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Dermatology/Pathology

S. Eliza Halcomb, MD

http://en.wikipedia.org/wiki/Black_tongue

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http://en.wikipedia.org/wiki/Gingival_enlargement

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Oral Discoloration

Tongue •  Brown

•  Green

•  Black, Hairy

•  White

•  Blue •  Blue Gray Gums

•  Bromine, bismuth, arsenic, phenolpthalein, doxrubicin, quinacrine, tobacco

•  Vanadium •  Cefoxitin, corticosteroids,lansoprazole,

penicillin, sodium perborate, sodium peroxide, tetracycline

•  Chlorhexidine, phenol, caustic acids, hydrogen peroxide

•  Methylene blue •  Bismuth, lead, mercury, copper salts,

thallium, zinc

Fecal Discoloration

•  Black

•  Blue •  Yellow-green •  Orange-red •  Pink

•  Acetazolamide, aluminum hydroxide, aminophylline,amphotericin b,barium, benzene,bismuth, bromides, charcoal,chloramphenical,chlorpropamide,clindamycin,corticosteroids,cyclophosphamide,digitalis,feroous salts,fluoruracil,formaldehyde,halides,halothane, metals (Ag,As, Cu,Hg,Mn,Pb,Tl),hydralazine,methotrexetae,methylene blue, nitrates,NSAIDs, tetracycline,theophylline,warfarin

•  Boric acid, chloramphenical, maganese dioxide, methylene blue

•  Mercurous chloride, yellow phosphorus

•  Phenazopyridine, rifampin

•  Manganese dioxide, phenolthalein

Teratogens

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Teratogens •  Coumadin

–  Midface hypoplasia •  Bromides

–  Polydactyly, clubfoot •  Ethanol

–  FAS •  Danazol

–  Pseudo-hermaphrodism •  Lithium

–  Ebstein’s anaomaly •  Mycophenolate

–  Cleft lip/palate –  Distal limb anomalies

•  Quinine: –  Hypoplasia 8th CN

•  Retinoids –  Craniofacial abnormalities –  Absent ears

•  SMZ/TMP –  Neural tube defects

•  Valproate –  Spina bifida

http://en.wikipedia.org/wiki/Fetal_alcohol_syndrome

Buehler BA et al. N Engl J Med 1990;322:1567-1572.

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http://en.wikipedia.org/wiki

http://en.wikipedia.org/wiki/Phocomelia#mediaviewer/File:Ears_of_phocomelia_patients.jpg

Adverse Drug Reactions – Cutaneous Manifestations

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http://en.wikipedia.org/wiki/Stevens–Johnson_syndrome

http://en.wikipedia.org/wiki/Toxic_epidermal_necrolysis

An. Bras. Dermatol. vol.87 no.4 Rio de Janeiro July/Aug. 2012

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Neurology November 10, 2009 vol. 73 no. 19 e94-e95

http://en.wikipedia.org/wiki/Coumadin_necrosis

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http://en.wikipedia.org/wiki/Mees'_lines

http://www.medicinenet.com/image-collection/melasma_picture/picture.html

http://drugline.org/img/term/gray-baby-syndrome-6642_2.jpg

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Cutaneous Manifestations •  Red Man Syndrome - Vancomycin •  Grey Baby Syndrome - Chloramphenical •  Blue (MetHgb): Sulfonamides, Dapsone, Primaquine, chloroquine,

nitrofurans •  Yellow: Dinitrophenol •  Stevens-Johnson: PNC, Cephalosporins, Sulfa, nevirapine •  TEN: PNC, Sulfas, nevirapine •  Vesiculobullous: PNC, Rifampin, Sulfonamides, Griseofulvin •  Vasculitis: Levamisole •  Acute Hypersensitivity Syndrome: Sulfas, Bacitracin,

Clindamycin, Lincomycin, Nitrofurazone, nevirapine •  Alopecia: Selenium Sulfide

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Occupational Exposures

http://www.cdc.gov/niosh/topics/skin/occderm-slides/ocderm8.html

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http://www.cdc.gov/niosh/topics/skin/occderm-slides/ocderm8.html

http://www.cdc.gov/niosh/topics/skin/occderm-slides/ocderm8.html

http://www.cdc.gov/niosh/topics/skin/occderm-slides/ocderm10.html

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http://www.cdc.gov/niosh/topics/skin/occderm-slides/ocderm11.html

http://en.wikipedia.org/wiki/Hydrofluoric_acid#Health_and_safety

http://roentgenrayreader.blogspot.com/2009/05/acroosteolysis.html