EBV-induced erythema multiforme: a case report

To the Editor, Erythema multiforme (EM) is a type of dermatosis That OCCURS as a hypersensitivity reaction in response to medications or infections. Erythema multiforme is mostly Associated With The herpes simplex virus (HSV) or mycoplasma infections, 1-but it is rare EM That is the Epstein Barr Associated With Virus (EBV). We report on an 11-year-old male patient to our hospital ADMITTED With redness, swelling, burning sensation, an itchy rash on hands and feet, and a rash on the body That HAD Begun four days with previously. The patient Suffered fever, sore throat and running a day donot Before These complaints Manifested. The skin rash Began on the sole of the right foot, Which was noticed upon a sensation of something stuck on the right sole, and then a spread to the left sole and the hands. At the outset, the skin rash was pinhead sized, then a Increased in size, and swelling in the hands and feet occurred. Consulted The first physician wrote a prescription for cefuroxime, cetirizine and feniramine. However, the patient’s complaints Were not resolved after one day of using esta medication, and so I was Referred to our hospital. In our physical examination of the patient, to maculopapuler That included rash desquamation Which regions paled under pressure, was Observed on Both palms, soles, arms and legs. His body temperature was 37 ° C. Other system examinations revealed no abnormal findings (Figure 1, Figure 2). Face, body and Mucosal Involvement was not noted.

Figure 1. A red-purple dispersed colored maculopapular rash That pales under pressure was shown around ankle and medial side of the foot. Figure 2. Red-purple erythematous maculopapular lesions colored show desquamation That Were seen in patches on bilateral palmar regions. Laboratory examination revealed leukocyte count: 9900 / mm3, hemoglobin: 14. 1 g / dl, platelet count: 214,000 / mm3, erythrocyte sedimentation rate: 22mm / hour, urea: 32mg / dl, creatinine: 0. 8mg / dl, serum sodium: 134 MEq / L, potassium: 4. 5 mEq / L, AST 31 IU / L, ALT: 22 IU / L. The patient was Also tested for the Rickettsia IgG, HSV type I IgM, HSV type II IgM, EBV VCA IgM, CMV IgM, the Parvovirus IgM, and Mycoplasma pneumoniae IgM antibodies in order to rule out rickettsial diseases and other infectious skin eruptions Because of the symmetrical maculopapular rash Involving the Hands and Feet. Doxycycline treatment was subsequently Initiated with a presumptive clinical diagnosis of rickettsial diseases. On the second day following the patient’s admission to hospital, Appeared typical target lesions, the largest of Which was 2cm in diameter, on the proximal Both thighs and area of ​​the forearms (Figure 3). EBV VCA IgM and IgG Rickettsia Were positive at a titer of 1/10 and 1/64 respectively. Repeated tests in the week and one Performed one month later, there was no Increase in the Rickettsia IgG titres.


Doxycycline treatment was halted on day seven, and EBV infection was thought to be responsible for EM in our patient. Other viral markers and examinations for mycoplasma Were found to be negative. On the fifth day of admission, the patient was discharged from the hospital as the rash had a tendency to pale. The rash Disappeared on the 14th day from the beginning and the patient was cured without sequela. Figure 3. Were Dispersed target lesions shown on the proximal part of the fore arm. One month later, in order to rule out a possible adverse drug reaction due to cefuroxime Reported use in the patient’s history, a patch test (10 mg / ml) was done, Which came out negative. Then a prick test and an intradermal test using cefuroxime Were applied. These tests since turned out negative Also, an oral provocation test was Performed using cefuroxime, Which turned out negative too. Erythema multiforme is acute, self-limited and Usually at times life threatening dermatosis With Which May multiforme lesions present. They include multiple, symmetric, persistent macules, papules, vesicles, and bullae. What has pathognomonic for erythema multiforme Become is the so-called iris or targetoid lesions, plaques Representing center of duskiness in expanding erythematous macules and papules. Commonly Involved areas are extensor surfaces: the palms, the soles, and sites of trauma.

