Uncategorized - Clinical Advisor

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Derm Dx: Papules and Plaques of the Posterior Neck

Acne keloidalis nuchae (AKN) begins as papules and pustules that develop into firm crusted plaques.1 Despite its name, AKN is not a keloid.2 The posterior scalp and neck are the primary sites of involvement, and the condition is almost exclusively found in Black teenagers and young adults.1,2 Hereditary predisposition and the combination of coarse curly…

Ortho Dx: Clavicle Discomfort Following a Fall

Figure 2 shows a hypertrophic nonunion of the clavicle fracture. The process of fracture healing usually takes place over a 6-week period and is typically completed by 3 to 4 months. The size and location of the fracture usually determines the healing time; smaller bones in the hand may take 4 to 6 weeks to…

Derm Dx: Prominent Lesion on the Upper Lip

Verruca vulagris (warts) are among the most common growths encountered by physicians.1 Classic sites of these lesions include the fingers, the dorsal surface of hands, the soles of feet (plantar verrucae), and genitalia (condyloma). Verrucae result from an infection of human papillomavirus (HPV), of which some 200 distinct genotypes have been identified.2 HPV infects basal…

Derm Dx: Itching and Burning on the Arm

The patient was diagnosed with brachioradial pruritus (BP), a type of chronic localized neuropathic itch that commonly presents on the upper arms, elbows, and forearms with or without evidence of scratching.1 The etiology of this entity is uncertain; pathogenesis has been linked to several factors including previous cervical spine or rib injury, as well as…

Hyperpigmented Scaly Plaque on Midline of Back

Confluent and reticulated papillomatosis (CARP) is a relatively rare form of dermatosis that occurs in both sexes and all ethnic groups.1 However, 2 recent studies suggest that CARP occurs more commonly in white patients and ethnicities with lighter skin.1,2 In addition, the average age of onset and sex of CARP patients varies by ethnicity.  Although…

Ortho Dx: Evaluation and Management of Scoliosis

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis in patients between the ages of 10 and 18 years.1 Scoliosis is defined as a lateral curvature >10°.1 Girls are 10 times more likely to have curvatures of >30° and are more likely to have a progressive deformity.1 AIS is best managed based on…

Derm Dx: Nodule on the Forearm

Nodular fasciitis is a self-limited myofibroblastic neoplasm that affects subcutaneous tissue as well as muscle and fascia. The condition was first described in 1955 and was originally classified as a pseudosarcoma because of its resemblance to sarcoma but with a benign outcome.1 The term nodular fasciitis was first proposed in 1966.2 The tumors most frequently…

Ortho Dx: Lower Back Pain Radiating Down Leg

Degenerative spondylolisthesis is a forward slippage of a single vertebra over another and generally occurs in patients >40 years of age.1 Spondylolisthesis can be characterized as degenerative, isthmic, dysplastic, traumatic, or pathologic. Degenerative spondylolisthesis represents 25% of all types of spondylolisthesis of the lumbar spine.1 Degenerative spondylolisthesis originates with disk degeneration and narrowing of the…

Ortho Dx: Chronic Shoulder Pain

The patient’s shoulder pain can be attributed to end-stage shoulder arthritis consistent with rotator cuff arthropathy. Stability of the glenohumeral joint largely depends on the ability of the rotator cuff to keep the humeral head centered in the glenoid cavity.1,2 The rotator cuff exerts an inferior pull on the humeral head that is balanced by…

Derm Dx: Blistering of the Lower Lip

This patient was diagnosed with bullous lichen planus affecting his oral mucosa based on the presence of classic lesions of lichen planus on his extremities, as well as subsequent biopsy findings. Bullous lichen planus is an uncommon variant of lichen planus, a cell-mediated inflammatory disorder that may affect the skin, nails, and mucous membranes. The…

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