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Skin Disorders

Nonhealing painless ulcer on the sole

Michael L. Sonabend, MD, Nicholas R. Snavely, MD, and Sylvia Hsu, MD February 03, 2010

For three years, the patient lived with an enlarging painless ulcer on the sole of his foot. The lesion....

Increase skin cancer screening in primary care

February 01, 2010

Primary-care clinicians are ideally suited to screen and triage people who are at high risk for skin cancer and those with suspicious lesions, but a survey of medical residents revealed....

Facial plaques in aging men

Noah S. Scheinfeld, MD, JD November 03, 2009

Two aging men develop similar-appearing asymptomatic facial plaques

Acute paronychia following cuticle injury

Question by Maria Dellaplain and answered by Philip R. Cohen, MD October 11, 2009

Five months ago, a teenager suffered an injured cuticle while trimming his toenail. The lesion oozes and bleeds after the patient wears shoes, and the surrounding area is very tender and warm. What diagnosis and treatment should I consider?

Evaluation for proximal muscle weakness and rash

Question by Linda Schwab and answered by Philip R. Cohen, MD October 11, 2009

What is the differential diagnosis for a formerly active and healthy 70-year-old woman with worsening proximal weakness, torticollis, and a widespread raised red rash across her cheeks bilaterally?

Hair loss in discrete areas

Noah S. Scheinfeld, MD, JD October 05, 2009

A 40-year-old woman and a 3-year-old boy experience similar patterns of hair loss—one of sudden onset and the other present at birth.

Bilateral pruritic papules on a woman's axillae

Natalia Rompoti, MD, Deborah J. Yang, MD, and Sylvia Hsu, MD September 29, 2009

Skin-colored papules develop on the axillae of an African-American woman.

Linear serpiginous eruptions on the extremities

Carina A. Wasko, MD, and Sylvia Hsu, MD September 28, 2009

A 12-year-old African-American male presented with a two-week history of pruritic linear scaling patches on his feet, legs, and arms after walking barefoot around his backyard.

Skin fusion on the fingers and toes of an adolescent girl

Craig G. Burkhart, MD, MPH September 25, 2009

A 12-year-old white girl seeks treatment for trauma-induced blistering and scarring that had led to fusion of the skin of her fingers and toes. There was no family history of blistering disorders or nail dystrophy.

Differentiating cutaneous dells

Noah S. Scheinfeld, MD, JD August 07, 2009

Two men present with cutaneous heel lesions. Similar growths appear on the patients' hands as well.

Perinasal papules

Thomas Berk and Noah S. Scheinfeld, MD, JD July 07, 2009

A 42-year-old man presented to the dermatology clinic complaining of a white-yellow papule that he had first noticed on his nose about three years ago. Meanwhile, a 55-year-old man complained of small, soft, yellow papules on his nose and face. Test your skills by indentifying these lesions.

Increasing scalp rash blamed on a haircut

Craig G. Burkhart, MD, MPH July 06, 2009

Were an African-American man's scalp bumps caused by his barber?

Painful pedal erythema

By Noah S. Scheinfeld, MD, JD June 02, 2009

An 82-year-old, mildly obese man presented with painful red swollen toes (particularly his second toe) and some pedal redness and pain. Another patient, this an 80-year-old man with a history of painful red lower limbs, said his condition kept him awake at night and had been worsening over the past several months. Can you tell what each of these patients is suffering from?

Peculiar violaceous, atraumatic rash

By Esan O. Simon, MD, MBA June 02, 2009

A 79-year-old Caucasian man with a history of chest pain, light-headedness, and diaphoresis was admitted to rule out acute coronary syndrome. He incidentally noted a bruise that had appeared spontaneously on his chest without trauma four days prior to admission.

Discrete yellow lesions on the eyelid

By Craig G. Burkhart, MD, MPH June 02, 2009

A 57-year-old Caucasian woman has had discrete yellow areas on her eyelids for several years. According to the patient, the precipitating factor was an episode of poison ivy that involved her eyelids four summers ago.

