Author: Saba Suleman

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
Program Director: Rick Lin, DO MPH FAOCD

Submitted on: September 18, 2024

CHIEF COMPLAINT:  “Two of my nails turned black “

CLINICAL HISTORY:

Signs and symptoms: A 70-year-old female with no past medical history presented to our clinic with greenish-black discoloration of two fingernails on the right hand. She states she first noticed the color change three months ago after removing nail polish. She further states she goes to the nail salon regularly and was instructed to soak her nails in vinegar. She saw her primary care provider two weeks ago and was started on oral terbinafine. She reports no improvement in the discoloration. Patient denies pain, swelling, and discharge. She also denies a history of smoking, alcohol use, illicit drug use, or recent travel. Patient states she has no personal or family history of skin cancer. 

Continue reading “Green-black discoloration of fingernails in a 70-year-old female”

Presenter: Valeria González-Molina, MD, Thomas L Davis, MD, Rick Lin, DO
Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program
Program Director: Rick Lin, DO MPH FAOCD

Submitted on: June 12, 2024

CHIEF COMPLAINT:  “I have dark patches on both sides of my chest“

CLINICAL HISTORY:

Signs and symptoms: A 66-year-old Hispanic male presented to our clinic with a one-year history of mildly pruritic, purple to brown plaques located on both inframammary folds. The patient reported that the lesions first appeared one week after being hospitalized for a urinary tract infection complicated by sepsis. Initially, the lesions developed on the right inframammary fold and subsequently spread to the left side. He denies involvement of mucosal surfaces or nails.

His medical history included diabetes, gout, hypertension, and dyslipidemia. He had a surgical history of a benign scrotal mass. He reported taking Novolog, Synjardy, allopurinol, lisinopril, metoprolol, and atorvastatin. The patient denied use of  over-the-counter medications and reported no known drug allergies. He was a non-smoker, denied alcohol use, and was currently retired.

Continue reading “Post-Hospitalization Dilemma: Investigating Purple-Brown Plaques on the Chest”

Presenter: Eric Sandrock, DO, Thomas L Davis, MD, Rick Lin, DO
Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program
Program Director: Rick Lin, DO MPH FAOCD

Submitted on: June 12, 2024

CHIEF COMPLAINT: “I have a painful bump growing on my foot”

CLINICAL HISTORY:

Signs and symptoms: A 40-year-old female with a medical history of anemia and hypothyroidism presented to our clinic with a two-month history of a rapidly growing, tender lesion on her right foot. The patient reported no prior trauma to the area and denied experiencing any similar lesions in the past. She also reported no discharge or itching at the site of the lesion. She reported no recent travel, exposure to sick contacts, and has no personal or family history of similar lesions or skin cancer. 

During the evaluation, the patient denied additional systemic symptoms, including fever, chills, night sweats, or unintentional weight loss. Her surgical history was unremarkable, with no recent surgeries noted. The patient is currently on levothyroxine 125 mcg daily for her hypothyroidism.

Continue reading “A Rapidly Growing, Tender Nodule on the Foot”

Presenter: Eric Sandrock, DO, Thomas L Davis, MD, Rick Lin, DO
Dermatology Program:  South Texas Dermatology Residency Program, Bay Area Corpus Christi Medical Center
Program Director: Rick Lin, DO MPH

Submitted on: March 20, 2024

CHIEF COMPLAINT:  “multiple papules on buttocks“

CLINICAL HISTORY:

Signs and symptoms: A 6-year-old female presented to our clinic with a four-month history of asymptomatic flesh-colored papules along the intergluteal cleft. The patient’s mother denied any other involved areas. The patient denies any pain, tenderness, or itching of the lesions. The patient has a past history of intellectual delay, right lower extremity hypertrophy, syndactyly of the 2nd through 4th toes on the right foot, venous malformation involving the right lower thigh, knee, and proximal calf, and lichen striatus of the left lower extremity. The papules had been previously treated with over-the-counter cryotherapy without noticeable improvement. The patient follows closely with a vascular malformation clinic in San Antonio for her diagnosis of Klippel Trenaunay Syndrome. Past surgical history includes syndactyly release of the 4th toe. The patient denies constipation, diarrhea, fevers, chills, trouble sitting or standing, unwanted sexual activity, or use of fragrance wipes. No one in the household has similar lesions.

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Presenter: Valeria González-Molina, MD, Thomas L Davis, MD, Rick Lin, DO
Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program
Program Director: Rick Lin, DO MPH FAOCD

Submitted on:  March 20, 2024

CHIEF COMPLAINT:  “I have a rash all over my body and felt sick the past few days”

CLINICAL HISTORY:

Signs and symptoms: An 18-year-old Hispanic female presented to our clinic with diffusely spread, erythematous plaques and pustules covered by crusts, which had evolved over the past eight months. She denied any mucosal involvement but reported significant symptoms over the last three days, including difficulty walking, fever, skin tenderness, malaise, arthralgia, and headaches. Notably, no one else in her household exhibited similar lesions. The patient denied recent travel, sick contacts, alcohol use, illicit drug use, or smoking.

Of note, she had been admitted to the hospital one week prior to this visit due to concerns about a burn or drug reaction. During her hospitalization, she was started on high-dose oral steroids and was currently taking 10 mg of prednisone daily. Additionally, she had been applying over-the-counter Caladryl lotion to her entire body. The patient denied any known allergies to medications.

Continue reading “Rash Decisions: A Case of Persistent Pustules and Plaques in a Young Female”