1 The appearance of the rash in our patient shortly after pricking Caused us to think That trauma played a role in esta Facilitating case. In MS, aetiology of herpes simplex mostly Consist and mycoplasma. Medications and some vaccines Also Participate in the aetiology, but in half of the cases an underlying cause can not be found. 2 EBV VCA IgM, tested in our patient was found to be positive. Erythema multiforme occurring EBV infection is Dramatically During rare. 2,3,4,5,6 Certain it is not, Although, the pathophysiological mechanism for the EBV-related MS is thought to be immunocomplex mediated. 4 Hughes et al. Demonstrated perivascular IgM and C3 deposition in direct immunofluorescent examination. 2 In Addition, Carrera et al. Investigated the presence of specific gene sequence of EBV and Herpes simplex by PCR in a tissue biopsy of a Case with cholestatic hepatitis and acute MS; however the result was negative. 5 On the other hand, Chen et al. detected an EBV specific gene sequence in two cases by 32 EM PCR.

6 Due to a lack of the facilities for investigating EBV in tissue With PCR, since we clinically diagnosed MS, and Also for ethical issues, we did not perform a tissue biopsy in our patient. It is well Known viral infections During That, drug-related allergic reactions Rashes increase. 7 related to infectious mononucleosis are aminopenicillins During Often seen; however, serious cutaneous lesions: such as MS and Stevens Johnson Syndrome (SJS) are rare. 8 Our patient was EVALUATED for cephalosporin-related drug reaction due to previous cefuroxime use, but skin tests and oral provocation test results came out negative. Delgado et al. Reported a case of MS due to aminopenicillin use EBV infection. 8 During Contrary to our patient, They found a positive patch test and a delayed reading of an intradermal test Performed for an evaluation of drug sensitivity. They Claimed That cell-mediated hypersensitivity was responsible for the development of drug-related MS. In research Conducted by Jappe, WHO EVALUATED 41 Patients With drug eruptions following the intake of amino-penicillins, 20% of Patients had a florid infectious mononucleosis at the time of the drug eruption. 9 In our case, in terms of explaining aetiology, EBV was determined to infection and an evaluation was made due to drug allergy to cefuroxime in light of Existing Knowledge About virus-drug interaction, and the result was determined to be negative to. 80% of erythema multiforme is classified as minor, is postinfectious Usually, the skin and Primarily Affects more than one and no mucosal surface. 1 It is thought That there is a relationship Between the severity of the disease and factors in aetiology That exist. While viral infections cause erythema multiforme minor Usually and major, medications cause SJS Which progresses with a more serious clinical course.

10 Our patient was diagnosed as erythema multiforme minor, Because there was no mucosal Involvement. The drug allergy tests Were case of the negative and the viral infection was mostly related EM Encountered in minor form. Consequently, our patient was diagnosed as EBV related MS. The prognosis is quite good in EM minor, and it can be cured without sequela in 2-4weeks by Eliminating the triggering cause or by treatment of the underlying infection. Progression to SJS does not Occur In These Cases. Our patient was closely for six weeks Monitored With only the first five days in hospital, and it was Observed That His injuries healed completely. As a result, even though HSV is the MOST Observed of viral infections in the aetiology MS, EBV Might be a rare but a causative factor. Corresponding author. drpinar1975@hotmail. com

Tea Tree Oil

Tea tree is obtained from the Australian tea tree (Melaneuca alternifolia). The oil is obtained by steam distillation. For 1 l one needs 50 – 70 kg leaves and young twigs. Due to its antibacterial and skin regenerating properties Tea tree is effective in abscesses, poorly healing wounds, boils, and is also indicated for acne, as it promotes the healing process and the healthy tissue is not damaged. Also Tea tree acts antifungal, analgesic, blood circulation, anti-rheumatic and anti-inflammatory. Tea tree should be protected as other ethereal oils also from light, air and high temperatures. Therefore, it should always be kept in dark glass bottle tightly closed at normal room temperature. Tea tree can be applied in many different ways, as it exerts its effect both on the nose and on the skin, mucous membranes, and gastrointestinal tract. In Respiratory Diseases Tea tree has antibacterial, antiviral, antispasmodic, expectorant, expectorant and schleimhautregenerierend. Inhalation them in a bowl with hot water 2 – 3 drops of Tea tree, for children only 1 drop. Lie down a towel over your head and breathe about 5 minutes long, the fumes, 2 -. 3 times daily. Warning: Risk of scalding!

