Featured Derm Dx

Derm Dx: A rash that doesn't respond to steroids

On receiving treatment for seborrheic keratosis on his back, another rash is noted on a man’s chest and abdomen. The other rash has not responded to steroid treatment in the past.

Derm Dx: Scattered papules on a high school football player

A 16-year-old high school football player presents with scattered flesh-colored papules, and he does not know if his girlfriend, other family members, or teammates has the same lesions.

Derm Dx: An asymptomatic flesh-colored nodule of unknown duration

A flesh-colored nodule is found on examination of a 42-year-old fair-skinned woman. She does not know how long it has been present.

Derm Dx: A growing rash on a man with a history of sun exposure

A fair-skinned 48-year-old man with a history of ample sun exposure presents with dilated blood vessels, brownish hyperpigmentation, and thinning of the epidermis on his neck and upper chest.

Derm Dx: A painful lesion on the inside of the lip

A 50-year-old woman presents with a painful lesion on the inside of her upper lip. She has had similar lesions before, and they heal without scarring.

Derm Dx: A rash on the axillae that sometimes itches or burns

A 45-year-old moderately obese man presents with well-demarcated erythematous patches on the axillae and an erythematous patch with scale on his scalp.

Derm Dx: A rash about the umbilicus

A 53-year-old man presents with a well-demarcated zone of erythema about the umbilicus that has not responded to treatment with betamethasone dipropionate/clotrimazole cream, ketoconazole cream, or oral terbinafine.

Derm Dx: A rare neoplasm on the nose

An 87-year-old man presents with a 3-mm, flesh-colored papule on his nose. He has no history of skin cancer or of similar lesions.

Derm Dx: A persistent pruritic rash on the buttocks

A 22-year-old man presents with a pruritic rash that was diagnosed as scabies 3 weeks earlier. However, the rash has persisted despite treatment with oral ivermectin.

Derm Dx: A farmer's rash that worsened with topical corticosteroid

A farmer, aged 76 years, presents with a moderately pruritic rash on his chest that became worse when he used triamcinolone cream for 3 weeks.

Derm Dx: Dermatitis over the torso that looks like an allergic reaction

A 28-year-old woman presents with a 3-week history of a minimally pruritic dermatitis involving her chest, back, and abdomen. It was initially diagnosed elsewhere as an “allergic reaction.”

Derm Dx: A new growth on a woman who has had skin cancer

A 59-year-old woman presents with a 3-month history of a growth on her forearm. She is a cigarette smoker and admits to both outdoor and indoor ultraviolet light exposure.

Derm Dx: Is this Lyme disease?

A 20-year-old college student tests negative for Lyme disease but is placed on doxycycline. She questions the treatment and why another Lyme titer has not been obtained.

Derm Dx: A waxy, yellowish plaque since birth

A 3-month-old male presents with a waxy, yellowish 3-cm plaque located on his scalp since birth.

Derm Dx: Deeply hyperpigmented, slightly raised papules

A 30-year-old woman presents with a 2-month history of a pruritic eruption on her legs and back.

Derm Dx: Penile lesions in an HIV-positive man

A 52-year-old, HIV-positive man presents with penile lesions that have persisted despite treatment with acyclovir.

Derm Dx: Linear dermatosis that follows the lines of Blaschko

A 3-year-old boy presents with linear bands of slightly hypopigmented papules that follow the lines of Blaschko.

Derm Dx: Striking pigmentation on a former chemical plant worker

A 43-year-old man who has impaired mentation and currently resides in an extended-care facility is being followed for discoid lupus erythematosus affecting his right cheek.

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