DermDx

Derm Dx: Grey-brown discoloration around the mouth and nose

A 39-year-old Hispanic woman complains of discolored skin around her mouth and nose. She is unsure how long it has been present. The patient reports that she tried using a “bleaching cream” without improvement. Her past-medical history is significant for acne for which she previously took minocycline. She denies prescription medications but is currently drinking…

Derm Dx: An embarrassing mole

A 15-year-old girl presents complaining of a mole on her chest that is inferior to her right breast. The mole was present since birth, but the patient’s mother thinks it may have thickened and darkened slightly during puberty. The girl complains that the mole is very embarrassing, and she is too ashamed to wear a…

Derm Dx: Abrupt skin eruption after brain surgery

A dermatology consult is called to the neurosurgical unit of a children’s hospital for a 16-year-old male patient who developed a rash on his face, chest and lateral upper arms after a surgery. The patient was admitted to the hospital with headaches and seizures and was subsequently found to have a high-grade anaplastic astrocytoma that…

Derm Dx: White lumps on the heel when standing

A 55-year-old man presents complaining of asymptomatic lumps on the sides of his heels that appear when he is standing up, but seem to disappear when sitting. The patient has a history of gout, having experienced two gouty attacks in his left large toe in the past 20 years. He takes hydrochlorothiazide for hypertension. His…

Derm Dx: Itchy red plaques and blisters

A 75-year-old woman presents with extremely itchy red plaques on her trunk and extremities, which she reports were present for months. Initially the eruption started on her shins, but subsequently generalized. Her face and genitals are spared, and she denies any blisters or erosions in her mouth. Symptom review is otherwise negative. The patient has…

Derm Dx: A teen with palmar desquamation

A 19-year-old Hispanic male presents complaining that the skin on his palms has been peeling for several months. He denies any new activities or exposures. The skin is not itchy or painful and, there were no preceding blisters. The patient denies fever or other illness prior to the onset of the condition. He is otherwise…

Derm Dx: A patient with erosions and reddish urine

A 50-year-old white man presents complaining he’s had blisters and erosions on the back of his hands, forearms and posterior neck for months. He describes the erosions as mildly painful, and said they heal with small scars. The patient recently started managing a construction project, and he has been spending most of the day outdoors.…

Derm Dx: Dark papules after stage IA melanoma

A 68-year-old white male with a history of stage IA melanoma presents for his annual full body skin exam. He complains of dark papules on his left ear. The lesions are asymptomatic. On exam, you notice a well-healed scar on his left upper back at the site of melanoma excision. You also note several dark…

Derm Dx: White papule on the nose

A 54-year-old man presents complaining of a whitish papule on his nasal sidewall. He is uncertain how long it has been present but complains that it is embarrassing. The patient’s past medical history is significant for renal cell carcinoma, which was treated with nephrectomy and basal cell carcinomas of the forearm, which were treated with…

Derm Dx: A 25-year history of red spots

A 60-year-old white man presents with a chief complaint of red spots on his trunk and extremities that have developed during the past 25 years. Besides obesity, the patient has no significant past medical history. He is not taking any medications, and a recent physical exam including a complete metabolic panel was unremarkable. The patient…

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