Skin of Color Image Atlas

Topics

Adnexal Neoplasms
Allergic Contact Dermatitis
Amyloidosis
Bullous Disorders
Cutaneous Vasculitis
Drug/Vaccine Reactions
Fibrous and Fibrohistiocytic Proliferations of the Skin and Tendons
Genetic Basis of Cutaneous Disease
Hair/Nail Disorders
Human Herpes Viruses
Infectious/Bacterial Disease
Inflammatory
Mycobacterial Infections
Other - Lymphoproliferative and Myeloproliferative Disease
Neoplasms - Benign
Neoplasms- Malignant
Other - Genodermatoses
Pigment Alteration
Systemic Sclerosis (Scleroderma) and Related Disorders
Vascular

Adnexal Neoplasms

Allergic Contact Dermatitis

Perioral and periorbital edema and erythema before patch testing. Perioral and periorbital edema and erythema in allergic contact dermatitis
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Significant improvement in dermatitis, including the oral and perioral areas, after dye avoidance. Improved allergic contact dermatitis after irritant avoidance
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Amyloidosis

Patchy alopecia involving the majority of the scalp but sparing the mid-lower portion of the occipital scalp. Plasma cell dyscrasia
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Bullous Disorders

Bullous eruptions. Fig 2. Bullous eruptions. Scattered tense bullae and large ulcerations on the trunk with surrounding erythematous to hyperpigmented patches in patient taking a programmed cell death 1 inhibitor. The biopsy specimen revealed subepidermal bullae with eosinophils and direct immunofluorescence revealed linear anti-C3 and anti-immunoglobulin G antibodies along the dermoepidermal junction. He was treated with rituximab at lymphoma protocol dosing for 1 cucle and 500 mg twice daily mycophenolate mofetil and a super potent topical steroid ointment with resolution of bullae.
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Pruritus. Fig 4. Pruritus. Large, hyperpigmented patches on the trunk with overlying excoriations and hypopigmented scars in patient with severe pruritus caused by therapy with a programmed cell death 1 inhibitor. He responded well to pregabalin 25 mg daily.
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Tense blisters in a previously healthy young woman Bullous systemic lupus Erythematosus (BSLE)
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Cutaneous Vasculitis

Multiple nodules on the bilateral aspect of the upper extremities Erythema elevatum diutinum
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Drug/Vaccine Reactions

Brentuximab vedotin�induced drug reaction with eosinophilia and systemic symptoms. Brentuximab vedotin–induced drug reaction with eosinophilia and systemic symptoms
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Brentuximab vedotin�induced drug reaction with eosinophilia and systemic symptoms. Brentuximab vedotin–induced drug reaction with eosinophilia and systemic symptoms
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Cutaneous purpuric lesions after the first continuous erythropoietin receptor activator injection. Cutaneous purpuric lesions after the first continuous erythropoietin receptor activator injection - Diffuse erythematous-to-violaceous purpura on the legs of the patient
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Recurrent purpura after the second continuous erythropoietin receptor activator injection. Recurrent purpura after the second continuous erythropoietin receptor activator injection - worsened purpuric lesions on the extremities
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A, Disseminated verrucae: multiple pink to skin-colored papules in a scattered distribution over the bilateral lower extremities. B, Patient after 3 PDT cycles: significant improvement in the number and size of verrucous lesions. A, Disseminated verrucae: multiple pink to skin-colored papules in a scattered distribution over the bilateral lower extremities. B, Patient after 3 photodynamic therapy cycles: significant imprpovement in the number and size of verrucous lesions
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Clinical images on the day of admission to the hospital. Janssen Ad26.COV2.S vaccination- induced cutaneous small vessel vasculitis, initial
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Clinical response to systemic corticosteroids. Janssen Ad26.COV2.S vaccination- induced cutaneous small vessel vasculitis, initial
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The patient had well-demarcated, erythematous, psoriasiform plaques Lenvatinib-induced psoriasiform eruption
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Round ulcers with erythematous borders and collarettes of scale on the lower extremities. Methotrexate-induced cutaneous ulceration
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Resolving ulcers of the lower extremity at the 4-week follow-up. Methotrexate-induced cutaneous ulceration, resolving
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Mogamulizumab-associated rash. Mogamulizumab-associated rash, initial eruption
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Example of acute vulvar Steven-Johnson syndrome and toxic epidermal necrolysis overlap. Steven-Johnson syndrome/toxic epidermal necrolysis
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Fibrous and Fibrohistiocytic Proliferations of the Skin and Tendons

