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Ecchymosis and Bullous Lesions on a Young Male’s Back

A 20-year-old male with a medical history of diabetes mellitus type 1 presents with ecchymosis and bullous lesions on his back, posterior legs, and buttocks. He was playing football when he ran into another player and became unconscious. He was immobile in the hospital for 3 days before he regained consciousness. He has about 7…

Dry, Scaly Skin in a Young Boy

A 6-year-old Caucasian boy is brought to the clinic by his parents for dry, scaly skin that has persisted for the past 2 years despite the use of commercial moisturizers. His scaly skin is especially notable over his lower extremities, back, and elbows. The patient denies any pain over the affected areas and reports only…

A Pink Rash with Fine Scale in a 7-Year-Old Boy

A 7-year-old healthy boy is brought to the dermatology clinic by his parents after having had a 3-week history of a rash. The patient’s rash was slightly pruritic, and it involved predominantly the trunk, starting as one larger pink patch with fine scale and subsequently spreading with smaller similar macules and patches. The boy’s palms…

Inflammatory Papulopustules in a Young Woman

A 24-year-old Caucasian woman presented with intermittent, inflammatory papulopustules and nodules on the face, neck, chest, and back. The lesions would appear 1 week premenstrually and resolve 1 week postmenstrually with normal menstrual cycles. She has a history of adolescent acne that is only responsive to isotretinoin 6 years ago. Examination revealed scarring and postinflammatory…

Blistering Skin on a Boy’s Hands and Feet

A 15-month-old boy presents with a history of skin blistering since birth, primarily on his hands, feet, and the perioral face. Blisters and erosions also involve the trunk, some in an annular configuration. There is no family history of neonatal blistering or skin fragility. Over time, the patient has had a decreased number of new…

Painful Plaques on the Elbows

A 71-year-old Caucasian man with myelodysplastic syndrome and on chemotherapy with azacitidine presented to the hospital with 2 days of high fever and 4 days of worsening skin lesions. The lesions appeared on the elbows as “blood blisters,” which grew larger and more painful. He denied any other new medications. He was placed on broad…

An itchy rash on a man’s hand

A 37-year-old man without a significant past medical history presents to the dermatology clinic with an itchy rash on his right hand that he has had for about 4 months. He had tried numerous over-the-counter hand creams and hydrocortisone cream with no improvement. Additional questioning revealed a 1-year-history of dry, itchy feet. As a construction…

Hairless plaque on a woman’s forearm

The patient is a 46-year-old woman who presents at your primary care office for an examination with a single lesion that appears on her left arm. During the examination, it is revealed that the patient has a large sclerotic, indurated, hyperpigmented, anhidrotic, and hairless plaque on the right dorsal forearm. The patient states that these…

Spots on the torso and arms

A 38-year-old African American woman was referred to dermatology because of spots on her torso and arms. The lesions were asymptomatic, but their development, cause, and cosmesis were of concern. No benefit was seen with the use of OTC remedies such as hydroxycortisone 1% cream or vitamin E oil. Her medical history was significant for…

Severe acne on the face and chest

The patient is a 21-year-old male who presents for continued acne therapy. He has had severe acne on his face, chest, and back for years. He is happy with his current acne regimen of topical tretinoin, topical clindamycin, and oral minocycline. He has been on the regimen for years. On examination, you notice significant blue-black…

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