2007-2008 Academic Year Archives - Dermatology Grand Rounds

Facial mass

February 26, 2008

Presenter: Alice Do, DO, Brian Kopitzki, DO, Chris Buatti, DO

Dermatology Program: Genesys / Michigan State University

CHIEF COMPLAINT: Facial mass.

CLINICAL HISTORY: A 73-year-old Caucasian woman presented with a 20-year history of violaceous masses of the left periocular area and left chest that has waxed and waned. These lesions were asymptomatic. 10 years ago, the lesions were biopsied and diagnosed as a low-grade B cell lymphoma without systemic involvement, and no chemotherapy was indicated at that time. Over the years, the lesions continued to wax and wane, but recently, the lesions have gotten larger.

Pruritic plaques in the axillae

February 26, 2008

Presenter: Nicole Bright, DO, Sharon Zellis, DO, Tanya Ermolovich, DO

Dermatology Program: Philadelphia College of Osteopathic Medicine/Frankford Hospital

CHIEF COMPLAINT: Pruritic rash in the axillae

CLINICAL HISTORY: A 70-year-old female presents with several month histories of hyperpigmented pruritic lesions in bilateral axillae. No previous treatment history. Her past medical history is significant for arthritis, thyroid disease, diabetes, and hypertension. Her medications include pioglitazone, calcium, valsartan, and thyroid medication. She denies any changes in her soap or laundry detergent. The patient’s lesions persist despite the switching brand of deodorant. She denies dryer sheet usage but uses a scented fabric softener. She also has no known drug allergies.

Pruritic erythematous rash after sun exposure

January 26, 2008

Presenter: John P. Minni, DO and Dwayne D. Montie, DO

Dermatology Program: Columbia Hospital

CHIEF COMPLAINT: “My son gets a rash when he goes outside”

CLINICAL HISTORY: 7 yo male with several month histories of a pruritic red rash which occurs minutes to hours after sun exposure. Patient has tried topical low potency steroids without success. The patient’s mother later related that the patient suffers from frequent cold sores.

Persistent plaques after bone marrow transplant

September 26, 2007

Presenter: Risa Gorin, DO

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

CHIEF COMPLAINT: persistent rash for 7 years

CLINICAL HISTORY: A 19 yr old Hispanic male with a seven-year history of a persistent rash presented to our clinic. The lesions began on his proximal extremities and increased in number and size over time. The lesions began one year after allogeneic bone marrow transplant for acute myelogenous leukemia. However, he stated that he was not taking any immunosuppressants when the rash started. The lesions were occasionally pruritic and unresponsive to super-high potency topical steroids. Family history was non-contributory. Patient was not taking any medications at the time of presentation to our office.

Reddish-brown macules

August 26, 2007

Presenter: Andrea Costanza, DO, Nanda Channaiah, DO, Kevin Belasco, DO, Kevin Dehart, DO, Aaron Bruce, DO and Roger Sica, DO

Dermatology Program: NOVA Southeastern University – Suncoast Hospital

CHIEF COMPLAINT: Adolescent-onset rash and progressively worsening symptoms

CLINICAL HISTORY: We present a 25 y/o female with a history of adolescent-onset rash and progressively worsening symptoms. Upon review of history, the patient admitted to recurrent episodes of headaches, fainting spells, flushing, pruritus, palpitations, wheezing, abdominal pain, and vomiting within the last year. Her skin lesions periodically become raised, erythematous, and pruritic, which are exacerbated with “asthma attacks.” Exercise and Naprosyn worsen her symptoms and induce acute attacks. Neurocardiogenic syncope was also noted in medical history.