A swollen thumb Giant Cell Tumor of the Tendon Sheath (GCTTS)
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Genetic Basis of Cutaneous Disease

Bottom right canine tooth, hypoplastic with conical shape. Bottom right canine tooth, hypoplastic with conical shape.
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Hair/Nail Disorders

Pediatric scleroderma en coup de sabre presenting in a patient with skin of color. Central centrifugal cicatricial alopecia
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Improvement of central centrifugal cicatricial alopecia after application of topical metformin in case 2. Central centrifugal cicatricial alopecia
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Lipedematous alopecia. Lipedematous alopecia
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Compressibility of the scalp showing edema. Lipedematous alopecia
Compressibility of the scalp showing edema
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Frontal fibrosing alopecia. A, Extensive hairline recession. Frontal fibrosing alopecia is unusual in individuals of African descent. Note the loss of the eyebrows. B, Discrete frontal fibrosing alopecia. Note the loss of the eyebrows. C, Inflammatory frontal fibrosing alopecia. Primary Cicatricial Alopecia - Frontal fibrosing alopecia with extensive hairline recession
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Black pigmentation of the fingernails on the right hand. Total melanonychia of the fingernails on the right hand
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Total melanonychia of the toenails. Total melanonychia of the toenails
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Marked improvement of the hyperpigmentation after 3 months of treatment. Improved hyperpigmentation of total melanonychia after 3 months treatment with cyanocobalamin, pyridoxine and thiamine
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Whorled pattern of hypopigmentation and alopecia or vellus hairs on the scalp. Whorled pattern of hypopigmentation and alopecia or vellus hairs on the scalp.
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Widespread alopecia arerata of the scalp 4 months after denosumab injection. Widespread alopecia arerata of the scalp 4 months after denosumab injection. B, Hair growth 11 months after denosumab injection.
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Human Herpesviruses

Verrucous herpes simplex virus (HSV) infection. Verrucous herpes simplex virus (HSV) infection, initial
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Verrucous herpes simplex virus (HSV) infection. Verrucous herpes simplex virus (HSV) infection, 14-days later
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Verrucous herpes simplex virus (HSV) infection. Verrucous herpes simplex virus (HSV) infection, 28-days later
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Infectious/Bacterial Disease

Tinea Cutaneous complication of skin-lightening agents
Tinea
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Erythrasma of the lower abdomen and medial aspect of thighs in a hospitalized preoperative patient with chronic hidradenitis suppurativa. Erythrasma of the lower abdomen and medial thighs
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Erythrasma and active hidradenitis suppurativa. Erythrasma and active hidradenitis suppurativa
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Erythrasma of the lower abdomen and inguinal folds in a patient with erosive hidradenitis suppurativa. Erythrasma in erosive hidradenitis suppurativa
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Erythrasma of the axillae in a patient with chronic hidradenitis suppurativa. Erythrasma of the axilla in a patient with chronic hidradenitis suppurativa
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Herpes zoster duplex symmetricus. A 6-year-old boy with a symmetric distribution of erythematous grouped vesicles and crusts on his back at the bilateral T2 to T4 dermatomes. Herpes zoster duplex symmetricus. A 6-year-old boy with a symmetric distribution of erythematous grouped vesicles and crusts on his back at the bilateral T2 to T4 dermatomes.
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Periorbital hyperpigmentation and mildly erythematous eczematous patches. Microblading-induced preseptal cellulitis - Periorbital hyperpigmentation and mildly erythematous eczematous patches
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Multibacillary leprosy. Ear edema. Multibacillary leprosy. Ear edema.
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Multibacillary leprosy. Swelling of the hands. Multibacillary leprosy. Swelling of the hands.
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Well-demarcated, violaceous, hypertrophic, erosive plaques on the posterior calves (A) and dorsal feet (B). Necrolytic acral erythema
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Papular purpuric gloves and socks-distributed eruption. Papular purpuric gloves and socks syndrome- violaceous papules coalescing into plaques on the dorsal aspects of the hands
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One-centimeter flesh-colored nodule at the left thigh adjacent to the knee. Pleurostomophora richardsiae fungal infection
One-centimeter flesh-colored nodule at the left thigh adjacent to the knee
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eroded plaque on the left side of the neck with ulceration and sharply demarcated angular borders Postherpetic neuralgic ulcer, initial
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Photograph from October 2020 displayed a 6 � 1-cm ulcer. Postherpetic neuralgic ulcer, 7 months of treatment
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Photograph from March 2021 displayed a resolved, epithelialized ulcer. Postherpetic neuralgic ulcer, resolved
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Verrucous ulcerative plaques in an immunocompetent Hispanic man Verrucous Ulcerative Plaques
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Inflammatory