Pain: For muscle tension, rheumatic complaints and minor injuries acts Tea tree analgesic and anti-inflammatory. In acute pain helps as an emergency measure 15-20 drops to 20 ml Tea tree Trägeroel, such as jojoba oil or St. John’s wort oil. With this oil you can rub the painful area several times a day. For athlete’s foot Tea tree is about a week applied with a cotton swab. Then, 20 drops of Tea tree continues to treat 20 ml Aloe Vera gel and thus over a longer period. Herpes: several pure dab tea tree oil daily with a cotton swab to the affected areas. Against itching, redness and hives, in mosquito, bee and wasp stings one drop pure on the stitch, repeat if necessary. Acne: Tea tree oil directly onto the pimples and inflammatory nodules. Gums: massage In gingival abscesses and canker sores in the mouth, the gums with 1 to 2 drops of Tea tree often, until healed. Please remember that tea tree oil may be irritating too strong in sensitive individuals. Furthermore, tea tree oil is one of the substances which can generate an allergy in an increased extent! Important note for pets: Cats can be poisoned strong with only a few drops of tea tree.

therefore tea tree oil should not be taken for pest control in cats! You have any orders or questions? So you can always reach us: Old Sonnen-Apotheke OHG, market 2, 49740 Haselünne (Emsland) Phone 05961-294 Fax 05961-9247 e-mail: request at alte-sonnen-apotheke-app. de (To protect against spam, we have advertised the at sign you need to replace this advertised at by the @ sign, so that the e-mail address is valid. . ) Telephone inquiries and phone orders we process immediately, to fax and e-mail requests? Usually no later than two working days an answer. Opening times :

Monday: 8:30 to 13:00 and 14:30 to 7:00 p. m. Tuesday 8:30 to 13:00 and 14:30 to 7:00 p. m. Wednesday 8:30 to 13:00 and 14:30 to 18:00 Thursday: 8:30 to 13:00 and 14:30 to 7:00 p. m. Friday 8:30 to 13:00 and 14:30 to 18:00

Saturday 9:00 to 13:00 We are at any time available. Pharmacists Charlotte Erpenbeck and Tanya Kramer and the team of the Old Sonnen-Apotheke Incidentally, the images on our side either ownership of our cooperation, the Parma Pharm, or themselves are made or purchased from Shutterstock (and labeled)

The diagnostic view [Schattauer: Sixth, revised and expanded edition]

The diagnostic view Atlas and Textbook of differential diagnosis  Published by  F. W. Tischendorf  Founded by G. F. Klostermann,  H. Südhof and W. Tischendorf  With contributions from

 K. Bork, D. W. Büttner, H. Fischer,  M. W. Hartmann, H. Kaffarnik,  H. Kirchhübel, J. W. King, C.

Meyer,  G. Meyer-Hofmann, D. Reinwein,  H. Riechelmann, Ingrid Rudzki-Janson,  Dietmar Seidel, Dietrich Seidel,  E. Saturday, F. W. Tischendorf,  U. Venzlaff, J.

-W. knows  6, revised and  extended edition  With 1000 pictures,  of 985 multicolored  Schattauer  contents VII Clinical examination 1 polycythemia vera, rosacea; arterial  hypertension 47  Blue Red Skin 48 Changes in skin color 2  Polycythemia vera, chronic pulmonary heart disease,

Pale skin 2 Hypertension 49 Pseudo anemia, anemia 3 Chronic pulmonary heart disease 51 Anemia: General signs 5 Chronic pulmonary heart disease, Myokardsklerose, Iron deficiency anemia 9 carcinoid 53 Pale-yellow skin 10 mitral stenosis 55 Anemia and jaundice: Pernicious anemia 11 mitral regurgitation, mitral valve disease combined, Anemia and jaundice: Hereditary spherocytosis, “Pseudomitralgesicht” 57  Elliptocytosis 13 Congenital heart disease, aortic aneurysm 59 Anemia and jaundice: thalassemia, chronic atrophic acrodermatitis  Sickle cell disease 15 Herxheimer 61 Depigmentation skin 16  Erythema – Exanthema 62 Albinism totalis, Piebald, Vitiligo 17

