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REVIEW OF CASES
January 2005:
St. Johns Episcopal Hospital, South Shore, Far Rockaway, New York
Case 1:
Growth on the Left Foot
History
Lesion was slightly tender to palpation. The patient had a past
medical history significant for Milroy’s disease (Congenital Lymphedema).
She reported that the lesion began as a brown patch and slowly enlarged
to a dome-shaped nodule over several years. She also reported multiple
similar, but smaller lesions on her upper and lower extremities and
trunk. The patient was only taking Hydrochlorothiazide for the lower
extremity edema....
[Read the Entire Case]
Case 2:
Large, Itchy Bumps All Over the Body
History
Intense pruritus and pain at lesion
sites. Denies burning, discharge, fever or other constitutional
symptoms. This patient was diagnosed with chronic plaque psoriasis
in 1989. He had been treated with multiple different regimens without
significant improvement. Three months prior to his presenting complaint,
he was treated with etanercept 25 mg SQ injections BIW. He discontinued
etanercept after two months of treatment secondary to complaint of
severe headache. The patient presented to our clinic five months after
discontinuation of the injectable biologic. He denies other psoriasis
treatments between the time of discontinuation and the outbreak of his
eruption. He denies household contacts with similar complaints, recent
travel, or prior episodes of similar lesions.....
[Read the Entire Case]
September 2004:
St. Johns Episcopal Hospital, South Shore, Far Rockaway, New York
Enlarging Skin Lesion
Since Birth
History
1 month old female presents with an
enlarging skin lesion since birth of the right forearm, wrist and hand.
The mother states that the lesion has been present since the baby was
born and has been getting bigger. The child demonstrates full range of
motion of the arm, no crying,crankiness or failure to thrive...
[Read the Entire Case]
History
2 year-old girl, presented to the
clinic at the age of 11 months. She had a 4-month history of change in
the color and texture of her hair. Per the patient’s mother, her hair
had gradually gotten lighter, kinkier, and more difficult to comb.
Mother denies any hair loss or breakage. Patient is otherwise healthy.
Growth and development have been normal. Patient takes no medicines. The
patient’s 1 year-old sister is now experiencing similar complaints.
Patient’s great aunt had similar hair complaints as a child, which
subsequently improved with her age....
[Read the Entire Case]
History
69 year old
Caucasian female. Mild to moderate pain of
the mouth and tongue for approximately five years. Semi-controlled
with topicals (steroid and antifungal preparations). “Spots”
appearing sporadically on the scalp. No history of bone marrow
transplant, hematopoietic stem cell transplantation, transfusion of
unirradiated blood products or solid organ transplantation...
[Read the Entire Case]
History
A 64 year old Caucasian female presents to our
clinic complaining of a “swollen, sore red eye” for the past three
weeks. In addition to her using over the counter topical antibiotics,
her primary doctor placed her on ciprofloxacin 500mg P.O. Q.D.,
currently day 5. Both the patient and her primary doctor are concerned
that her condition is worsening despite treatment...
[Read the Entire Case]
History
40 year old Caucasian Male had been in a hot tub two weeks prior to the
onset of his lesions. The suddenly appeared suddenly on his knees and
elbows and subsequently spread to his abdomen, lower back, thighs and
buttocks....
[Read the Entire Case]
History
A 7 month-old, healthy appearing, well-nourished male presented with a
0.5cm firm, yellow-pink, dome-shaped nodule was noted on the right,
lateral, distal third digit. An adjacent, well-healed scar from previous
surgery was also present. There was no evidence of any physical
impairment secondary to the growth... [Read the Entire Case]
History
A 50 year old
Caucasian Female believed it first appeared after a
radiographic study with contrast for follow up of her metastatic breast
carcinoma.
[Read the Entire Case]
History
A 74 year old
Caucasian Female stated the lesion had no discharge and was
neither tender nor pruritic. She denied any history of similar lesions.
She also denied fever, night sweats, heat/cold intolerance, and weight
fluctuation.
[Read the Entire Case]
November 2003: North
Broward Hospital District
Generalized Pustules
History
A 17-year-old Hispanic female was admitted to the hospital with fever,
malaise, and skin rash with suspected bacterimia. Patient
complained initially of pruritis with subsequent burning pain of skin,
which worsened with movement. Patient had concomitant fever up to 103.7,
nausea, anorexia, and malaise. .
