2003-2004 Academic Year Archives - Dermatology Grand Rounds

Lesion on Right Forehead

December 25, 2003

Presenter: Rick Lin DO MPH and Dan J Ladd DO

Dermatology Program: Kirksville College of Osteopathic Medicine Dermatology Department

CHIEF COMPLAINT: A spot on the right forehead

CLINICAL HISTORY: Patient with a history of basal cell carcinoma returned to clinic for a follow-up visit to be monitored for possible recurrence of Skin Cancer and to evaluate skin for the possible development of new pre-cancers. The patient was found to have a spot on his right forehead. He did not know how long the spot had been there. The lesion is asymptomatic.

Progressively Enlarging Papule

December 25, 2003

Presenter: Jocelyn E. Harris, DO

Dermatology Program: Lehigh Valley Hospital

CHIEF COMPLAINT: A progressively enlarging papule on the patient’s left cheek

CLINICAL HISTORY: Patient presented to clinic for a lesion with no discharge and was neither tender nor pruritic. She denied any history of similar lesions. She also denied fever, night sweats, heat/cold intolerance, and weight fluctuation. Upon initial presentation to her primary care physician, a diagnosis of an irritated epidermal cyst was made and she was prescribed three courses of azithromycin. Incision and drainage by her PCP failed to express any culturable material or cause the lesion to involute.

Generalized Pustules

November 25, 2003

Presenter: Peter Vitulli Jr. DO and Chris Manlio DO

Dermatology Program: North Broward Hospital District

CHIEF COMPLAINT: Fever, malaise, and a skin rash with suspected bacteremia

CLINICAL HISTORY: A 17-year-old Hispanic female was admitted to the hospital with fever, malaise, and a widespread skin rash suggestive of bacteremia. Initially, she experienced pruritus followed by burning pain in her skin, which worsened with movement. She reported a fever reaching 103.7°F, along with nausea, anorexia, and malaise. The patient had a history of psoriasis, previously controlled with mid- to high-potency topical steroids and Dovonex ointment. Approximately six days prior to admission, she was seen by her dermatologist for worsening psoriasis, presenting with multiple erythematous macules in the flexor areas and silvery plaques on the extensor surfaces of her elbows and knees. She was started on triamcinolone 0.1% cream and Dovonex ointment, both to be applied twice daily. Over the next six days, her rash spread extensively, leading to the formation of pustules and prompting her pediatrician to admit her to the hospital.

Disseminated Papules

August 31, 2003

Presenter: Igor Chaplik, D.O., Charles Gropper, M.D., Cindy Hoffman, D.O.

Dermatology Program: St. Barnabas Hospital Dermatology Department, Bronx, New York

CHIEF COMPLAINT: Fever, cough, intermittent headaches, weakness, shortness of breath, and a twenty-pound weight loss over the last month.

Pearly Papule of the Ear

July 25, 2003

Presenter: Dan J. Ladd, DO, Rick Lin DO MPH

Dermatology Program: Texas Division of KCOM Dermatology Residency Program

CHIEF COMPLAINT: Lesion on the left ear that has been slowly growing x 1 year

CLINICAL HISTORY: A 74-year-old Caucasian male presents with a lesion on the left ear that has been slowly growing for 1 year. The lesion is asymptomatic, does not bleed or ulcerate, and has had no previous treatment.