Leucoderma syphiliticum, leucoderma erysipelas 63  leprosum, depigmentation Systemic lupus erythematosus 65  in pityriasis versicolor alba 19 Systemic lupus erythematosus; pemphigus Pigmented skin 20 erythematosus Seborrhoicus (Senear-Usher) . . . 67 Addison 21 Systemic Lupus Erythematosus 69 Addison’s disease, Arsenmelanose, argyrosis, dermatomyositis 71  Hemochromatosis 23 dermatomyositis, Poikilodermatomyositis 73 Stauungsdermatose, chronic nephritis, drug eruptions 75  Discolorations by Atebrin 25 drug eruptions – infectious allergic Estrogen-melanosis (chloasma uterinum, rash 79

 Therapy for prostate cancer), drug eruptions: urticaria 81  Alterskomedonen 27 drug eruptions: urticaria, Becker’s melanosis, cafe-au-lait spot, angioedema 83  Ephelides, Alterspigmentierungen 29 drug eruptions – infectious allergic Pigmentfleckenpolypose (Peutz-Jeghers monastery eruptions: Stevens-Johnson syndrome,  man-Touraine Syndrome), LAMB syndrome. , , , 31 Lyell Syndrome 85 Urticaria pigmentosa 33 drug eruptions – infectious allergic  Eruptions: Masernpemphigoid; Jaundice: Acute hepatitis, obstructive;  Fat Skieren 35 mechanobullous dermatoses: epidermolysis  bullosa Dystrophic Hereditaria 87 Jaundice: cirrhosis, hemochromatosis 37

Jaundice: Cirrhosis – halonierte eyes, psoriasis vulgaris 89  Brown discoloration of the skin, white, Uhrglas- psoriasis vulgaris: nummular type mikrobiell-  nails, palmar erythema 39 seborrheic dermatitis, impetigo. , 91 Jaundice: Cirrhosis – gynecomastia, paint tongue, smallpox (variola vera), varioloid (Variola mitigata)  Dupuytren’s contracture, Rhinophyma vs. Eccema vaccinatum 93  chickenpox 95  Telangiectasia-rich nose as constitutional  Peculiarity 41 scarlet 97 Wilson’s 43 scarlet: orbital cellulitis; periorbital  phlegmonous inflammation 99 Red skin 44

 measles 101 Polycythemia vera, Pseudokonjunktivitis;  Sportsman 45 rubella, fifth disease 103 VIII contents  Circulatory disorders 142  Herpes zoster 105  Herpes zoster, herpes simplex 107 Raynaud’s syndrome (Digiti mortui), chronic  Erythema nodosum, erythema induratum Bazin, Cold agglutinin, acrocyanosis  Artifacts 109 sui generis 143  Arteriosclerosis obliterans (atherosclerosis);  Changes in fungal diseases combined with deep leg vein  the skin 110 145 thrombosis  Fungal infections caused by dermatophytes: Obliterative arteriosclerosis (atherosclerosis);

 Tinea capitis, tinea corporis, tinea p e d u m. , , , 111 of the “diabetic foot” 147  Fungal diseases caused by yeasts: Hautsoor, thromboangiitis obliterans, Temporalarteriitis 149  Genitalsoor, tinea versicolor 113 Arterial embolism 151  Arterial embolism, iatrogenic tissue necrosis  Pruritus – scratching effects 114 (Paravasatnekrosen) 153  Scratch effects in pruritus 115 frostbite, burns, radiation injuries 155  Pruritus lymphogranulomatosus, pruritus-induced leg ulcers Arterial, venous leg varicose. , , 157  Secondary infections: impetigo; Leg ulcers of various origins:  Pemphigus neonatorum 117 leg ulcer with thalassemia major,  Epizootic: Scabies, larva migrans, myiasis. , , , 119 ulcer agranulocytoticum 159