The cutaneous findings noted in patient A, at the time of clinical presentation. Pernio-like eruption associated with COVID-19
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The cutaneous findings noted in patient B, at the time of clinical presentation. Pernio-like eruption associated with COVID-19
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The cutaneous findings noted in patient C, at the time of clinical presentation. Pernio-like eruption associated with COVID-19
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The cutaneous findings noted in patient D, at the time of clinical presentation. Pernio-like eruption associated with COVID-19
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The cutaneous findings noted in patient E, at the time of clinical presentation. Pernio-like eruption associated with COVID-19
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The cutaneous findings noted in patient F, at the time of clinical presentation. Pernio-like eruption associated with COVID-19
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The cutaneous findings noted in patient G, at the time of clinical presentation. Pernio-like eruption associated with COVID-19
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Pediatric scleroderma en coup de sabre presenting in a patient with skin of color. Scleroderma en coup de sabre
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Patient 1, an African man, age 49 years, with a lesion of less than 2.5 cm vertical width in the upper half of the nuchal area. Acne Keloidalis Nuchae
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Patient 1 one year after AKN excision with trichophytic closure. The scar is still thin and well camouflaged. One year post Acne Keloidalis Nuchae Excision with Trichophytic Closure
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Patient 2 after application of tension sutures that are padded with povidone-iodine�soaked gauze pads. Acne Keloidalis Nuchae after excision with tension suture application and trichophytic closure
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Patient 2 at 4 months. The scar is thin, with hair growing through to camouflage it. Residual AKN was treated with clobetasol solution. Acne Keloidalis Nuchae 4 months post excision with tension suture application and trichophytic closure
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Atopic dermatitis on the neck Atopic dermatitis on the neck
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Atopic dermatitis inside the elbow Atopic dermatitis inside the elbows
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Case 1: bullous erythema multiforme. Bullous erythema multiforme
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Patient examination finding. Cutaneous sarcoidosis of scalp – imitating acne keloidalis nuchae (AKN)
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Erythema of rosacea on Asian skin. Erythema of rosacea on Asian skin
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Erythema and papules and pustules of rosacea on Latin American skin. Erythema and papules and pustules on rosacea of Latin American skin
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Clinical presentation at week 0 of risankizumab therapy demonstrating inflamed inguinal nodules, draining tunnels, and significant scarring. Hurley stage 2 hidradenitis suppurativa
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Ill-defined, erythematous to hyperpigmented thin plaques over the (A) anterior and (B) posterior aspects of the trunk. IgG4-related skin disease
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Lupus erythematosus tumidus: hundreds of hypopigmented soft nodules on the back of this 54-year-old black man. Lupus Erythematosus Tumidus
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Patient with oral involvement of morphea. Morphea, oral involvement with reduced oral aperture
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Nasal extranodal natural killer (NK)/T-cell lymphoma (ENKTL). Diffuse centrofacial edema, ulceration of the right alar groove. Nasal extranodal natural killer (NK)/T-cell lymphoma (ENKTL). Diffuse centrofacial edema, ulceration of the right alar groove.
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Nasal extranodal natural killer (NK)/T-cell lymphoma (ENKTL). Necrosis of soft palate. Nasal extranodal natural killer (NK)/T-cell lymphoma (ENKTL). Necrosis of soft palate.
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Numerous erythematous eroded papules and plaques on the back (A), vertex of scalp (B), and left breast (C). Numerous erythematous eroded papules and plaques on the back (A), vertex of scalp (B), and left breast (C).
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Palmoplantar psoriasis. Left sole of the patient before her first treatment. Large, hyperpigmented lichenified plaque extending from the distal midplantar part of the foot to the proximal midplantar part of the foot with significant scale. Palmoplantar psoriasis. Left sole of the patient before her first treatment. Large, hyperpigmented lichenified plaque extending from the distal midplantar part of the foot to the proximal midplantar part of the foot with significant scale.
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Palmoplantar psoriasis. Four weeks after the first treatment wit hthe 40% TCA peel and gentian violet application. The patient noted a significant improvement of the scale, itch, and redness of her soles. Residual postinflammatory hyperpigmentation was noted. Palmoplantar psoriasis. Four weeks after the first treatment wit hthe 40% TCA peel and gentian violet application. The patient noted a significant improvement of the scale, itch, and redness of her soles. Residual postinflammatory hyperpigmentation was noted.
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Palmoplantar psoriasis. Four weeks after the second treatment with TCA 40% and gential violet. The patient reports continued improvement of her itch, scaling, and redness. Lichenified plaques of the posterior parts of the soles, which were previous confluent, were starting to resolve. Residual postinflammatory hyperpigmentation is still observed. Palmoplantar psoriasis. Four weeks after the second treatment with TCA 40% and gential violet. The patient reports continued improvement of her itch, scaling, and redness. Lichenified plaques of the posterior parts of the soles, which were previous confluent, were starting to resolve. Residual postinflammatory hyperpigmentation is still observed.
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Erythroderma and Annular Pustular Plaques Pemphigus foliaceus
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The cutaneous findings noted in patient G, at the time of clinical presentation. Pernio-like eruption associated with COVID-19
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Phymatous changes of rosacea on African skin. Phymatous changes of rosacea on African skin
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Left hand and forearm of 7-year-old Asian girl with pityriasis rubra pilaris at her initial appointment (A) and at week 8 of ustekinumab therapy (B). Patient's parents declined full-body photographs. By week 4 of treatment, patient was clear of generalized erythema. By week 8, hyperkeratotic plaques of the hands had resolved. Pityriasis Rubra Pilaris – Initial appointment (A) and week 8 of ustekinumab therapy (B)
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Purpuric macules and papules overlying the lower extremities bilaterally. Purpuric macules and papules overlying the lower extremities bilaterally.
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Cutaneous pyoderma gangrenosum eruption of the lower leg during extracutaneous pulmonary flare. Pyoderma gangrenosum
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Scaly polygonal lichenoid papule on the right wrist. Scaly polygonal lichenoid papule on the right wrist.
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Mycobacterial Infections