Vitamin B₁₂ soothes oral ulcers

April 13, 2009

A nightly dose of vitamin B12 is an easy, effective, and inexpensive therapy for recurrent aphthous stomatitis, an Israeli study reports.

Enlarging purple pruritic nodules on the back of the neck

By Michael Sonabend, MD March 13, 2009

A 34-year-old African American man presented to our clinic for evaluation of enlarging purple nodules over his neck. The lesions, which had first appeared two months earlier, caused significant itching. A painful rash had preceded the nodules by about a month...

Increased melanoma burden is real

February 11, 2009

If you think you've been seeing more cases of malignant melanoma, you probably have.

3.1

February 05, 2009

Annual percentage increase in new diagnoses of malignant melanoma from 1992 to 2004.

Otitis externa

By Matthew Brier, MD, MPH, and Steven R. Brown, MD February 04, 2009

A quick summary of the latest evidence from the literature on this diffuse inflammation of the external ear canal.

Mysterious body rash

Question by Dennis A. Fito, MD, Oklahoma City, and answered by Jeffrey M. Weinberg, MD January 26, 2009

What's causing this itchy rash on the body but not the face?

Distinguishing dysplastic nevi

By Craig G. Burkhart, MD, MPH January 13, 2009

Two patients present with suspicious moles that could be benign or premalignant. How can you tell which ones bear watching and which ones require excision?

Disfiguring violaceous papules on a woman's nose

By Deborah Yang, MD November 19, 2008

A 47-year-old black woman presented with a several-month history of violaceous papules coalescing into plaques on her nose and cheeks. The lesions were either painful nor pruritic, but she was distressed by the cosmetic disfigurement they caused.

Brown bumps that evolved into verrucous plaques

By Mandy Harting, MD November 19, 2008

A 17-year-old black woman presented with a rash that had first appeared eight months earlier on her back and chest. The eruption, which had begun as just a few bumps, now appeared to be spreading.

Two erythematous leg rashes

By Noah S. Scheinfeld, MD, JD November 19, 2008

Psoriasis drug gets updated label

October 20, 2008

The FDA announced labeling changes for efalizumab (Raptiva) to highlight the risks of life-threatening infections, including progressive multifocal leukoencephalopathy (PML).

Tender, rupturing facial pustule in an otherwise healthy man

BY CRAIG G. BURKHART, MD, MPH October 12, 2008

A healthy 35-year-old white man complained of mild-to-moderate sensitivity in his lower incisor whenever he chewed for the past year. Four months ago, a recurrent painful tender swelling developed on his chin. The lesion began as a small pustule that subsequently ruptured. A bacterial culture revealed...

Nail pitting

Question submitted by Sandra Willingmyre, MD, Camden, N.J., and answered by Jeffrey M. Weinberg, MD October 06, 2008

In addition to psoriasis, what conditions cause nail pitting, and what can be done about it? Nail pitting occurs in response to pathology in the nail matrix, mostly the...

Clinical Quiz: Dermatology Dx

Craig G. Burkhart, MD, MPH October 06, 2008

A 13-year-old girl complained that her eyes had a red, swollen appearance (Figure 1). She estimated that the problem had been present for three months. Antifungal creams, moisturizers, and topical steroids had not proven beneficial. Although she reported no other rashes, there were violaceous, flat-topped papules over her finger joints (Figure 2) and a symmetric macular erythema on the backs of her elbows. On questioning, she stated that she felt tired and had difficulty walking the steps to her junior high school classes.

A growing number of flesh-colored facial papules

BY MANDY S. HARTING, MD, AND SYLVIA HSU, MD October 02, 2008

A 19-year-old Caucasian woman presented with a number of small skin-colored papules on her face. The first lesion had appeared on the nasal ala two years earlier. Since then, many more papules had developed on her face....