 Epizootic and zoonotic diseases: Dress Erlau infection, leg ulcers of various origins:  Flea bites, tick bites, african ulcer syphiliticum, ulcer tropicum  Zeckenbißfieber 121 (Cancrum oris) 161  Hemorrhagic diathesis 122 Visible collateral circulation,  Influence jams 162  Physical examination methods 123  Coagulopathies: hemophilia A 125 Scheme of the body venous system 163  Coagulopathies: bleeding due to closure of the superior vena cava 165  Anticoagulant 127 closure of the iliac vein, closure  Thrombopathies: Myelodysplastic syndrome, the inferior vena cava 167  acute leukemia, Hodgkin Werlhof 129 Scheme of the portal 169  Thrombopathies: Acute leukemia; Narrowing of the axillary vein (cicatricial  Hematoma with skull base fracture and after Mamma amputation and irradiation)

 other traumatic hematoma 131 narrowing of the superior vena cava (retrosternal  Vascular defects: Purpura, Purpura goiter) 171  Majocchi, purpura senilis 133 Portal Hypertension: visible collateral  Vascular defects: Infectious-toxic purpura, circulation, hemorrhoids 173  Micro emboli in endocarditis lenta  sclerodermas 174  and meningococcal sepsis  Waterhouse-Friderichsen syndrome 135 scleroderma progressiva diffusa 175  Scleroderma progressiva diffusa,  Hemorrhagic diathesis, hemangiomas. 136 177 Skleropoikilodermie  Crohn Rendu-Osler, senile hemangiomas 137 scleroderma circumscribed; Amnionfurchen 179  Nodes, tumors 180

 hemangiomas 138  Hemangioma cavernosum hemangioma malignant lymphomas: Hodgkin’s disease,  Simplex 139 Immunoblastom, Burkitt’s lymphoma 181  Hemangioma simplex, Sturge-Weber Syndrome, Malignant Lymphomas: Chronic Lymphocytic  Klippel-Trenaunay syndrome 141 183 leukemia  contents IX Malignant lymphomas: Chronic lymphocytic precancerous lesions of the skin: solar and senile  Leukemia, Sezary syndrome, mycosis keratosis, Cornu Cutaneous, actinic cheilitis. , , 235  fungoides; Skin infiltrates in acute mumps, allergic and purulent parotitis,  Monocytic 185 Parotismischtumor 237 Monoclonal gammopathy: amyloidosis,  Scleromyxoedema 187 fistulae, abscesses, suppuration 238

AIDS: Hematological Complications 189 swelling and fistulae due Zahnaffektion . . 239  Fistulas in lymph node tuberculosis, AIDS: Kaposi’s sarcoma, the early stages 191  Actinomycosis, chronic osteomyelitis AIDS: Kaposi’s sarcoma, late stages 193  and Crohn’s disease 243 AIDS: secondary infections and reactions  (Herpes labialis, herpes zoster, erythema Cold abscess, Spritzenabszeß;  Exsudativum multiforme, inverse psoriasis). , , 195 rib metastasis 245 Inflammatory lymphomas: Trypanosomiasis, Spritzenabszeß, paranephritic abscess,

 Lymphogranuloma inguinale 197 Ophthalmoblennorrhoea neonatorum 247  Osteomyelitis in sickle cell disease, tropical Inflammatory lymphomas: lymphogranuloma  inguinal (Genitalulkus, elephantiasis scrotum), Pyomyositis, amoebic liver abscess 249  Syphilis (chancre) 199  edema 250 Inflammatory lymphomas: Halslymphknoten-  heart failure 251  tuberculosis, onchocerciasis; Onchocerca-  Heart failure, scrotal 253  Node; Calabarschwellungen with loiasis. , , , 201  Nephrosis, kwashiorkor 255

Onchocerciasis: Chronic dermatitis,  Glomerulonephritis, Sudeck syndrome 257  Xeroderma, “hanging groin”, leopard skin,  Lymphedema, lipoedema 259  papular skin reaction to ivermectin 203 Lupus vulgaris; rhinophyma 205  Symptom “big belly” 260 Lupus vulgaris; Intracutaneous 207  Ascites, cirrhosis, 261 ovarian cyst Leprosy: Lepromatous and tuberculoid,  Obesity, abdominal wall, incisional hernia 263  Borderline type, ENL. , 209

Sarcoidosis, cutaneous leishmaniasis 211  Changes in nichtvenerischen sarcoidosis; Lues: papular Sekundärsyphilid. , , 213  Genital Diseases 264 Lues: Makulopapulosquamöses secondary  Inflammation of the glans penis and vulva,  syphilide, tertiary syphilitic changes 215  genital herpes simplex virus infection 265 Neurofibromatosis Generalisata v. Reckling-  Genital warts, hirsuties papillaris  live 217

 penis, phimosis, paraphimosis 267 Crohn Pringle, Tuberous Sclerosis Syndrome. , , , 219  Heterotopic sebaceous glands, lymphangiectasia, lipomas 221  Tanchoknötchen, lichen planus 269 Virchow gland Nabelmetastase, skin metastases . . 223  Kraurosis genital, penile cancer, Skin Metastases 225  vulvar Cancer 271 Pigment Leading skin tumors:

