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eFigure 6–14. Superficial basal cell carcinoma. (Used, with permission, from Lindy Fox, MD.) A photo of two pale red basal cell lesions on a patient’s back. The size of each lesion is measured with a stick-on ruler.

Current Medical Diagnosis & Treatment 2025 > Basal Cell Carcinoma

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Figure 6–13. Umbilicated—molluscum. (Reproduced with permission from Richard P. Usatine, MD, in Usatine RP, Smith MA, Mayeaux EJ Jr, Chumley H. The Color Atlas of Family Medicine, 3rd ed. McGraw-Hill, 2019.) A close-up photo of a molluscum lesion, which appears as a pale pink, raised bump with a shiny, dimpled center.

Current Medical Diagnosis & Treatment 2025 > Molluscum Contagiosum

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eFigure 6–58. Crusted scabies. (Used, with permission, from Lindy Fox, MD.) A photo of thick, pale white crusty patches on the patient’s scalp and back of neck. Erythema is observed along the periphery.

Current Medical Diagnosis & Treatment 2025 > Scabies

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Figure 6–24. Pityriasis rosea with scaling lesions following skin lines and resembling a Christmas tree. (Used, with permission, from EJ Mayeaux, MD, in Usatine RP, Smith MA, Mayeaux EJ Jr, Chumley HS. The Color Atlas and Synopsis of Family Medicine, 3rd ed. McGraw-Hill, 2019.) A photo of a patient’s back covered with pale, scaled lesions from neck to hip.

Current Medical Diagnosis & Treatment 2025 > Pityriasis Rosea

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eFigure 6–83. Discoid lupus erythematosus of the arm. (Used, with permission, from Lindy Fox, MD). A patient with extensive plaques over the upper arm. The lesions are irregular in shape and size, depigmented to a pale pink at the center, and hyperpigmented to a dark brown along the borders.

Current Medical Diagnosis & Treatment 2025 > Cutaneous Lupus Erythematosus

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eFigure 6–85. Subacute cutaneous lupus erythematosus: erythematous nonscarring red plaques on the back. (Used, with permission, from Lindy Fox, MD). Three large, oval shaped lesions on a patient’s back are pale pink with red, demarcated borders.

Current Medical Diagnosis & Treatment 2025 > Cutaneous Lupus Erythematosus

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eFigure 6–87. Contact dermatitis with linear pattern due to poison ivy. (Used, with permission, from TG Berger, MD, Dept Dermatology, UCSF.) A persons hand is covered with small, pale pink, raised blisters clustered on the right side of the hand.

Current Medical Diagnosis & Treatment 2025 > Contact Dermatitis

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Figure 6–29. Porphyria cutanea tarda of hands in a patient with darker skin. (Used, with permission, from Kanade Shinkai, MD.) A patient with porphyria cutanea tarda exhibits pale pink blisters of varying sizes over the dorsal surface of both hands.

Current Medical Diagnosis & Treatment 2025 > Porphyria Cutanea Tarda

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Figure 6–36. Depigmented—vitiligo. (Reproduced with permission from Richard P. Usatine, MD, in Usatine RP, Smith MA, Mayeaux EJ Jr, Chumley H. The Color Atlas of Family Medicine, 3rd ed. McGraw-Hill, 2019.) A photo of extensive pale depigmented patches in the fingers and back of hand.

Current Medical Diagnosis & Treatment 2025 > Pigmentary Disorders

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eFigure 7–32. Vogt–Koyanagi–Harada (VKH) disease. A: Poliosis of the eyelashes. B: Alopecia, vitiligo, and poliosis of the hair. (Reproduced, with permission, from A: Lueder GT. Pediatric Practice: Ophthalmology. McGraw-Hill, 2011; B: Riordan-Eva P, Augsburger JJ. Vaughan & Asbury's General Ophthalmology, 19th ed. McGraw-Hill, 2018.) An eye with a white section of eyelashes at the medial end of the upper eyelid. A patient with patchy hair loss, as well as white hair patches, just above the ear along the front hairline. Depigmented pale pink patches of skin are found over the forehead, scalp, and below the ear.

Current Medical Diagnosis & Treatment 2025 > Uveitis

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eFigure 7–32. Vogt–Koyanagi–Harada (VKH) disease. A: Poliosis of the eyelashes. B: Alopecia, vitiligo, and poliosis of the hair. (Reproduced, with permission, from A: Lueder GT. Pediatric Practice: Ophthalmology. McGraw-Hill, 2011; B: Riordan-Eva P, Augsburger JJ. Vaughan & Asbury's General Ophthalmology, 19th ed. McGraw-Hill, 2018.) An eye with a white section of eyelashes at the medial end of the upper eyelid. A patient with patchy hair loss, as well as white hair patches, just above the ear along the front hairline. Depigmented pale pink patches of skin are found over the forehead, scalp, and below the ear.

