Causes of Bowen's disease
Bowen's disease Causes: Book Excerpts
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Skin, scaly:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Bowen’s disease
Bowen’s disease is a common form of intraepidermal carcinoma that causes painless, erythematous plaques that are raised and indurated with a thick, hyperkeratotic scale and, possibly, ulcerated centers.
Dermatitis
Exfoliative dermatitis begins with rapidly developing generalized erythema. Desquamation with fine scales or thick sheets of all or most of the skin surface may cause life-threatening hypothermia. Other possible complications include cardiac output failure and septicemia. Systemic signs and symptoms include a low-grade fever, chills, malaise, lymphadenopathy, and gynecomastia.
With nummular dermatitis, round, pustular lesions commonly ooze purulent exudate, itch severely, and rapidly become encrusted and scaly. Lesions appear on the extensor surfaces of the limbs, posterior trunk, and buttocks.
Seborrheic dermatitis begins with erythematous, scaly papules that progress to larger, dry or moist, greasy scales with yellowish crusts. This disorder primarily involves the center of the face, the chest and scalp and, possibly, the genitalia, axillae, and perianal regions. Pruritus occurs with scaling.
Dermatophytosis
Tinea capitis produces lesions with reddened, slightly elevated borders and a central area of dense scaling; these lesions may become inflamed and pus-filled (kerions). Patchy alopecia and itching may also occur. Tinea pedis causes scaling and blisters between the toes. The squamous type produces diffuse, fine, branlike scales. Adherent and silvery white, they’re most prominent in skin creases and may affect the entire dorsum of the foot. Tinea corporis produces crusty lesions. As they enlarge, their centers heal, causing the classic ringworm shape.
Lymphoma
Hodgkin’s disease and non-Hodgkin’s lymphoma commonly cause scaly rashes. Hodgkin’s disease may cause pruritic scaling dermatitis that begins in the legs and spreads to the entire body. Remissions and recurrences are common. Small nodules and diffuse pigmentation are related signs. This disease typically produces painless enlargement of the peripheral lymph nodes. Other signs and symptoms include a fever, fatigue, weight loss, malaise, and hepatosplenomegaly.
Non-Hodgkin’s lymphoma initially produces erythematous patches with some scaling that later become interspersed with nodules. Pruritus and discomfort are common; later, tumors and ulcers form. Progression produces nontender lymphadenopathy.
Parapsoriasis (chronic)
Parapsoriasis produces small or moderate-sized maculopapular, erythematous eruptions, with a thin, adherent scale on the trunk, hands, and feet. Removal of the scale reveals a shiny brown surface.
Pityriasis
Pityriasis rosea, an acute, benign, and self-limiting disorder, produces widespread scales. It begins with an erythematous, raised, oval herald patch anywhere on the body. A few days or weeks later, yellow-tan or erythematous patches with scaly edges erupt on the trunk and limbs and sometimes on the face, hands, and feet. Pruritus also occurs.
Pityriasis rubra pilaris, an uncommon disorder, initially produces seborrheic scaling on the scalp, progressing to the face and ears. Later, scaly red patches develop on the palms and soles, becoming diffuse, thick, fissured, hyperkeratotic, and painful. Lesions also appear on the hands, fingers, wrists, and forearms and then on wide areas of the trunk, neck, and limbs.
Psoriasis
Silvery white, micaceous scales cover erythematous plaques that have sharply defined borders. Psoriasis usually appears on the scalp, chest, elbows, knees, back, buttocks, and genitalia. Associated signs and symptoms include nail pitting, pruritus, arthritis, and sometimes pain from dry, cracked, encrusted lesions.
Systemic lupus erythematosus (SLE)
SLE produces a bright-red maculopapular eruption, sometimes with scaling. Patches are sharply defined and involve the nose and malar regions of the face in a butterfly pattern — a primary sign. Similar characteristic rashes appear on other body surfaces; scaling occurs along the lower lip or anterior hair line. Other primary signs and symptoms include photosensitivity and joint pain and stiffness. Vasculitis (leading to infarctive lesions, necrotic leg ulcers, or digital gangrene), Raynaud’s phenomenon, patchy alopecia, and mucous membrane ulcers can also occur.
Tinea versicolor
Tinea versicolor is a benign fungal skin infection that typically produces macular hypopigmented, fawn-colored, or brown patches of varying sizes and shapes. All are slightly scaly. Lesions commonly affect the upper trunk, arms, and lower abdomen; sometimes the neck; and, rarely, the face.