 Melanosis Circumscripta praeblastomatosa,  Skeletal abnormalities, postural and  malignant melanoma 229  Movement abnormalities 272 Pigment Leading skin tumors:  Nevus cell nevus, Sutton nevus, seborrheic spina bifida 273  Wart, histiocytoma, thrombosed Angioma; spondylolisthesis 275  supernumerary nipple 231 Muscular torticollis 277 Pigment Leading and hyperkeratotic tumors osseous torticollis, Klippel-Feil syndrome cal. , , 279  skin: Seborrheic wart; vulgar heart hump, chicken and funnel chest,  Wart; Calluses 233 281 Hutkrempenthorax X content

 Flat back, kyphosis 283 campodactyly (claw hand), Digitus malleus,  Hallux valgus deformity Madelungsche. , , , 331  Ankylosing spondylitis spondylitis 285  Synthesis, poly, oligodactyly 333  Gibbus: tuberculous spondylitis 287  scoliosis 289  Coxitis, youth Hüftkopfepiphysenlösung. , , 293  Change in skin attachments 334  Sprengeische deformity, shift  the scapula in Crohn v. Reckling- deviations of the coat 334

 live 295 Acquired hypotrichosis: hypothyroidism,  Rickets bowlegged, Crus varum congenitum. , , 297 Kwashiorkor, hair loss as a result rays. , , , 335  Varus and valgus 299 Acquired hypotrichosis: Toxic Hair Loss  (Thallium, cytostatics), alopecia areata 337  Signs of neurological disorders hirsutism 300 339  Amyotrophic Lateral Sclerosis,  Changes in the nails 340  Progressive muscular dystrophy,  Meessche lines Beausche transverse grooves,  Myotonic dystrophy Curschmann-Steinert. , 301 hypoproteinemic strips (double

 Isolated serratus; hereditary motor Muehrcke band), leukonychia striata,  and sensory neuropathy (HMSN), Radialis-  Leukonychia partialis 341  palsy, proximal median nerve 303  Nail psoriasis, nail dystrophy with epidermolysis  Daumenballenatrophie with carpal tunnel syndrome,  bullosa, onychomycosis, onychogryposis. , , , 343  Syringomyelia, ulnar nerve 305  Horner’s syndrome, facial paralysis, central  Oral lesions  Facial paralysis, Hypoglossuslähmung 307  and the tongue 344

 Oculomotor, Abduzenslähmung,  Herpes simplex virus infection:  Hypomimia with Parkinson’s disease . . . . 309  Herpes labialis, herpetic gingivostomatitis;  Bulbar paralysis, myasthenia gravis 311  Herpes zoster 345  Parkinson’s disease, spasmodic torticollis,  Habitual aphthous ulcers, oral mucosa  Torsion dystonia, state after

 candidose: Perleche, lip, Zungensoor. . . 347  acute ischemic stroke, multiple sclerosis 313  Geographic Tongue sive geographic tongue,  “Coated tongue” Glossitis median rhomboid,  Joint changes 314  Glossitis praeatrophica 349  Rheumatoid arthritis; hyperextensibility  Lingua villosa nigra (black hairy tongue)  the finger (constitutional anomaly) 315  Tongue discoloration by potassium

 Rheumatoid arthritis, arthritis mutilans 317  permanganate 351  Psoriatic arthritis 319  Lingua plicata, Glossitis interstitial (syphilis III)  Rheumatoid nodules, tophi 321  Actinomycosis, syphilitic Gumma  Rheumatoid nodules, tophi, xanthomas,  tuberculous ulceration 351  Ganglia 323  Melkersson-Rosenthal syndrome, lipodystrophy,  Heberden’s nodes, nodes Bouchardsche  Crohn Rendu-Osler 355  (Polyarthritis); nodules rheumatici