Current Medical Diagnosis & Treatment 2025 > Uveitis

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eFigure 7–34. Granulomatous keratic precipitates located on the inferior corneal endothelium. (From Emmett T Cunningham, Jr. Reproduced, with permission, from Riordan-Eva P, Augsburger JJ. Vaughan & Asbury's General Ophthalmology, 19th ed. McGraw-Hill, 2018.) A patient with granulomatous uveitis exhibits mutton fat keratic precipitates, which appear as round, pale yellow globular spots on the cornea.

Current Medical Diagnosis & Treatment 2025 > Uveitis

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eFigure 7–64. Optic disk swelling with hemorrhages and pallor due to anterior ischemic optic neuropathy. An image shows a swollen optic disc, with spots of hemorrhage in the retina.

Current Medical Diagnosis & Treatment 2025 > Ischemic Optic Neuropathy

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eFigure 7–65. Bilateral optic atrophy with disk pallor due to chronic optic neuritis. An image shows pale optic nerves originating from the optic disk in the retina.

Current Medical Diagnosis & Treatment 2025 > Optic Neuritis

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eFigure 14–8. CT scan with contrast enhancement of the abdomen depicting 6.0 cm infrarenal aortic aneurysm. White arrow, luminal flow enhanced by contrast; blue arrow, mural thrombus; red arrow, calcification of arterial wall. An abdominal C T scan of an infrarenal aortic aneurysm reveals the pale grey areas of luminal flow, the grey area of the mural thrombus, and the narrow white line around the thrombus, indicating the calcified arterial wall.

Current Medical Diagnosis & Treatment 2025 > Abdominal Aortic Aneurysm

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eFigure 15–1. Normal peripheral blood smear. The RBCs are uniform in size and shape with small central pallor. Normal RBCs are the size of a small lymphocyte nucleus (the center leukocyte shown). Also shown is a polymorphonuclear neutrophil (upper leukocyte) and a monocyte (lower leukocyte). The small purple bodies are platelets. The upper inset is an eosinophil (eosinophilic granules do not cover the nuclei) and the lower is a basophil (basophilic granules do sit on the nuclei). (Used, with permission, from Andrew D. Leavitt, MD.) Two micrographs of a normal peripheral blood smear in high and low magnification.

Current Medical Diagnosis & Treatment 2025 > Anemias

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eFigure 15–1. Normal peripheral blood smear. The RBCs are uniform in size and shape with small central pallor. Normal RBCs are the size of a small lymphocyte nucleus (the center leukocyte shown). Also shown is a polymorphonuclear neutrophil (upper leukocyte) and a monocyte (lower leukocyte). The small purple bodies are platelets. The upper inset is an eosinophil (eosinophilic granules do not cover the nuclei) and the lower is a basophil (basophilic granules do sit on the nuclei). (Used, with permission, from Andrew D. Leavitt, MD.) Two micrographs of a normal peripheral blood smear in high and low magnification.

Current Medical Diagnosis & Treatment 2025 > Anemias

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eFigure 15–2. Iron deficiency anemia, on peripheral blood smear. Virtually all the cells are hypochromic with a pale center and only a thin rim of hemoglobin (arrow). The cells are also smaller than normal (microcytic) as judged by comparison to the size of the nucleus of the typical small lymphocyte shown. (Reproduced, with permission, from Lichtman MA, Shafer MS, Felgar RE, Wang N. Lichtman's Atlas of Hematology. McGraw-Hill, 2016.) A micrograph of the blood smear from a case of iron deficiency anemia. There are small, red cells with increased pallor and a thin, pink border of hemoglobin, indicated by arrows.

Current Medical Diagnosis & Treatment 2025 > Iron Deficiency Anemia

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eFigure 15–3. Hemoglobin H disease, on peripheral blood smear. Note strikingly small RBCs (microcytosis), with pallor and thin rim of hemoglobin (hypochromia), and abnormally shaped RBCs (poikilocytes), including target cells. (Reproduced, with permission, from Lichtman MA, Shafer MS, Felgar RE, Wang N. Lichtman's Atlas of Hematology. McGraw-Hill, 2016.) A micrograph of the blood smear from a case of Hemoglobin H disease reveals small, abnormally shaped red blood cells with pale centers and pink borders. Some of the cells have a bull's eye appearance with a red border and a red center, and some are elongated.

