau 5ernie in #one locali#ate ale pielii' Gn pre#entanetodermia este clasi&icata ca anetodermie primar(idiopatic) sau secundara (asociata cu o varietate dea&ectiuni ale pielii utili#are de penicilamina sauprematuritate neonatal)' Le#iunile apar pe parteasuperioar a braelor trunc5iului i coapselor'

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    au#a necunoscuta% !laci de atro&ie teg' 7argini bine delimitate contur deprimat b run- albastrui%mai &recv' la &emei adult tinar% orice virsta% La palpare nu se produce 5ernierea teg( ca in aneto-dermie nu &ormea#a pliuri% &ara simpt locale% persista inde&init%

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    LIPOATROFIE

    SEMICIRCULARA

    !igmentar: disordersNaevus ac5romicus (including5:pomelanosis o& ,to)pidermal Naevus

    Nevus sebaceous,n&lammator: linear verrucousnaevus

    C-linEed genetic sEin disorder

    ,ncontinentia pigmenti3,L+ s:ndrome6cHuired in&lammator: sEin ras5es

    Lic5en striatuslic5en planuslupus er:t5ematosus

    5imerism

    *unt linii invi#ibile n condiiinormale' le devin evidente nmomentul cand unele boli ale pieliisau mucoaselor se mani&est n&uncie de aceste modele' le

    urmea# &orma unui IVI pe spatesau &orm unui I*I sau spirale pepiept stomac i &lancuri sau &ormeondulate pe cap'Liniile sunt considerate a urmrimigrarea celulelor embrionare'+ungile sunt un tip de mo#aicismgenetic ' le nu corespund

    sistemului nervos muscular sau

    L,N,, 9L6*3D.

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    PORFIRIA CUT TARDIVANECROBIOZA LIPOIDICA

    EPIDERMOLIZA BULOASA

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    6tro&ie topic steroidic

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    9oala cronica a pielii si a mucoaselor de origine necunoscutaa&ectea#a in principal #onele genitale'- Lic5enul scleroatro&ic al vulvei sau Eraurosis al vulvei a&ectea#a&emeia trecuta de J= ani' l se traduce prin mancarimi vulvare prinarsuri la mictiune si prin dureri in timpul raporturilor sexuale acestesimptome asociindu-se cu o decolorare a vulvei care ia o culoare alb-side&ie sau galbuie'

    - Lic5enul scleroatro&ic al barbatului se traduce prin le#iuni albicioase'le pot a&ecta glandul si meatul - si pot antrena o ingustare uretrala -sau santul balanopreputial% le#iunile &ormea#a in acest ca# ineleprocand o stramtare patologica uneori o &imo#a'- Lic5enul scleroatro&ic al pielii se traduce prin mici papule albe-side&iii#olate sau con&luand in placarde si a&ectand gatul spatele siradacinile membrelor' 6ceste le#iuni pot sa se asocie#e unui lic5enscleroatro&ic genital'

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    COMEDONUL FISTULA

    SANTUL ACARIAN GODEUL

    FAVIC

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    "ata persoane seboreice 'ic punct negru in infundibulul pilo sebaceu Sebum solidi(cat G detritusuri celulare G melanina

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    %raiect patologic cu perete propriu, Leaga + diverse colectii purulente tegumentare

    + desc/iderea spre suprafata a unei colectiiprofunde;

    8,*/UL6 .4.-86,6L6 (69* .+.N/.2N

    *,NU* !,L.N,+6L

    N.+UL 8LU/U6N/ 8,*/UL,06/6N/946/

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    xteriorizarea tunelului sapat de parazitul femel alscabiei;

    %raiect sinuos; citiva mm.

    La extremitate& eminenta acariana parazit;

    videntiat prin badi2onarea zonei cu %+ra de #od; 8one de electie& #.3; teca penis, scrot, areole mamare,

    sant subfesier;

    *6N/ 664,6N ! 86/6 8LC.4, 66N/946/ULU,

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