 Sjogren’s syndrome 357  (Acute rheumatic fever);  Palm keratoses (Reiter’s syndrome) 325  Changes in the gums  Joint effusion, Blutergelenk 327  and the teeth 358  Malformations and anomalies changes on oral mucosa and  the hands and feet 328 gingiva: hemangioma simplex, leukoplakia,  Klino-, brachytherapy, campodactyly, thrush, mechanical irritation, pemphigoid,  Dupuytren’s contracture 329 359 necrosis  content XI Gingivaveränderungen: gingivitis simplex, Bindehautdegerationen, conjunctival tumors:  Acute necrotizing ulcerative gingivitis pterygium, Pinguekula, Squamous

 (AUG) AUG at AIDS with Kaposi’s sarcoma. , 361 Carcinoma, dermoid, melanosis bulbi, Periodontitis 363 nevus pigmentosus, malignant melanoma,  Bowen 395 Gingival hyperplasia 365 Gingival hyperplasia and proliferation; Corneal opacities: Arcus senilis,  melanoma metastasis; Breakthrough cysts 367 Kayser-Fleischer ring, band keratopathy, Gingivaverfärbungen 369 keratoconus, keratitis filiformis; ocular Melting and Dentinhypoplasien, pemphigoid 397  Enamel changes 371 opacities, injuries, burns and Enamel changes, Hutchinson’s teeth. , , 373 inflammation of the cornea 399  Colorations in pupil area: cataract,

Changes pharynx ectopia of the lens, Glaucoma absolutum 401 and tonsils 374 pupil, iris changes: Viral diseases: Acute viral Anisocoria, tonic pupil (Adie’s syndrome),  Pharyngotonsillitis, Monocytic, Argyll-Robertson’s syndrome, iris coloboma,  Herpangina, angina herpetic, herpes zoster. , , 375 Iridodialysis, persistent pupillary membrane, Bacterial diseases: angina follicularis, state after iridocyclitis 403  Angina lacunaris, peritonsillar, iris changes: albinism,  Diphtheria 377 Iris bicolor, congenital heterochromia, Bacterial diseases: Chronic iritis, Rubeosis, iris nodules 405  Tonsillitis, Angina Plaut-Vincenti, chronic relocations, positioners  Pharyngitis, angina agranulocytotica; (And moving) anomalies  Mycosis: thrush 379 of the eyeball: blow-out fracture,

Non-infectious mucosal changes: cavernous sinus syndrome, strabismus 407  erythroplasia; benign tumors: Iceberg tumor  changes  (Neuromas), pleomorphic adenoma, papilloma,  in bone diseases 408  fibroma 381 Tonsillenkarzinom, Non-Hodgkin lymphoma, Blue sclera, osteogenesis imperfecta tarda. , , , 409  Tonsils, retention cyst 383 Paget’s osteitis deformans, Paget’s sarcoma 411  Paget’s osteitis deformans, Crohn Uehlinger 413 Clefts of the stomatognathic System 384 changes in diseases  the endocrine glands 414

Cleft lip and palate 385  Hyperthyroidism, thyroid eye disease 415 Ocular changes 386 hyperthyroidism, thyroid eye disease, Swollen eyelids: allergies, ophthalmic zoster, myxedema circumscriptum Pretibial 419  Dacryoadenitis, Mikulicz syndrome 387 hyperthyroidism: Thyrotoxic crisis Swollen eyelids, eyelid tumors: pituitary tumor; acute suppurative thyroiditis;  Dacryocystitis, hordeolum, chalazion, normometabolischer bilateral exophthalmos  Basal cell carcinoma, melanoma 389 (constitutional anomaly) 421 Changes in the eyelid margin and the Lidstellung, Normometabolischer unilateral exophthalmos:  Conjunctivitis 391 meningioma, Orbitametastase, Swelling, redness and bleeding of the Orbital 423  Eye: scleritis, papillary protrusions of Struma: Blande Struma, bland retrosternal  Tarsal conjunctiva, chemosis, Hyposphagma, goiter; Thyroid tumor 425

 Hyphema, nodular episcleritis 393 Hypothyroidism 427 XIV employee contributions  Changes in the gums and teeth,  Erythema – Exanthema: drug eruptions,  S. 358-373  74-75 and 80-81  H. Fischer E. Sonnabend  Changes of the throat and tonsils,  S. 374-383

 Changes in fungal infections of the skin,  S. 100-112 H. Riechelmann  K. Bork clefts of the stomatognathic system,  S. 384-385  Pruritus – scratching effects: epizootic and zoonotic diseases, Ingrid Rudzki-Janson  S. 118-120  M. W.