Other - Lymphoproliferative and Myeloproliferative Disease

Cutaneous lesions in patients with hydroa vacciniforme-like lymphoma. Hydroa vacciniforme-like lymphoma
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Neoplasms - Benign

Extra-mammary Paget disease (EMPD). A 2 x 2 cm well-demarcated, smooth, slightly hypopigmented-to-pinkish patch in the lower one-third of the left labium majus without any surface change or underlying induration. Extra-mammary Paget disease (EMPD). A 2 x 2 cm well-demarcated, smooth, slightly hypopigmented-to-pinkish patch in the lower one-third of the left labium majus without any surface change or underlying induration.
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Clinical findings at baseline. Multiple, discrete, well-circumscribed, smooth, somewhat flat-topped, erythematous-to-violaceous papules on the bilateral dorsal hands. Multinucleate cell angiohistiocytoma
Clinical findings at baseline. Multiple, discrete, well-circumscribed, smooth, somewhat flat-topped, erythematous-to-violaceous papules on the bilateral dorsal hands
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Clinical findings at 8-month follow-up. Significant reduction in the induration and discoloration of MCAH after KTP laser. Multinucleate cell angiohistiocytoma
Clinical findings at 8-month follow-up. Significant reduction in the induration and discoloration of multinucleate cell angiohistiocytoma after potassium-titanyl-phosphate laser
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Neoplasms- Malignant

