2005-2006 Academic Year Archives - Dermatology Grand Rounds

Skin Irritation of Arms, Face, Ears, and Legs

December 26, 2005

Presenter: JoAnne M. LaRow. D.O.

Dermatology Program: Northeast Regional Medical Center/KCOM

CHIEF COMPLAINT: Skin irritation of arms, face, ears, and legs of two weeks duration

CLINICAL HISTORY: Patient presented to our clinic for skin irritation first noted on her face that gets itchy when she is overheated. She also endorsed arthralgias and fatigue. Patient is post=partum 15 weeks and delivered twin girls via c-section 2/7/03. Her pregnancy was complicated by hypertension in the third trimester. After delivery, she was started on Lisinopril 20 mg QD (started April 2003). She initially saw her primary care provider for the facial eruption and was started on erythromycin 333mg orally three times a day for ten days. The patient completed this treatment four days prior to presentation to our office and was also applying triamcinolone 0.1# cream two to three times a day. She has noted progressive spreading to her arms, ears, and legs.

Diffuse Scaling over Trunk, Neck and Extremities

April 26, 2005

Presenter: Tara H. Lawlor, D.O.

Dermatology Program: Lehigh Valley Hospital-Muhlenberg/PCOM

CHIEF COMPLAINT: “Dry skin all my life”

CLINICAL HISTORY: Patient presented with concerns of dry skin and diffuse scaling on trunk, neck and extremities. He has tried over the counter emollients (Eucerin®). The patient has a nephew with similar skin findings. His birth history was unremarkable with no prolonged labor or failure to progress and he had no history of undescended testes. Urologic and ophthalmologic exams were both within normal limits.

Large, Itchy Bumps All Over the Body

January 25, 2005

Presenter: Nilam Amin DO PGY-3, Marcy Alvarez DO PGY-2, Raymond Ramirez DO PGY-2

Dermatology Program: New York United Medical Center, New York

CHIEF COMPLAINT: Large, Itchy Bumps All Over the Body x 3 days

CLINICAL HISTORY: 60 years old Hispanic male presented with with diffusely spread large, pruritic and painful bumps for three days. Denies burning, discharge, fever or other constitutional symptoms. Has tried topical corticosteroids, blinded biologic trial drug for psoriasis (name unknown), phototherapy, and etanercept (Enbrel®). This patient was diagnosed with chronic plaque psoriasis in 1989. He had been treated with multiple different regimens without significant improvement. Three months prior to his presenting complaint, he has treated with etanercept 25 mg SQ injections BIW. He discontinued etanercept after two months of treatment secondary to the complaint of severe headache. The patient presented to our clinic five months after discontinuation of the injectable biologic. He denies other psoriasis treatments between the time of discontinuation and the outbreak of his eruption. He denies household contacts with similar complaints, recent travel, or prior episodes of similar lesions.

Growth on the Left Foot

January 25, 2005

Presenter: Suleman Bangash, DO, and Carissa Summa, DO

Dermatology Program: New York United Medical Center, New York

CHIEF COMPLAINT: Growth on the Left Foot

CLINICAL HISTORY: Patient with Milroy’s disease (congenital lymphedema) presented with a new growth on left foot that was slightly tender to palpation. She reported that the lesion began as a brown patch and slowly enlarged to a dome-shaped nodule over several years. She also reported multiple similar, but smaller lesions on her upper and lower extremities and trunk. The patient was only taking Hydrochlorothiazide for the lower extremity edema.