[Read the Entire Case]
September 2003: St.
Barnabas Hospital Dermatology Department, Bronx, New York
Affiliated with NYCOM
Persistent Plaques
After Bone Marrow Transplant
History
NC is a 19 yr old Hispanic male with a seven year history of a
persistent rash. The lesions began on his proximal extremities and
increased in number and size over time. The lesions began one year after
allogeneic bone marrow transplant for acute myelogenous leukemia.
However, he stated that he was not taking any immunosuppressants when
the rash started. The lesions were occasionally pruritic and
unresponsive to super-high potency topical steroids.
[Read the Entire Case]
August 2003: St.
Barnabas Hospital Dermatology Department, Bronx, New York
Affiliated with NYCOM
Disseminated Papules
History
41 year old African American male with fever, cough, intermittent
headaches, weakness, shortness of breath, and a twenty-pound weight loss
over the last month.
[Read the Entire Case]
July 2003: Texas
Division of KCOM Dermatology Residency Program, Dermatology Institute of
North Texas
Pearly Papule of the Ear
History
74 year old causcasian male presents with a lesion on the left ear that
has been slowly growing for 1 year. The lesion is asymptomatic, does not
bleed or ulcerate and has had no previous treatment..
[Read the Entire Case]
MAY 2003: St. John’s Episcopal Hospital, Far Rockaway, New York
History
33 year old Yemenite male complains of itchy, dark rash on upper back for 5 years. Patient states that he was treated in Yemen with unknown topical medications. He states that he had some resolution, but then had recurrences.
[Read the Entire Case]
APRIL
2003: University Hospitals of Cleveland-Richmond Heights
47 year old Caucasian male
cames to the office complaining of redundant skin around his neck with a
yellow discoloration. Signs and symptoms: On a review of systems,
patient admits to having had a number of laser surgeries to his eyes and
has been legally blind since 1996. He reports his sister has similar
problems with her eyes but her neck is normal in appearance. Upon
further questioning, patient states he underwent triple bypass surgery
two years ago.
[Read the Entire Case]
FEBRUARY
2003:
St.
John Oakland, Madison Heights, MI
History
73
year-old Caucasian female, was seen about a year ago for evaluation of
multiple papules on her cheeks and nose. The lesions are asymptomatic
but have gradually increased in number since the time of menopause. The
patient's mother and sisters have similar lesions on their faces, which
also started around menopause. However, 4 daughters are currently
unaffected by this process. The patient's past surgical history includes
colonoscopy, left breast lumpectomy, and removal of kidney stone. Her
medications include Fosamax and Premarin. Her past dermatologic history
includes treatment of actinic and seborrheic keratoses. [Read the Entire Case]
JANUARY
2003: AZCOM/KRMC Desert Dermatology, AZ
History
4 yr old with unresponsive fever,
irritability, adenopathy, orolabial erythema/fissures adenopathy, and
distal edema. Patient is a Caucasian male with 7day history of
fever >102.5, malaise, anorexia, and irritability followed by a
nonpruritic truncal eruption on day 2 then a progressively worsening
conjunctival injection (mild), orolabial and nostril dryness and
fissures, cervical adenopathy, and swollen/painful distal extremities.
[Read the Entire Case]
DECEMBER 2002:
Kirksville College of
Osteopathic Medicine Dermatology Department, Duncanville Dermatology
Clinic
History
Past history of basal cell carcinoma. Patient returns
for a follow up visit to be monitored for possible recurrence of Skin
Cancer and to evaluate skin for the possible development of new
pre-cancers. Patient did not know how long the spot on the right
forehead had been there. The lesion is asymptomatic.
[Read the Entire Case]
NOVEMBER 2002:
Sun Coast Hospital, NOVA
Southeastern University Dermatology Program
History
A 58 year-old uncircumcised white male presented to
our dermatology clinic for evaluation of a “rash” on his penis for >5
years. Past medical history was significant for hypertension,
hyperlipidemia and coronary artery disease.
[Read the Entire Case]
History
57 year old Caucasian
female reported a 5-year history of two brown spots on the left hand.
Initially the lesions were blue and attributed to ink stains although
the patient denied contact with any staining chemicals or dyes. The
“spots” increased in size over a two-year period and changed from blue
to brown in color.
