Chapter 21 The Skin and Neurologic Disease Orest Hurko Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-1 Neurofibromatosis type 1: axillary freckling—a cluster of freckle-sized café- au-lait macules. (From Kurlemann G: Neurocutaneous syndromes. Handb Clin Neurol 108:513, 2012, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-2 Tuberous sclerosis: ash leaf spot in Wood light. (From Kurlemann G: Neurocutaneous syndromes. Handb Clin Neurol 108:513, 2012, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-3 Tuberous sclerosis: ash leaf spot and shagreen patch. (From Kurlemann G: Neurocutaneous syndromes. Handb Clin Neurol 108:513, 2012, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-4 Tuberous sclerosis: nail-fold fibroma. (From Kurlemann G: Neurocutaneous syndromes. Handb Clin Neurol 108:513, 2012.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-5 Neurocutaneous melanosis. (From Jones, K: Smith’s Recognizable Patterns of Human Malformation. Saunders, Philadelphia, 2005, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-6 Early cutaneous lesions of meningococcemia. (From Tyring S, Lupi O, Hengge U: Tropical Dermatology. Courtesy of Dr. Luc Van Kaer. Churchill Livingstone, New York, 2005, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-7 Large 5-cm targetoid patch with central clearing, bright-red expanding border and central bite inflammation, characteristic of the erythema migrans rash of Lyme disease. (From Habif T, Campbell J, Chapman MS, et al: Dermatology DDX Deck. Saunders, Philadelphia, 2006, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-8 Secondary syphilis: disseminated papular lesions. (From Tyring S, Lupi O, Hengge U: Tropical Dermatology. Courtesy of Dr. Luc Van Kaer. Churchill Livingstone, New York, 2005, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-9 Secondary syphilis: hyperkeratotic lesions on palms and soles. (From Tyring S, Lupi O, Hengge U: Tropical Dermatology. Courtesy of Dr. Luc Van Kaer. Churchill Livingstone, New York, 2005, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-10 Systemic lupus erythematosus. (From Callen J, Jorizzo J, Bolognia J, et al: Dermatological Signs of Internal Disease. Saunders, Philadelphia, 2009, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-11 Small petechiae in an individual with thrombocytopenia. (From Callen J, Jorizzo J, Bolognia J, et al: Dermatological Signs of Internal Disease. Saunders, Philadelphia, 2009, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-12 Sturge–Weber syndrome: port-wine stain. (From Jones K: Smith’s Recognizable Patterns of Human Malformation. Saunders, Philadelphia, 2005, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-13 Incontinentia pigmenti (Bloch–Sulzberger) stage 3: the beginning of hyperpigmentation. (From Kurlemann G: Neurocutaneous syndromes. Handb Clin Neurol 108:513, 2012, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-14 Incontinentia pigmenti (Bloch–Sulzberger) stage 4: hypopigmentation on the trunk. (From Kurlemann G: Neurocutaneous syndromes. Handb Clin Neurol 108:513, 2012, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-15 Linear nevus sebaceous above the left eye near the hairline in Schimmelpenning–Feuerstein–Mims syndrome. (From Kurlemann G: Neurocutaneous syndromes. Handb Clin Neurol 108:513, 2012, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-16 Ataxia-telangiectasia: bulbar conjunctiva. (From Jones K: Smith’s Recognizable Patterns of Human Malformation. Saunders, Philadelphia, 2005, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-17 Infiltrated nodules of the forehead and face resulting in the leonine facies of lepromatous leprosy. (From Peters W, Pasvol G: Atlas of Tropical Medicine and Parasitology. 6th Ed. Mosby, St Louis, 2007, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-18 Cutaneous small-vessel vasculitis was the first evidence of recurrence in this patient with Wegener’s granulomatosis. (From Callen J, Jorizzo J, Bolognia J, et al: Dermatological Signs of Internal Disease. Saunders, Philadelphia, 2009, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.

Copyright © 2014 Elsevier Inc. All rights reserved. Figure 21-19 Characteristic heliotrope rash of dermatomyositis on the eyelids. (From Habif T, Campbell J, Chapman MS, et al: Dermatology DDX Deck. Saunders, Philadelphia, 2006, with permission.) Copyright © 2014 Elsevier Inc. All rights reserved.