By Craig G. Burkhart, MD, MPH

All articles by By Craig G. Burkhart, MD, MPH

A single growing erythematousnonpruritic plaque

A 23-year-old black man complained of a nonpruritic, peripherally growing, annular erythematous eruption that had first appeared on his cheek four weeks ago. The lesion had a slightly raised bright red border with fine trailing scales inside the advancing edge. Tests for fungus were negative. Biopsy of the active border showed discrete parakeratosis, spongiosis, and…

Pruritic swelling in a young woman’s colorful tattoo

<img src="https://www.clinicaladvisor.com/wp-content/uploads/sites/11/2018/12/dc1007case1.gif" A fit and healthy 28-year-old woman presented with an eight-week history of swelling, erythema, and pruritus arising from a defined area of her back. The affected region corresponded exactly to the red pigmented areas of the tattoo she had acquired 18 months before. The patient had previously consulted her primary-care clinician, who had…

Erythematous papules on the extremities

A 38-year-old, mildly obese Caucasian man reported the sudden onset of erythematous, papular lesions. The papules had presented four weeks earlier in crops on the extensor surfaces of his arms and legs and as scattered discrete lesions on his trunk. The patient did not complain of pruritus or pain. He denied any health problems and…

Red weeping nodule on the hand of a young farmer

A 20-year-old agricultural worker requested evaluation of a 3-cm reddish weeping nodule with an ulcerative center. The lesion had first appeared on his hand more than two weeks earlier. The patient noted minimal tenderness of the area but had no other symptoms or constitutional complaints. He had applied bacitracin/polymyxin (Polysporin) ointment, with no success. One…

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