Other causes
Drugs
Many drugs — including penicillins, sulfonamides, barbiturates, quinidine, diazepam, phenytoin, and isoniazid — can produce scaling patches.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Squamous cell carcinoma:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Predisposing factors associated with squamous cell carcinoma include overexposure to the sun's ultraviolet rays, the presence of premalignant lesions (such as actinic keratosis or Bowen's disease), X-ray therapy, ingestion of herbicides containing arsenic, chronic skin irritation and inflammation, exposure to local carcinogens (such as tar and oil), and hereditary diseases (such as xeroderma pigmentosum and albinism). (See Premalignant skin lesions.) Rarely, squamous cell carcinoma may develop on the site of smallpox vaccination, psoriasis, or chronic discoid lupus erythematosus.
Squamous cell carcinoma usually occurs in fair-skinned white males older than age 60. Outdoor employment and residence in a sunny, warm climate (southwestern United States and Australia, for example) greatly increase the risk of developing squamous cell carcinoma.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Skin, scaly:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Bowen’s disease
This common form of intraepidermal carcinoma causes painless, erythematous plaques that are raised and indurated with a thick, hyperkeratotic scale and, possibly, ulcerated centers.
Dermatitis
Exfoliative dermatitis begins with rapidly developing generalized erythema. Desquamation with fine scales or thick sheets of all or most of the skin surface may cause life-threatening hypothermia. Other possible complications include cardiac output failure and septicemia. Systemic signs and symptoms include low-grade fever, chills, malaise, lymphadenopathy, and gynecomastia.
With nummular dermatitis, round, pustular lesions commonly ooze purulent exudate, itch severely, and rapidly become encrusted and scaly. Lesions appear on the extensor surfaces of the limbs, posterior trunk, and buttocks.
Seborrheic dermatitis begins with erythematous, scaly papules that progress to larger, dry or moist, greasy scales with yellowish crusts. This disorder primarily involves the center of the face, the chest and scalp and, possibly, the genitalia, axillae, and perianal regions. Pruritus occurs with scaling.
Dermatophytosis
Tinea capitis produces lesions with reddened, slightly elevated borders and a central area of dense scaling; these lesions may become inflamed and pus-filled (kerions). Patchy alopecia and itching may also occur. Tinea pedis causes scaling and blisters between the toes. The squamous type produces diffuse, fine, branlike scales. Adherent and silvery white, they’re most prominent in skin creases and may affect the entire dorsum of the foot. Tinea corporis produces crusty lesions. As they enlarge, their centers heal, causing the classic ringworm shape.
Discoid lupus erythematosus
This cutaneous form of lupus may occur without systemic signs and symptoms. Separate or coalescing lesions (macules, papules, or plaques), ranging from pink to purple, are covered with a yellow or brown crust. Enlarged hair follicles are filled with scales, and telangiectasia may be present. After this inflammatory stage, the lesions heal and hypopigmentation or hyperpigmentation and noncontractile scarring and atrophy may occur. Discoid lupus commonly involves the face or sun-exposed areas of the neck, ears, scalp, lips, and oral mucosa. Alopecia may also occur.
Lichen planus
With this disorder, small, flat, violet lesions with a fine scale and gray lines on the surface usually affect the lumbar region, genitalia, wrists, ankles, and anterior lower legs.
Lymphoma
Hodgkin’s disease and non-Hodgkin’s lymphoma commonly cause scaly rashes. Hodgkin’s disease may cause pruritic scaling dermatitis that begins in the legs and spreads to the entire body. Remissions and recurrences are common. Small nodules and diffuse pigmentation are related signs. This disease typically produces painless enlargement of the peripheral lymph nodes. Other signs and symptoms include fever, fatigue, weight loss, malaise, and hepatosplenomegaly.
Non-Hodgkin’s lymphoma initially produces erythematous patches with some scaling that later become interspersed with nodules. Pruritus and discomfort are common; later, tumors and ulcers form. Progression produces nontender lymphadenopathy.
Parapsoriasis (chronic)
This disorder produces small or moderate-sized maculopapular, erythematous eruption, with a thin, adherent scale on the trunk, hands, and feet. Removal of the scale reveals a shiny brown surface.