Hartmann eyes changes, pp 386-407  C. Meyer; S. 400-405 together with F. W. T.  Nodes, tumors: AIDS, Kaposi’s sarcoma, etc. ,  S. 188-195 changes in bone disorders:  M. G. Hartmann Paget’s osteitis deformans, Crohn Uehlinger,

 Loiasis, onchocerciasis, S. 200-203 S. 412-413  D. W. Büttner F. W. T. together with E. Sonnabend  Pigment Leading tumors and precancerous lesions  skin, pp 228-231 and 234-235  Changes in diseases of the endocrine

 H. Fischer; S. 228-231 together with F. W. T.  Glands: Cushing’s disease, Cushing’s syndrome, p 435  F. W. T. together with D. Reinwein  Fistulae, abscesses, suppuration: swelling and  Hypogonadism, S.

436-441,  Fistulae due Zahnaffektion, pp 238-241  Dwarfism, pp 442-448  E. Sonnabend  D. Reinwein  Changes in nichtvenerischen  Changes in metabolic diseases:  Genital Diseases, S. 264-271  Hyperlipoproteinemia, pp 460-465  K.

Bork  H. Kaffarnik and Dietrich Seidel  S. 460-461 together with F. W. T.  Skeletal abnormalities, postural and movement  anomalies, S. 272-299  Larger contributions to various diseases:  H. Kirchhübel and J.

-W. Knows;  F. W. T. , smaller contributions:  S. 272-273 and 284-285 together with F. W. T.  F. W. T.

together with G. Meyer-Hofmann  Signs of neurological disorders, pp 300-313  Dietmar Seidel and U. Venzlaff; Internal Diseases and Skin Diseases  in blacks, with particular reference  S. 304-307 together with F. W. T.  tropical diseases:  F. W.

T. together with J. W. king  Changes of the oral mucosa and tongue,  S. 346-347 leprosy, pp 208-209  J. W. king  F. W. T.

together with K. Bork PDF version

ICD-10-GM-2016 L01.0 Impetigo [each pathogen] [any location] ICD10

ICD-10-GM-2016 L01. 0 Impetigo [each pathogen] [any location] ICD10 L00-L08 Infections of the skin and subcutaneous tissue Info. : If the infectious agent are given an additional code (B95-B98) is to be used. excl . : Angulus infectiosus oris (by): Candidiasis (B37. -) Angulus infectiosus oris (by): riboflavin (E53. 0)

Angulus infectiosus oris (by): o. n. A. (K13. 0) Granuloma pediculatum (L98. 0) Hordeolum (H00. 0) Infectious dermatitis (L30. 3) Local skin infections that are classified in Chapter I, as e. g .

: erysipelas (A46) Local skin infections that are classified in Chapter I, as e. g . : Erysipeloid (A26. -) Local skin infections that are classified in Chapter I, as e. g . : infection by herpes virus [herpes simplex] (B00. -) Local skin infections that are classified in Chapter I, as e. g . : infection by herpes virus [herpes simplex] in the anogenital (A60. -)

Local skin infections that are classified in Chapter I, as e. g . : Molluscum contagiosum (B08. 1) Local skin infections that are classified in Chapter I, as e. g . : mycoses (B35-B49) Local skin infections that are classified in Chapter I, as e. g . : pediculosis, Akarinose and other parasitic infestation of the skin (B85-B89) Local skin infections that are classified in Chapter I, as e. g . : Viral warts (B07)

Panniculitis: lupus erythematosus (L93. 2) Panniculitis: neck and back (M54. 0-) Panniculitis: relapsing [Pfeifer-Weber-Christian disease] (M35. 6) Panniculitis: o. n. A. (M79. 3-) Zoster (B02. -)

L01. – impetigo excl . : Impetigo herpetiformis (L40. 1) Pemphigus acutus neonatorum (L00. -) L01. 0 Impetigo [each pathogen] [any location] Incl .

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