Current Medical Diagnosis & Treatment 2025 > The Thalassemias

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eFigure 15–4. Thalassemia minor, beta, on peripheral blood smear. The red cells are small (microcytic). Compare cell areas to that of small lymphocyte nucleus. The red cells are pale (hypochromic) on average. There is marked variation in hemoglobin content of RBCs (anisochromia) and marked variation in RBC size (anisocytosis). Misshapen red cells (poikilocytes) are frequent, including teardrop, oval, elliptical, and fragmented cells. The arrow points to a stippled red cell, characteristic of thalassemia minor and a very important distinguishing feature from iron deficiency anemia, which does not have stippled red cells as a feature. (Reproduced, with permission, from Lichtman MA, Shafer MS, Felgar RE, Wang N. Lichtman's Atlas of Hematology. McGraw-Hill, 2016.) A micrograph of the blood smear from a case of beta thalassemia minor. There are multiple cells with abnormal shapes, including tear drop, elliptical, and fragmented. An arrow indicates a stippled red cell.

Current Medical Diagnosis & Treatment 2025 > The Thalassemias

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eFigure 15–8. Megaloblastic anemia due to vitamin B12 deficiency, peripheral blood smear. The RBCs exhibit marked variation in RBC size (anisocytosis), ranging from macrocytes to microcytes. Misshapen RBCs (poikilocytes) are present. Occasional spherocytes are noted. The cells are normochromic. The asterisks indicate the classical oval macrocytes that are hallmarks of megaloblastic anemia. (Reproduced, with permission, from Lichtman MA, Shafer MS, Felgar RE, Wang N. Lichtman's Atlas of Hematology. McGraw-Hill, 2016.) A micrograph of the blood film from a case of megaloblastic anemia. The image reveals oval, large, red blood cells, with reduced central pallor.

Current Medical Diagnosis & Treatment 2025 > Vitamin B₁₂ Deficiency

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eFigure 15–13. Sickle cell disease, peripheral blood smear. In this patient with hemoglobin SS disease, there are two characteristic cells (arrows). One is the classic crescent shaped cell pathognomonic of sickle cell disease. The other is an elliptical RBC with condensation of hemoglobin leaving a paler outer rim of cytoplasm, also characteristic of hemoglobin SS. Also present in the center of the smear are two target cells. (Reproduced, with permission, from Lichtman MA, Shafer MS, Felgar RE, Wang N. Lichtman's Atlas of Hematology. McGraw-Hill, 2016.) A micrograph of the blood film from a case of sickle cell disease. The image reveals crescent shaped cells, indicated by arrows. There are also elongated cells, and target cells with dark borders, internal pallor, and dark centers.

Current Medical Diagnosis & Treatment 2025 > Sickle Cell Anemia & Related Syndromes

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eFigure 15–15. Hemoglobin CC disease, peripheral blood smear. In this patient who is post-splenectomy, it is easy to note characteristic elliptical crystal-like precipitates of hemoglobin C as well as markedly increased frequency of target cells. The RBC inclusion in the upper right corner is a Howell Jolly body, indicative of the asplenic state. (Reproduced, with permission, from Lichtman MA, Shafer MS, Felgar RE, Wang N. Lichtman's Atlas of Hematology. McGraw-Hill, 2016.) A micrograph of the blood film from a case of Hemoglobin C C disease. The reveals numerous target cells, which have dark borders, pallor, and dark centers. There are dark elliptical precipitates, and a tiny, dark spherical inclusion in the top right of the field.

Current Medical Diagnosis & Treatment 2025 > Hemoglobin C Disorders

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eFigure 15–16. Autoimmune hemolytic anemia, warm antibody type, peripheral blood smear. Spherocytes are markedly increased in number. In the center, there is an example of erythrophagocytosis (a leukocyte with ingestion of two RBCs). (Reproduced, with permission, from Lichtman MA, Shafer MS, Felgar RE, Wang N. Lichtman's Atlas of Hematology. McGraw-Hill, 2016.) A micrograph of the blood film from a case of autoimmune hemolytic anemia. The image reveals numerous spherical red cells with reduced pallor, and two red cells within a single, dark leukocyte.

