DermDx

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…

Derm Dx: Painful facial eruptions

A 79-year-old man presents with a rash on his face and oral cavity. He has a history of head and neck squamous cell carcinoma and was referred by his radiation oncologist. The patient has been undergoing radiation therapy for the past several months, according to the referring physician. This eruption developed six days after the…

Derm Dx: Nonhealing pruritic rash after vacation

A 28-year-old man developed a pruritic, nonhealing rash after brushing his hand and leg against coral while snorkeling in the British Virgin Islands. The patient did not notice any stinging or pruritus and found no foreign material in the abrasion. During the ensuing nine days, however, the areas became inflamed, pruritic and tender. He denied…

Derm Dx: Bluish-black skin changes, tendinitis and arthritis

A 69-year-old man reports that he began to develop bluish discoloration over his ears in his early 30s. In his late 30s, he started developing deposits of a dark pigment in his sclera. The patient subsequently developed severe arthritis and tendonitis requiring extensive surgical interventions, including spinal laminectomies; bilateral knee, hip and shoulder replacement; and…

Derm Dx: Linear, streaky vesicles at birth

An infant in the pediatric clinic has been exhibiting interesting skin findings. At birth, she had a linear and streaky distribution of vesicles on her trunk and extremities, which subsequently progressed to verrucous plaques at age 2 months and hyperpigmented streaks at age 5 months. The infant appears to have a small patch of alopecia…

Derm Dx: Symmetrical pink papules on the cheeks, arms and legs

A 3-year-old male presents with an eruption of pink papules on the cheeks, arms and legs that has been present for four days. The boy’s mother reports he has not been scratching the lesions. Both the patient and his older sister had a recent cold, but the older sister does not have a rash. The…

Derm Dx: Asymptomatic eruption between the shoulders

A 16-year-old black female presents complaining of an eruption between her shoulder blades. She is not sure when the eruption first appeared, but her mother complains that it is unsightly. The patient denies pain or itch in the affected area. She also denies any prior past medical history or medication use. She reports that her…

Derm Dx: Bright pink malar rash

A 5-year-old girl presents with a rash on her cheeks that has been present for one day. The girl’s mother reported that the rash appeared quite suddenly. The patient is otherwise well, without fevers, upper-respiratory symptoms, arthralgias or malaise. A complete review of symptoms is negative. The girl has no sick contacts or history of…

Derm Dx: Red plaque with ulceration

A 3-month-old infant presents with a lesion on the scalp that her parents are concerned about. At birth, there was only a very small bruise-like lesion on the scalp that the girl’s pediatrician thought may have been due to trauma from delivery. At three weeks of age, the “bruise” developed into a pink patch and…

Derm Dx: Flat-topped, slightly violaceous papules

A 50-year-old otherwise healthy black male presents complaining of itchy papules that have been present for several months. He denies any preceding illnesses or medication changes. Besides extreme pruritis, his review of symptoms is negative. Past medical history is unremarkable. Family history is noncontributory. He was seen recently at an urgent care clinic and prescribed…

Next hm-slideshow in Clinical Quiz