[Read the Entire Case]
OCTOBER 2002:
Western University of Health
Sciences, Arizona Dermatology Program, Mesa, AZ
History
Patient: 11 years old Hispanic Female with Painful blisters/ ulcerations
since birth. Fragility of skin and slowly healing, scarring
erosions and ulcers, difficulty swallowing, decreased appetite and
weight loss
[Read the Entire Case]
SEPTEMBER 2002:
Pontiac Osteopathic
Hospital, Pontiac, MI
History
Patient: 34 yo male with a pruritic,
painful groin rash
for
approximately six weeks. The patient experienced a painful,
pruritic and progressive rash located in the groin. The rash began on
the sides of his scrotum and had steadily progressed to involve the
entire scrotum, sides of the penis and upper thighs.
[Read the Entire Case]
AUGUST 2002:
Philadelphia College of
Osteopathic Medicine / Lehigh Valley Hospital
History
Patient:
12 years old white female presented with chief
complaint of painful nodules on plantar aspects of the feet. The
patient states that she awoke two days ago with 1-2 slightly raised
erythematous nodules on her right foot, that were very tender to walk
on. By that afternoon, she had 4-6 lesions on the plantar and lateral
sides of both feet. They had become increasingly tender and now prevent
ambulation.
[Read the Entire Case]
History
Patient: A 60 year-old Hispanic female with a
two-year history of idiopathic crescentic glomerulonephritis presented
with chest pain and shortness of breath. Cardiac ischemia was
excluded with serial lab studies and intravenous heparin was started for
a potential pulmonary embolism. On hospital day three, subcutaneous
nodules were noted on her forehead. These nodules rapidly increased in
size and number over a 24-48 hour period. [Read the Entire Case]
JULY 2002:
Western University College
of Osteopathic Medicine of the Pacific, Coast Dermatology
History
Patient: 54 years old African American Female presents with
painless papules on the upper back for three months, which are
increasing in size and number. The patient states that lesions are
non-tender and have enlarged slowly over time. The patient also states
that new lesions also occur over time. There is no pruritus or discharge
from the lesions. They occur only on the upper back and neck.
[Read the Entire Case]
JUNE 2002:
Nova Southeastern University
/ North Broward Hospital District
History
A 78 year old African American male presents to the
dermatology clinic with a nine year history of a progressively
expanding, mildly pruritic rash on his neck and face. He states the
eruption began on his neck and spread to his face. In addition, he
complains of progressive hair loss and a chronic cough. He had not
sought previous medical attention for this condition.
[Read the Entire Case]
MAY 2002:
St. Barnabas Hospital Dermatology Department
History
Patient
is a 45-year-old black male presented from the nursing home with a 1-week history of bilateral lower
extremity edema and a few month history of a nonpruritic, progressively
enlarging growth of the left foot, that would bleed with mild trauma.
The patient’s past medical history was significant for HIV,
endocarditis, cardiomegaly, congestive heart failure, intravenous drug
abuse, end stage renal disease, and pneumonia.
[Read the Entire Case]
History
A 71 year old
Hispanic female with a past medical history of insulin dependent
diabetes, and left cerebral vascular accident was referred by her
primary care physician for evaluation of a unilateral, hyperpigmented
rash located in the right axilla. According to the patient the rash had
been present for three weeks. She admitted to using copious amounts of
deodorants in the area. The patient denied any symptoms of pruitus or
burning.
[Read the Entire Case]
Case 3:
Persistent Papules
History
Chief
Complaint: “I have rough skin on my neck that won’t go away.”
MZ is a 52 y.o. F with a 20-year history of non-pruritic, gradually
developing lesions on her left neck. The patient denies any previous
treatment of these lesions.
[Read the Entire Case]
APRIL 2002:
KCOM Dermatology Department
History
54 year old white female
presents for in hospital consultation with erythematous nodules on her
forearms bilaterally and her left medial thigh for 2 days duration.
The patient reports some associated tenderness and denies any
associated pruritis, burning or discharge.
She has had no previous occurrence of similar lesions.
[Read the Entire Case]
MARCH 2002:
KCOM/Duncanville Dermatology
History
Patient is a 38 year old black female presented to Dermatology Clinic with the chief •complaint
of multiple lesions on skin. The lesions onset 23 years ago, at
age 15. The symptom includes severe itching. The lesions
were previously diagnosed as keloids. [Read
the Entire Case]
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