Current Medical Diagnosis & Treatment 2025 > Autoimmune Hemolytic Anemia

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eFigure 15–17. Hemolytic-uremic syndrome, peripheral blood smear. Characteristic findings include anisocytosis (RBCs of varying size), spherocytosis (RBCs that are sphere-shaped rather than biconcave disks), and poikilocytosis (RBCs that are abnormally shaped) as well as an absence of platelets, reflecting a marked thrombocytopenia (low platelet level). The fragmented RBCs with pointed ends are schistocytes, consistent with this being a microangiopathic process. (Reproduced, with permission, from Lichtman MA, Shafer MS, Felgar RE, Wang N. Lichtman's Atlas of Hematology. McGraw-Hill, 2016.) A micrograph of the blood film from a case of hemolytic uremic syndrome. The image reveals blood cells of varying sizes, some with reduced pallor. Some cells appear spherical in shape, and some are fragmented.

Current Medical Diagnosis & Treatment 2025 > Microangiopathic Hemolytic Anemias

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eFigure 15–34. Hodgkin lymphoma, mixed cellularity subtype, excisional lymph node biopsy. Shown here at high power to emphasize the larger Reed-Sternberg cells pathognomonic for Hodgkin disease as well as Reed-Sternberg variant cells (or lacunar cells). At low power (not shown) the mixed cellularity subtype of Hodgkin lymphoma shows a mixture of lymphocytes and histiocytes without significant fibrosis. (Reproduced, with permission, from Lichtman MA, Shafer MS, Felgar RE, Wang N. Lichtman's Atlas of Hematology. McGraw-Hill, 2016.) A micrograph of the lymph node biopsy section from a case of Hodgkin lymphoma. The image reveals large, Reed Sternberg cells with decreased pallor and purple rings within, and smaller variant cells with dark purple lacunae.

Current Medical Diagnosis & Treatment 2025 > Hodgkin Lymphoma

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eFigure 17–6. Distal esophagus (squamocolumnar junction) with 2 linear erosions > 5 mm in length at 2 and 10 o'clock (LA Grade B). (Used, with permission, from Y. Chen.) An endoscopy image reveals two erosions at the squamocolumnar junction of the esophagus. The erosions appear as rough, pale pink patches spreading into the smooth, bright pink mucosa.

Current Medical Diagnosis & Treatment 2025 > Gastroesophageal Reflux Disease

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eFigure 17–18. A: A benign, clean-based gastric ulcer. B: A large deep gastric ulcer due to NSAID ingestion with red spots suggestive of recent bleeding. Biopsy of ulcer margins were negative for carcinoma. (Used, with permission, from Y. Chen.) An endoscopy image reveals an ulcerated lesion on the gastric mucosa. It appears pitted and pale pink, with a bright red border. An endoscopy image reveals a large, irregular gastric ulcer. The ulcer is white with bright red spots.

Current Medical Diagnosis & Treatment 2025 > Peptic Ulcer Disease

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eFigure 17–18. A: A benign, clean-based gastric ulcer. B: A large deep gastric ulcer due to NSAID ingestion with red spots suggestive of recent bleeding. Biopsy of ulcer margins were negative for carcinoma. (Used, with permission, from Y. Chen.) An endoscopy image reveals an ulcerated lesion on the gastric mucosa. It appears pitted and pale pink, with a bright red border. An endoscopy image reveals a large, irregular gastric ulcer. The ulcer is white with bright red spots.

Current Medical Diagnosis & Treatment 2025 > Peptic Ulcer Disease

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eFigure 17–28. Mild ulcerative colitis characterized by loss of normal vascularity and scattered small erosions. (Used, with permission, from A. Huang.) An endoscopy image of the colon reveals abnormally pale pink mucosa with a granular, white surface.

Current Medical Diagnosis & Treatment 2025 > Inflammatory Bowel Disease

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eFigure 17–39. External hemorrhoid characterized by its location adjacent but external to anal opening and squamous epithelium. (Used, with permission, from Y. Chen.) A photo taken from outside the rectum reveals the protrusion of an internal hemorrhoid appearing as a pale pink protrusion close to the dentate line.

Current Medical Diagnosis & Treatment 2025 > Hemorrhoids

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eFigure 22–25. Raynaud phenomenon of the hands characterized by paroxysmal bilateral digital pallor and cyanosis followed by rubor; early in attacks, only one or two fingertips may be affected but as it progresses, all fingers down to the distal palm may be involved. (Used, with permission, from Nicole Richman, MD.) A photo shows that the upper portion of fingers in both hands of a patient are purple in color.