A 4-mm hypopigmented papule (circled) Muir-Torre Syndrome
A 4-mm hypopigmented papule (circled)
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A 0.5- � 0.3-cm hyperpigmented, verrucous papule on the dorsal penile shaft. Penile Basal Cell Carcinoma
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Periungual SCC Periungual squamous cell carcinoma. Initial presentation as a scaly hyperpigmented papule at the base of the nail plate with longitudinal melanonychia and nail dystrophy
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Postoperative result Periungual squamous cell carcinoma. Postoperative result. Larger image shows immediate postoperative defect, and inset image shows the well-healed defect 3 years postoperatively without evidence of recurrence
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A tender pigmented papule in an African-American woman Primary cutaneous cribriform carcinoma
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Squamous cell carcinoma of the left cheek (arrow). Xeroderma pigmentosum
Squamous cell carcinoma of the left cheek (arrow)
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Acanthosis nigricans�like mycosis fungoides, clinical presentation. Acanthosis nigricans–like mycosis fungoides, clinical presentation. Hyperpigmented, thickened, velvety plaques with exaggerated skin markings on the flank
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Angiosarcoma. Ulcerated plaque on the right medial lower extremity studded with multiple firm black nodules. Angiosarcoma - Stewart-Treves syndrome
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Clinical presentation at week 0 of risankizumab therapy demonstrating inflamed inguinal nodules, draining tunnels, and significant scarring. CD8+ mycosis fungoides (poikilodermatous type)
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Solitary, firm, asymptomatic pink nodule on scalp, measuring approximately 8 � 7 mm. Cutaneous metastasis of sigmoid adenocarcinoma
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Clinical features of paraneoplastic pemphigus. Paraneoplastic pemphigus secondary to neuroendocrine carcinoma
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Folliculitis decalvans with malignant transformation to metastatic squamous cell carcinoma Squamous cell carcinoma
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Other - Genodermatoses

Clinical image of acrokeratosis verruciformis of Hopf. Multiple skin-colored to hypopigmented papules over the dorsal aspect of the left hand. Acrokeratosis Verruciformis of Hopf
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Clinical image of granulosis rubra nasi. Granulosis rubra nasi. Multiple skin-colored to erythematous papules over the alae (A) and dorsum (B) of the nose
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Pigment Alteration

COVID-19 prone positioning�induced atrophy and hypopigmentation of bilateral cheeks and submandibular area. COVID-19 prone positioning–induced facial atrophy and hypopigmentation, initial
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Marked improvement of COVID-19 prone positioning�induced atrophy and hypopigmentation of the cheek COVID-19 prone positioning–induced facial atrophy and hypopigmentation, after treatment
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Hyperpigmentation of fingers Cutaneous complication of skin-lightening agents
Hyperpigmentation of fingers
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Striae Cutaneous complication of skin-lightening agents
Striae
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Exogenous ochronosis Cutaneous complication of skin-lightening agents
A and B, Exogenous ochronosis
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Cutaneous lupus eruthematosus (CLE)/lichen planus (LP) overlap syndrome. Hypertrophic pink plaques with peripheral hyperpigmentation on the left shin. Cutaneous lupus eruthematosus (CLE)/lichen planus (LP) overlap syndrome. Hypertrophic pink plaques with peripheral hyperpigmentation on the left shin.
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Linear hypopigmented patches on bilateral hands following Blaschkoid lines. Linear hypopigmented patches on bilateral hands following Blaschkoid lines.
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Lip-tip variant of vitiligo in a young African girl. Lip-Tip variant of Vitiligo in a young African girl
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Clinical photographs of the anterior and posterior trunk of a patient treated with an afamelanotide 16-mg subcutaneous implant at (A, B) day 0, (C, D) day 28, (E, F) day 140, (G, H) day 196, and (I, J) day 280. Nonsegmental vitiligo
Clinical photographs of the anterior and posterior trunk of a patient treated with an afamelanotide 16-mg subcutaneous implant at (A, B) day 0, (C, D) day 28, (E, F) day 140, (G, H) day 196, and (I, J) day 280
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Physiologic hyperpigmentation. Generalized gingival pigmentation, which is normal in this African American patient. Physiologic Hyperpigmentation, generalized gingival pigmentation
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Segmental vitiligo Segmental Vitiligo – (A) baseline (B) 10 months and (C) 48 months after melanocyte keratinocyte transplantation procedure
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Universal vitiligo in an Asian man. Universal Vitiligo in an Asian man
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Clinical and dermoscopic images demonstrating repigmentation 8 and 18 weeks after initiating PRP treatment concomitantly with phototherapy. Vitiligo repigmentation after PRP treatment initiation
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Poikilodermatous changes of the upper extremity Xeroderma pigmentosum
Poikilodermatous changes of the upper extremity
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Systemic Sclerosis (Scleroderma) and Related Disorders

Vascular

Linear, round, oval, and geometric, skin-colored and yellow-to-brown indurated papules and thin plaques on the upper extremity (A and B) and trunk (C and D). Catastrophic Systemic Calciphylaxis also known as Calcific Uremic Ateriolopathy upper extremity (A and B) and trunk (C and D)
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