Lookalikes

Painless Nodules on the Fingers

Case #1 A 35-year-old man presents with several nodules on the dorsal aspect of his left hand. These lesions have been present for several weeks. On questioning, the patient states that his brother has similar nodules on his fingers.  He remembers injuring his hand at work a few days before he noticed the lesions. On…

Case #1

Dark Patch of Skin

Case #1 A 1-month old male infant whose family recently moved to the area presents to your office to establish care. The patient’s father says that he was born with “a patch of raw skin,” but he cannot recall the specific diagnosis. The patient is otherwise healthy and developing normally; there is no family history…

Case #1

Multiple erythematous plaques

Case #1 A 54-year-old Caucasian man presents for examination with a 2-year history of multiple, well-defined, erythematous plaques with fine scale on his abdomen and groin. The patient states that these lesions are very itchy and have significantly increased in size during the past several months. He has not tried any topical medications for the…

Case #1

Growing, dyspigmented lesions

Case #1 A 54-year-old African American woman presents with large dyspigmented patches on her shins bilaterally. She states that the lesions started as small dots that have progressed to large patches during the last several years. She denies pain, itching, or any type of discomfort associated with the lesions. On examination, the patient has large,…

A bilateral, itchy rash

Case #1 A 40-year-old Hispanic man presents with a bilateral rash on his arms that has been present for several weeks. The patient says the rash itches and appears to be getting worse. On examination, the patient has ill-defined erythematous patches and papules on his dorsal and ventral forearms, bilaterally. The patient has a past…

A rash on the upper extremities

Case #1 A 48-year-old man presents with a rash on the upper extremities that has been worsening for 5 months. On examination, the patient has thin erythematous plaques with overlying scale on the upper extremities and dorsal hands. The patient also has patches of hypopigmentation. On questioning, the patient states that the areas of hypopigmentation…

Lesions on the face, lip, and ear

Case #1 A 65-year-old man presents with two lesions on his face. The patient states that the lesions have slowly grown on his cheek and lower lip over the past year. They are not painful and do not itch. He decided to come in because they cause him trouble when shaving. On examination, the patient…

A brown macule on the arm and face

Case #1 A 52-year-old man presents with a lesion on his left arm. He decided to come into the office because he wife asked him to “have the spot checked out.” On examination, the lesion is a 1.2 × 0.8-cm irregularly pigmented, asymmetric brown macule, with color variegation and irregular borders. The patient says the…

A fever and a pruritic rash on the torso

Case #1 A 38-year-old man presents with fever and a pruritic pustular rash on the torso. On examination, the patient has widespread erythematous patches studded with nonfollicular, sterile, pinhead-sized pustules that coalesce into lakes of pus over the torso. The rash has been developing over 72 hours. The patient has had several similar rashes in…

A pruritic rash and erythematous plaque

Case #1 The patient is a 44-year-old woman who presents with a 2-month history of a pruritic rash on her arm. The patient states that she noticed the rash when her arm began to itch. On examination, the rash appears to be an annular, erythematous plaque with overlying scale. Over the past 2 months, the…

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