Pityriasis
Pityriasis rosea, an acute, benign, and self-limiting disorder, produces widespread scales. It begins with an erythematous, raised, oval herald patch anywhere on the body. A few days or weeks later, yellow-tan or erythematous patches with scaly edges erupt on the trunk and limbs and sometimes on the face, hands, and feet. Pruritus also occurs.
Pityriasis rubra pilaris, an uncommon disorder, initially produces seborrheic scaling on the scalp, progressing to the face and ears. Later, scaly red patches develop on the palms and soles, becoming diffuse, thick, fissured, hyperkeratotic, and painful. Lesions also appear on the hands, fingers, wrists, and forearms and then on wide areas of the trunk, neck, and limbs.
Psoriasis
Silvery white, micaceous scales cover erythematous plaques that have sharply defined borders. Psoriasis usually appears on the scalp, chest, elbows, knees, back, buttocks, and genitalia. Associated signs and symptoms include nail pitting, pruritus, arthritis, and sometimes pain from dry, cracked, encrusted lesions.
Syphilis (secondary)
Papulosquamous, slightly scaly eruptions characterize this disorder. A ring-shaped pattern of copper-red papules usually forms on the face, arms, palms, soles, chest, back, and abdomen. Annular papules may occur. Systemic findings include lymphadenopathy, malaise, weight loss, anorexia, nausea, vomiting, headache, sore throat, and low-grade fever.
Systemic lupus erythematosus
This disorder produces a bright-red maculopapular eruption, sometimes with scaling. Patches are sharply defined and involve the nose and malar regions of the face in a butterfly pattern—a primary sign. Similar characteristic rashes appear on other body surfaces; scaling occurs along the lower lip or anterior hair line. Other primary signs and symptoms include photosensitivity and joint pain and stiffness. Vasculitis (leading to infarctive lesions, necrotic leg ulcers, or digital gangrene), Raynaud’s phenomenon, patchy alopecia, and mucous membrane ulcers also can occur.
Tinea versicolor
This benign fungal skin infection typically produces macular hypopigmented, fawn-colored, or brown patches of varying sizes and shapes. All are slightly scaly. Lesions commonly affect the upper trunk, arms, and lower abdomen, sometimes the neck and, rarely, the face.
Other causes
Drugs
Many drugs—including penicillins, sulfonamides, barbiturates, quinidine, diazepam, phenytoin, and isoniazid—can produce scaling patches.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Squamous cell carcinoma:
Causes
(Handbook of Diseases)
Predisposing factors associated with squamous cell carcinoma include overexposure to the sun’s ultraviolet rays and the presence of premalignant lesions (such as actinic keratosis or Bowen’s disease).
Other predisposing factors include X-ray therapy, ingestion of herbicides containing arsenic, chronic skin irritation and inflammation, burns or scars, exposure to local carcinogens (such as tar and oil), and hereditary diseases (such as xeroderma pigmentosum and albinism). Rarely, squamous cell carcinoma may develop on the site of smallpox vaccination, psoriasis, or chronic discoid lupus erythematosus.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Skin, scaly:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Bowen’s disease
Bowen’s disease, a common form of intraepidermal carcinoma, causes painless, erythematous plaques that are raised and indurated with a thick, hyperkeratotic scale and, possibly, ulcerated centers. The head and neck are the most commonly affected sites.
Dermatitis
Exfoliative dermatitis begins with rapidly developing generalized erythema. Desquamation with fine scales or thick sheets of all or most of the skin surface may cause life-threatening hypothermia. Other possible complications include cardiac output failure and septicemia. Systemic signs and symptoms include low-grade fever, chills, malaise, lymphadenopathy, and gynecomastia.
With nummular dermatitis, round, pustular lesions commonly ooze purulent exudate, itch severely, and rapidly become encrusted and scaly. Lesions appear on the extensor surfaces of the limbs, posterior trunk, and buttocks.
Seborrheic dermatitis begins with erythematous, scaly papules that progress to larger, dry or moist, greasy scales with yellowish crusts. This disorder primarily involves the center of the face, the chest and scalp and, possibly, the genitalia, axillae, and perianal regions. Pruritus occurs with scaling.
