53 year old female with rash on the back, arms, and legs

    53 year old female with a history of hypothyroidism and Diabetes Mellitus presents with chronic, intermittently pruritic rash on back since 2009 as well as new similar lesions on the legs and arms since May 2014. The rash consists of erythematous, ill-defined plaques on the back, flanks, arms, and legs. The patient had a patch test done in 2011 which was positive for cinnamic aldehyde 1% SSO, Formaldehyde, Balsam of Peru, Bronopol, Dithiomorpholine, and yellow and possibly blue and black dye. In the past, had minimal imporvement with Desonide 0.05% cream and Triamcinolone cream.

    36 year old male with longstanding rash on palms and soles

    36 year old male presents with rash on his palms and soles since the 7th grade. He has tried topical therapy including steroid creams and moisturizers with some control, but no major improvement. Recently has developed nonhealing ulcer with foul smell over left sole after using pumice stone. Also complains of recurrent "red bumps" over his bilateral lower extremities that can be large, and have been previously treated with incision & drainage, and antibiotic therapy. He has no personal history or family history of psoriasis. No joint pain.

    24 year old male with scattered nonscaly guttate pink plaques

    24 year old male presents with multiple scattered nonscaly guttate pink plaques over chest and back that spread to upper arms then thighs, which has been intermittently present for one year. Has become pruritic over time, which is worse at night. Was treated with fluconazole by PCP, without improvement. No subjective GI complaints, no other systemic symptoms. 

    36 year old male with annular erythematous plaques on the bilateral arms and hips

    36 year old male presents with annular erythematous plaques on the bilateral arms and hips, predominantly in the axillae and the pantline respectively.

    47 year old female with painful fissuring of hands and feet as well as scaly erythematous plaques on the abdomen

    47 year old female presents with several years of painful fissuring of the hands and feet as well as a few new scaly erythematous plaques on the abdomen. The patient had a patch test in 12/2012 that showed positive reactions to nickel, cobalt, and formaldehyde. The patient has since changed all of her personal care products without much improvement. In the past, the lesions on the hands and feet have responded to Clobetasol. The patient had a biopsy of the abdominal lesions prior to grand rounds. Pathology shown here.

    47 year old female with mutliple evolving ulcerations and nonhealing wounds

    46 year old woman with a very complicated medical history, including history of aplastic anemia (2011) status post bone marrow transplant from sister later that year followed nearly 100 days later by sloughing, tightening skin all over her body. Patient has evolving ulcerations that often turn into nonhealing wounds as well as weeping, draining blisters predominantly on her legs and trunk (breasts). Involvement is strictly cutaneous

    56 year old female with orbital swelling and a mass

    The patient was a 56 year old female with orbital swelling and a mass. A biopsy was perfomed.

    Conference: 

    Case 5

    42 year old white man.  Lesion on the finger x 2 years.  Failed "drainage" by PCP.  Vague history of remote trauma (not convincing).  

    Case 4

    34 year old man.  "Lump" on the post-auricular area for years.  Rule out BCC.

    Case 3

    66 year old man.  Blue grey color to head, arms, hands, and other photoexposed areas.  Aficionado of alternative health medicines and supplements. 

    Case 2

    38 year old HIV positive man with nonspecific cutaneous lumps, cough, and headache.  

    Case 1

    A 43 year old man has a “boil” on the arm  2 months after a trip to Central America.

    61 year old female with unilateral facial wrinkling and curling of the hair

    61 year old female with history of Basal Cell Carcinoma on the nose and empty sella syndrome presents with unilateral facial wrinkling and unilateral curling of the hair x 2 years. The patient denies any other asymmetry on body appearance and any loss of senation or motor function in the affected regions or elsewhere. The patient also denies excessive unilateral sun/ruadiation exposure.

    25 year old male with linear erythematous plaques

    25 year old white male (originally from Russia) presents with rash on his right inner thigh x 2 months. The patient reports that the rash is pruritic, nontender, and has not bled or changed. The patient denies any recent travel or other unusual exposures. KOH done in clinic was negative.

    52 year old male with annular plaques

    52 year old male with a history of AAA repair and COPD presents with erythematous annular nonscaly plaques on bilateral upper and lower extremities. Patient reports the plaques are nonpruritic. They are exclusively in photo-exposed regions and improve in the winter.

    Syndicate content