Heberden's. Tender, firm bony outgrowth of the distal interphalangeal joints of the fingers of patients with osteoarthritis. Osler's. Transient, red, painful, nodules located on the palms and the soles in patients with chronic bacterial endocarditis.

Nodular fasciitis. Benign suddenly appearing, freely moveable, subcutaneous nodules especially on upper extremities that may resolve spontaneously. Etiology is unknown and histopathologic examinations may cause an erroneous diagnosis of a malignant tumor.

Nodules, weathering of the ear. Asymptomatic fairly common, multiple, white smooth nodules along the free margin of the helix seen mainly in elderly males with marked sun damage.

Nonspecific protein therapy. Includes injections of autohemotherapy, crude liver, staphylococcus toxoid, snake venom, and boiled milk. Of debatable benefit but may produce a mild increase in secretion of adrenal steroid hormones.

Notalgia paresthetica, 104. See also Pruritic hereditary localized patch on back

Obliterans, arteriosclerosis. A degenerative change mainly in the arteries of the extremities; most commonly seen in elderly men. Leg ulcers and gangrene can result from these vascular changes.

Obliterans, thromboangiitis. Buerger's disease is an obliterative disease of the arteries and the veins that occurs almost exclusively in young men. It mainly involves the extremities and produces tissue ischemia, ulcers, and gangrene.

Ochronosis, 245. A rare hereditary metabolic disorder characterized by a brownish or blackish pigmentation of cartilages, ligaments, tendons, and intima of the large blood vessels due to the deposit of a polymer of homogentisic acid. The urine in ochronosis turns black, particularly in the presence of alkali; hence the term alkaptonuria. See also pigmentary disorders.

Odors from the skin, 7, 374. See also Lochman DS: Cutis 27:645, 1981

Olmsted's syndrome. Very rare; consists of congenital keratoderma of the palms and soles, onychodystrophy, constriction of digits, and periorofacial keratoses. Can be confused with acrodermatitis enteropathica.

Omenn's syndrome. Combined immunodeficiency. Rare, congenital. A type of severe combined immunodeficiency with lymphocytosis and leukocytosis with eosinophilia. Often fatal in childhood with a chronic skin eruption mimicking severe seborrhea, lymphadenopathy, hepatosplenomegaly, recurrent infections, fever, and failure to thrive. Humoral and cellular immunity are both defective.

Onycho-. A prefix from the Greek onyx meaning "nail."

Optic atrophy. Atrophy of the optic nerve due to syphilitic involvement of the central nervous system of the tabetic type. Blindness is the end result. Ophiasis. Snake-like form of alopecia areata around the edges of the scalp. May be especially recalcitrant to therapy.

Orf. A viral infection characterized by a vesicular and pustular eruption of the mouth and the lips of lambs. Sheep herders and veterinarians become inoculated on the hand and develop a primary-type chancre lesion.

Osler's nodes. Tender, erythematous, blanchable, oval, papules on palms, soles, palmar fingers and plantar toes associated with subacute bacterial endocarditis.

Osler-Weber-Rendu disease (Hereditary hemorrhagic telangiectasia). Begins in puberty. Progressive telangiectasias on lips, tongue, palate, nasal mucosa, palms, soles, fingers, nail beds, and throughout gastrointestinal tract. Pulmonary and intranial A-V malformations may occur. Epistaxis and bleeding from internal organs is problematic in this autosomal disease.

Osmidrosis. Malodorous apocrine gland sweating usually in an axillary location. Ostomy skin care. See Stomas

Pachydactyly. Rare benign fibromatosis causing fusiform swelling of multiple fingers over the proximal interphalangeal joints or proximal phalanges. Pachydermoperiostosis. Pachydermia, hypertrophic osteoarthropathy and finger clubbing are part of a rare genetic syndrome.

Pachyonychia congenita. 316, 317f. A rare autosomal dominant condition with thickening of the palms and soles, thickening of the oral mucosa, and hyperkeratosis of the distal nail bed with accumulation of subungual debris.

Palmoplantar eccrine hidradenitis (PEH). Painful, erythematosus palmoplantar nodules in children with resolution after several days of bedrest. On biopsy, inflammation of neutrophils occur in and around eccrine glands and their ducts.

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