Current Medical Diagnosis & Treatment 2025 > Raynaud Phenomenon

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eFigure 22–31. Giant cell arteritis. This temporal artery has a wall that is thickened by an inflammatory infiltrate. The inflammatory infiltrate includes giant cell formation (arrow). Hematoxylin and eosin, 200 ×. (Reproduced with permission from Kemp WL et al. Pathology: The Big Picture. McGraw-Hill, 2008.) A micrograph shows a white area surrounded by pink tissue, followed by a wide ring of infiltrating tiny purple cells. At the leading edge of the ring on the right of the field are pale violet areas surrounded by tiny purple cells, indicated by an arrow.

Current Medical Diagnosis & Treatment 2025 > Polymyalgia Rheumatica & Giant Cell Arteritis

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eFigure 29–3. Necrobiosis lipoidica diabeticorum on the lower leg with typical findings of skin atrophy, yellow coloration, and prominent blood vessels. (Used, with permission, from Umesh Masharani, MB, BS, MRCP, University of California, San Francisco.) A patient with Necrobiosis lipoidica diabeticorum exhibits a few irregularly shaped lesions and spots on the lower leg. The lesions are pale brown with a red border.

Current Medical Diagnosis & Treatment 2025 > Diabetes Mellitus

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eFigure 33–2A. Recurrent oral aphthous stomatitis. A 58-year-old man presented with a 1-year history of recurrent painful sores in his mouth. He had lost 20 pounds over the year because it hurt so much to eat. The ulcers, which had a red base and were covered with a central white membrane, occurred in different locations—on his tongue, gums, inner lips, and buccal mucosa (shown here). HIV-AIDS is an underlying systemic disease that can be documented on work-up of such patients. (Used, with permission, from Richard P. Usatine, MD, in Usatine RP, Smith MA, Mayeaux EJ Jr, Chumley H. The Color Atlas of Family Medicine, 2nd ed. McGraw-Hill, 2013.) A photo of a pale, flat, glossy ulcer in the buccal mucosa. The margins are well-defined and reddish.

Current Medical Diagnosis & Treatment 2025 > HIV Infection & AIDS: Complications

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eFigure 33–2B. Two aphthous ulcers on the tongue. (Reproduced with permission from Richard P. Usatine, MD, in Usatine RP, Smith MA, Mayeaux EJ Jr., Chumley H. The Color Atlas of Family Medicine, 2nd ed. McGraw-Hill, 2013.) A photo of two pale, flat, slightly elongated ulcers on the tip of tongue.

Current Medical Diagnosis & Treatment 2025 > HIV Infection & AIDS: Complications

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eFigure 33–2C. Minor aphthous ulcer occurring on the buccal mucosa. (Reproduced with permission from Richard P. Usatine, MD, in Usatine RP, Smith MA, Mayeaux EJ Jr., Chumley H. The Color Atlas of Family Medicine, 2nd ed. McGraw-Hill, 2013.) A photo of a pale, flat, spherical ulcer in the inside of lower lip. The ulcer has a slight depression at its center.

Current Medical Diagnosis & Treatment 2025 > HIV Infection & AIDS: Complications

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eFigure 35–14. Chancroid. The genital ulcer of chancroid, caused by Hemophilus ducreyi, is deep and painful. It is often accompanied by tender inguinal lymphadenopathy. (Public Health Image Library, CDC) A patient with chancroid exhibits multiple, medium to large, deep moist ulcerous lesions with red margins and pale center, on the penile shaft.

Current Medical Diagnosis & Treatment 2025 > Chancroid

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Figure 36–2. A nonpruritic rash of secondary syphilis on the abdomen. (Used, with permission, from Richard P. Usatine, MD, in Usatine RP, Smith MA, Mayeaux EJ Jr, Chumley H. The Color Atlas and Synopsis of Family Medicine, 3rd ed. McGraw-Hill, 2019.) A patient with secondary syphilis has multiple small pale red splotches of various sizes scattered across the abdomen.

Current Medical Diagnosis & Treatment 2025 > Clinical Stages of Syphilis

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eFigure 37–49. Cutaneous larva migrans. (Reproduced with permission from Rajagopalan S. Parasitic Infection. In Kelly AP, Taylor SC, Lim HW, Serrano AMA, eds. Taylor and Kelly's Dermatology for Skin of Color, 2e. New York, NY: McGraw-Hill Education; 2016.) A patient exhibits a pale pink curvilinear band of plaque extending from under the ear to the lateral neck and transversely on the neck.

Current Medical Diagnosis & Treatment 2025 > Cutaneous Larva Migrans (Creeping Eruption)

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