Dermatophytosis
Tinea capitis produces lesions with reddened, slightly elevated borders and a central area of dense scaling; these lesions may become inflamed and pus-filled (kerions). Patchy alopecia and itching may also occur. Tinea pedis causes scaling and blisters between the toes. The squamous type produces diffuse, fine, branlike scales. Adherent and silvery white, they’re most prominent in skin creases and may affect the entire dorsum of the foot. Tinea corporis produces crusty lesions. As they enlarge, their centers heal, causing the classic ringworm shape.
Discoid lupus erythematosus
Discoid lupus erythematosus is a cutaneous form of lupus that may occur without systemic signs and symptoms. Separate or coalescing lesions (macules, papules, or plaques), ranging from pink to purple, are covered with a yellow or brown crust. Enlarged hair follicles are filled with scales, and telangiectasia may be present. After this inflammatory stage, the lesions heal and hypopigmentation or hyperpigmentation and noncontractile scarring and atrophy may occur. Discoid lupus commonly involves the face or sun-exposed areas of the neck, ears, scalp, lips, and oral mucosa. Alopecia may also occur.
Lymphoma
Hodgkin’s disease and non-Hodgkin’s lymphoma commonly cause scaly rashes. Hodgkin’s disease may cause pruritic scaling dermatitis that begins in the legs and spreads to the entire body. Remissions and recurrences are common. Small nodules and diffuse pigmentation are related signs. This disease typically produces painless enlargement of the peripheral lymph nodes. Other signs and symptoms include fever, fatigue, weight loss, malaise, and hepatosplenomegaly.
Non-Hodgkin’s lymphoma initially produces erythematous patches with some scaling that later become interspersed with nodules. Pruritus and discomfort are common; later, tumors and ulcers form. Progression produces nontender lymphadenopathy.
Pityriasis rosea
Pityriasis rosea, an acute, benign, and self-limiting disorder, produces widespread scales. It begins with an erythematous, raised, oval herald patch anywhere on the body. A few days or weeks later, yellow-tan or erythematous patches with scaly edges erupt on the trunk and limbs and sometimes on the face, hands, and feet. Pruritus also occurs.
Psoriasis
Silvery white, micaceous scales cover erythematous plaques that have sharply defined borders. Psoriasis usually appears on the scalp, chest, elbows, knees, back, buttocks, and genitalia. Associated signs and symptoms include nail pitting, pruritus, arthritis, and sometimes pain from dry, cracked, encrusted lesions.
Syphilis (secondary)
Papulosquamous, slightly scaly eruptions characterize secondary syphilis. A ring-shaped pattern of copper-red papules usually forms on the face, arms, palms, soles, chest, back, and abdomen. Annular papules may occur. Systemic findings include lymphadenopathy, malaise, weight loss, anorexia, nausea, vomiting, headache, sore throat, and low-grade fever.
Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) produces a bright-red maculopapular eruption, sometimes with scaling. Patches are sharply defined and involve the nose and malar regions of the face in a butterfly pattern — a primary sign. Similar characteristic rashes appear on other body surfaces; scaling occurs along the lower lip or anterior hair line. Other primary signs and symptoms include photosensitivity and joint pain and stiffness. Vasculitis (leading to infarctive lesions, necrotic leg ulcers, or digital gangrene), Raynaud’s phenomenon, patchy alopecia, and mucous membrane ulcers also can occur.
Tinea versicolor
Tinea versicolor, a benign fungal skin infection, typically produces macular hypopigmented, fawn-colored, or brown patches of varying sizes and shapes. All are slightly scaly. Lesions commonly affect the upper trunk, arms, and lower abdomen, sometimes the neck and, rarely, the face.
Other causes
Drugs
Many drugs — including penicillins, sulfonamides, barbiturates, quinidine, diazepam, phenytoin, and isoniazid — can produce scaling patches.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Intoeing and Outtoeing:
Principal Causes of Intoeing and Outtoeing
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
- Intoeing
- Foot
- Metatarsusadductus
- Talipes equinovarus (clubfoot)
- Imbalance of abductor and adductormuscles of the great toe
- Knee and leg
- Internal tibial torsion
- Bow legs (genu varum)
- Physiologicbowing
- Rickets
- Blount disease
- Knock knees (genu valgum)
- Hip
- Increased femoral anteversion
- Outtoeing
- Foot
- Calcaneovalgus foot
- Spasticity
- Hypermobile pes planus
- Knee and leg
- External tibial torsion
- Hip
- Femoral retroversion
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Skin, scaly:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Bowen's disease.Bowen's disease causes painless, erythematous plaques that are raised and indurated with a thick, hyperkeratotic scale and, possibly, ulcerated centers.
