Featured Derm Dx

Derm Dx: Discoloration on the buttocks and lower back

A 52-year-old woman with a history of chronic vertebral disk problems and lumbar surgery is referred for evaluation of a discoloration affecting her buttocks and lower back. Examination reveals hyperpigmented confluent macules in a mesh-like pattern.

Derm Dx: Pink to flesh-colored papules on a young child

A 17-month-old Hispanic female presents with a 6-week history of a rash most prominent on her arms and legs. A complete blood count reveals slight leukocytosis, and examination reveals multiple pink to flesh-colored papules and papulovesicles.

Derm Dx: A rash on the nasolabial folds, eyelashes, and scalp

A 68-year-old male presents for treatment of a rash affecting his nasolabial folds, eyelashes, forehead, and scalp. He complains that his condition is itchy and unsightly and that it is most severe in the colder months.

Derm Dx: Multiple moles and extensive sun exposure

The patient is a 47-year-old female requesting full body examination, as she has multiple moles and a family history of skin cancer. Numerous nevi are noted, none clinically or dermatoscopically suspicious.

Derm Dx: Bumps on the leg 10 years after cancer surgery

The patient had salivary gland cancer diagnosed and surgically excised 10 years ago. Examination of the affected ankle reveals scattered erythematous, firm papules.

Derm Dx: A pruritic eruption on the arms and trunk

A patient’s rash began more than 2 weeks ago and has not responded to 1% hydrocortisone cream. He denies fever and malaise and takes no oral medications.

Derm Dx: Simultaneous appearance of multiple indurated plaques

Several of these dusky red indurated plaques appeared simultaneously on the back, thigh, and scalp of a 70-year-old nonsmoker in good health 4 weeks earlier.

Derm Dx: A factory worker with an itchy rash on the wrists and ankles

A 42-year-old manufacturing plant worker presents with an itchy rash that was previously diagnosed as contact dermatitis. Mometasone cream has been ineffective.

Derm Dx: A reddish rash on the scrotum

A 38-year-old man presents with diffuse erythema of his scrotum. Oral fluconazole and topical econazole have been ineffective. He is taking alprazolam for anxiety.

Derm Dx: Discolored patches on the torso of a woman with vulvar lichen sclerosus

Examination of a 62-year-old woman with biopsy-confirmed lichen sclerosus of the vulvar region finds discolored patches with central telangiectasias on her abdomen and chest.

Derm Dx: A growing knot in the palm

A nonsmoker who admits to binge drinking presents with a firm, fixed cord in her palm and loss of mobility and contracture of the ring finger.

Derm Dx: Whitening and crumbling of fingernails

An 11-year-old boy presents with hand and foot blisters, a slight fever, mouth irritation, and most recently, distal whitening and crumbling of 3 fingernails.

Derm Dx: Purplish scrotal lesions in a man with hypertension

A 70-year-old man who takes hydrochlorothiazide for hypertension presents with violaceous papules on his scrotum, which also has a reddish tinge.

Derm Dx: Extensive sun exposure and red lesions on the arms and legs

A 65-year-old man presents with red lesions on his arms and legs. He has no history of skin cancer but admits to ample sun exposure since early childhood.

Derm Dx: A firm nodule with a positive skin crease sign

A 10-year-old boy presents with an asymptomatic firm nodule on his cheek. When the lesion is squeezed, a longitudinal crease is noted at the center.

Derm Dx: An enlarging erythematous nodule on the forehead

A 43-year-old woman presents with a growing nodule on her forehead. When it was smaller, it was "easily covered by my bangs," but now she wants it removed.

Derm Dx: A baby with a rash on the hands and feet

A 3-month-old Hispanic male presents with scattered flesh-colored papules and pustules on his palms and soles.

Derm Dx: Itchy bumps on a man who uses a hot tub regularly

A man presents with itchy bumps on his arms and legs. He lives alone, does not have pets, and uses a hot tub regularly.

Derm Dx: Hyperpigmented, hyperkeratotic papules covered by waxy scale

A moderately obese 40-year-old white woman presents with an intermittently pruritic rash on her chest and flexural and anogenital regions.

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