Presenter:  Eric Sandrock, DO; Rick JH Lin, DO

Dermatology Program: South Texas Dermatology Residency Program, HCA Corpus Christi Medical Center Bay Area

CHIEF COMPLAINT: Persistence of pigmented lesion on forehead

CLINICAL HISTORY: A 73-year-old female visited the dermatology clinic for a routine skin evaluation. She had no personal history of skin cancer but reported noticing changes in the appearance of some lesions. During the visit, five shave biopsies were performed. After receiving concerning pathology results, an excision was scheduled, but the patient did not return for 37 months. Upon her return at age 76, the patient was re-evaluated, and it was noted that the previously biopsied pigmented lesion on her right frontal hairline had enlarged.

Presenter: Victoria Comeau, DO, Alexandria Glass, DO, David Lemchak, DO, Haley Lewis, DO, Caitlin Porubsky, DO

Dermatology Program: PCOM/North Fulton Hospital

CHIEF COMPLAINT:  new growth under the right arm

CLINICAL HISTORY: A 36-year-old Caucasian male presented to the clinic with complaints of a new growth under the right arm that had been present for approximately 2 months and had progressively increased in size. He noted tenderness surrounding the lesion but aside from this, the lesion was asymptomatic. Review of systems was negative for any associated fevers, weight loss, night sweats, chest pain, shortness of breath, gastrointestinal discomfort, rash or edema. The patient had not received any previous treatment, as this was his initial presentation. He was, however, prescribed doxycycline due to concern for possible localized cellulitis. His past medical history was significant for hypertension, which was well controlled with Losartan. He denied any pertinent family history.

Presenter:  Francisca Valenzuela, MD, Thomas L Davis, MD, Michael Hohnadel, DO

Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program

CHIEF COMPLAINT: violaceous plaques on left leg

CLINICAL HISTORY: A 91-year-old gentleman with a history of hypertension, gastroesophageal reflux disease, and vitiligo presented to the clinic with two large violaceous ulcerated plaques on his left lower leg. The patient stated that a papule had formed four months prior after a ground-level fall, and it had continued to grow over the last few months, starting to bleed within a few weeks of his appointment. He denied experiencing pain, itchiness, fatigue, or other B symptoms, such as fever, weight loss, or night sweats. The patient also denied recent travel, smoking, using illicit drugs, drinking alcohol, or taking any new medications. His family history was notable for a deceased brother who had an unknown type of cancer. Current medications included carvedilol, doxazosin mesylate, isosorbide mononitrate, omeprazole, loratadine, clopidogrel bisulfate, losartan, benzonatate, and folic acid.

Presenter:  Francisca Valenzuela, MD, Thomas L Davis, MD, Michael Hohnadel, DO

Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program

CHIEF COMPLAINT: Large red protruding lesion on forehead

CLINICAL HISTORY: A 60-year-old female with no past medical history presented to the clinic with a large red lesion on her forehead and frontal scalp. The patient stated that it began as a small nodule approximately six months prior to her visit and had grown quickly, causing discomfort. She reported no history of head and neck surgeries or procedures. Notably, she had been seeing an oncologist for a couple of months due to anemia of unknown origin, and the oncology team referred her to dermatology for further evaluation of the large plaque.

Presenter:  Francisca Valenzuela, MD, Thomas L Davis, MD, Michael Hohnadel, DO

Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program

CHIEF COMPLAINT: painful nodule on finger nail

CLINICAL HISTORY: A 79-year-old female with no significant past medical history presented to the clinic with a painful nodule on her left third fingernail that had been present for 10 years. The patient reported that the nodule had been slowly growing and became very painful when she submerged her hand in cold water. For the past two years, she had been treated by a midlevel provider who diagnosed her with onychomycosis and a bacterial infection of the left third fingernail. Despite multiple courses of doxycycline and ciclopirox, she noted no improvement in her condition.

Presenter:  Francisca Valenzuela, MD, Thomas L Davis, MD, Michael Hohnadel, DO

Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program

CHIEF COMPLAINT:  “I have persistent growths on my back around a prior surgical scar”

CLINICAL HISTORY: A 23-year-old male with no significant past medical history presented to our clinic with multiple grouped lesions on his back surrounding a previous scar. The patient and his parents reported that he has had these spots since childhood, though they could not confirm whether he was born with them. They also did not remember the specific surgical procedure that created the scar during his childhood. The patient was worried about the spots, as they had recently begun to bleed. He denied any personal or family history of skin cancer.