Dermatitis.Exfoliative dermatitis begins with rapidly developing generalized erythema. Desquamation with fine scales or thick sheets of all or most of the skin surface may cause life-threatening hypothermia. Other possible complications include cardiac output failure and septicemia. Systemic signs and symptoms include a low-grade fever, chills, malaise, lymphadenopathy, and gynecomastia.
With nummular dermatitis, round, pustular lesions commonly ooze purulent exudate, itch severely, and rapidly become encrusted and scaly. Lesions appear on the extensor surfaces of the limbs, posterior trunk, and buttocks.
Seborrheic dermatitis begins with erythematous, scaly papules that progress to larger, dry or moist, greasy scales with yellowish crusts. This disorder primarily involves the center of the face, the chest and scalp and, possibly, the genitalia, axillae, and perianal regions. Pruritus occurs with scaling.
Dermatophytosis.Tinea capitis produces lesions with reddened, slightly elevated borders and a central area of dense scaling; these lesions may become inflamed and pus-filled (kerions). Patchy alopecia and itching may also occur. Tinea pedis causes scaling and blisters between the toes. The squamous type produces diffuse, fine, branlike scales. Adherent and silvery white, they're most prominent in skin creases and may affect the entire dorsum of the foot. Tinea corporis produces crusty lesions. As they enlarge, their centers heal, causing the classic ringworm shape.
Lymphoma.Hodgkin's disease and non-Hodgkin's lymphoma commonly cause scaly rashes. Hodgkin's disease may cause pruritic scaling dermatitis that begins in the legs and spreads to the entire body. Remissions and recurrences are common. Small nodules and diffuse pigmentation are related signs. This disease typically produces painless enlargement of the peripheral lymph nodes. Other signs and symptoms include fever, fatigue, weight loss, malaise, and hepatosplenomegaly.
Non-Hodgkin's lymphoma initially produces erythematous patches with some scaling that later become interspersed with nodules. Pruritus and discomfort are common; later, tumors and ulcers form. Progression produces nontender lymphadenopathy.
Parapsoriasis (chronic).Parapsoriasisproduces small or moderate-sized maculopapular, erythematous eruptions, with a thin, adherent scale on the trunk, hands, and feet. Removal of the scale reveals a shiny brown surface.
Pityriasis.Pityriasis rosea, an acute, benign, and self-limiting disorder, produces widespread scales. It begins with an erythematous, raised, oval herald patch anywhere on the body. A few days or weeks later, yellow-tan or erythematous patches with scaly edges erupt on the trunk and limbs and sometimes on the face, hands, and feet. Pruritus also occurs.
Pityriasis rubra pilaris, an uncommon disorder, initially produces seborrheic scaling on the scalp, progressing to the face and ears. Later, scaly red patches develop on the palms and soles, becoming diffuse, thick, fissured, hyperkeratotic, and painful. Lesions also appear on the hands, fingers, wrists, and forearms and then on wide areas of the trunk, neck, and limbs.
Psoriasis.Silvery white, micaceous scales cover erythematous plaques that have sharply defined borders. Psoriasis usually appears on the scalp, chest, elbows, knees, back, buttocks, and genitalia. Associated signs and symptoms include nail pitting, pruritus, arthritis, and sometimes pain from dry, cracked, encrusted lesions.
Systemic lupus erythematosus (SLE).SLE produces a bright-red maculopapular eruption, sometimes with scaling. Patches are sharply defined and involve the nose and malar regions of the face in a butterfly pattern—a primary sign. Similar characteristic rashes appear on other body surfaces; scaling occurs along the lower lip or anterior hair line. Other primary signs and symptoms include photosensitivity and joint pain and stiffness. Vasculitis (leading to infarctive lesions, necrotic leg ulcers, or digital gangrene), Raynaud's phenomenon, patchy alopecia, and mucous membrane ulcers can also occur.
Tinea versicolor.Tinea versicolor typically produces macular hypopigmented, fawn-colored, or brown patches of varying sizes and shapes. All are slightly scaly. Lesions commonly affect the upper trunk, arms, and lower abdomen; sometimes the neck; and, rarely, the face.
Other causes
Drugs.Many drugs—including penicillins, sulfonamides, barbiturates, quinidine, diazepam, phenytoin, and isoniazid—can produce scaling patches.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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