Case #1 A 24-year-old woman presents for treatment of “severe acne” that is unresponsive to all topical treatments, including topical benzoyl peroxide, tretinoin, clindamycin, and dapsone. She notes involvement mostly on her shoulders and back, with a few lesions on her chest. She reports that the lesions are often itchy and hypersensitive to touch. She…
Case #1 A 2-day-old infant boy who was born with large, ill-defined, blue-gray hyperpigmented patches on his posterior trunk and sacral area presents. The child’s parents are healthy and have no medical problems. No one in the child’s family has had similar dermatologic findings. The pregnancy was normal and the child was born without complications.…
Case #1 A 64-year-old woman presents with a lesion on her finger. She reports that it appeared 3 months earlier and is occasionally tender at times. At one point, she observed a thick mucus-like substance draining from the lesion. Physical examination reveals a translucent 6-mm nodule with surrounding erythema over the distal interphalangeal joint of…
Case #1 A 32-year-old woman presents with what a primary care physician believed was a “fungal infection” on both knees. The infection had been present there for 3 months. She denies any other affected areas; however, she admits to having had a similar rash in the past, behind her knees and on her arms. She…
Case #1 A 54-year-old woman presents with a 1-day history of a painful pruritic rash on the lower extremity. There are several intact and excoriated bullae on the lower extremity overlying large areas of erythema. The patient states that the rash developed 1 to 2 days after she returned home from her annual family camping…
Case #1 A 52-year-old white man with a history of hypertension and diabetes presents with an intermittent, ongoing blistering rash on his chest and back that has persisted for more than 3 years. The patient reports that the rash was sometimes irritated and painful, and he denies pruritus. He had tried over-the-counter antifungal creams for several…
Case #1 A 17-year-old adolescent girl presents for treatment of a lesion on her index finger. She reports that the lesion was present for approximately 2 years. Initially, it grew quickly, but recently, it has remained stable in size. A friend told her that it was a wart and she could have it frozen. The…
Case #1 A previously healthy 24-year-old man from Honduras presents with a 2-month history of a progressively growing skin lesion on his left knee. He arrived to the United States 1 month earlier and had previously received a 2-week course of unknown antibiotics in Honduras with no improvement. This lesion first appeared after he cut…
Case #1 A 60-year-old man with a history of Hashimoto thyroiditis and rheumatoid arthritis presents with a 3-month history of painful blisters and erosions, which initially presented in his oral mucosa and spread to his skin. Two months ago, he was prescribed captopril for blood pressure control. Examination reveals erosions of his oropharyngeal mucosa and…
Case #1 A 55-year-old man presents with skin lesions that have come and gone over the past several years. The lesions cause minor pain and irritation. The patient admits to picking at the lesions. He has been seen elsewhere several times over the years for this condition, and each time received a prescription for an…
