2007-2008 Academic Year Archives - Dermatology Grand Rounds

Facial mass

Chief Editor — Tue, 26 Feb 2008 04:54:07 +0000

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.

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Pruritic plaques in the axillae

Chief Editor — Tue, 26 Feb 2008 04:50:11 +0000

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.

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Pruritic erythematous rash after sun exposure

Chief Editor — Sat, 26 Jan 2008 03:37:42 +0000

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.

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Persistent plaques after bone marrow transplant

Chief Editor — Wed, 26 Sep 2007 03:24:35 +0000

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.

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Reddish-brown macules

Chief Editor — Sun, 26 Aug 2007 03:32:45 +0000

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.

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Painful nodules on the feet

Chief Editor — Sun, 26 Aug 2007 03:00:54 +0000

Presenter: Kenneth T. Kircher, DO

Dermatology Program: Philadelphia College of Osteopathic Medicine / Lehigh Valley Hospital

CHIEF COMPLAINT: Painful Nodules on Plantar Aspects of Feet

CLINICAL HISTORY: A well-appearing 12-year-old girl presented to the office with exquisitely tender erythematous dermal to subcutaneous nodules on the plantar and lateral aspects of both feet. The patient states that she awoke two days ago with 1-2 slightly raised erythematous nodules on her right foot, that were very tender to walk on. By that afternoon, she had 4-6 lesions on the plantar and lateral sides of both feet. They had become increasingly tender and now prevent ambulation. She denies fever, chills, or other constitutional symptoms. She denies exposure to cold, new medications, any recent illness, or trauma although she did have a prolonged ballet recital the day before. No prior treatments.

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Swollen, sore red eye

Chief Editor — Thu, 26 Jul 2007 03:27:50 +0000

Presenter: Tom Mackey, DO; Christian Anderson, DO; Jason Barr, DO

Dermatology Program: AZ Desert Dermatology

CHIEF COMPLAINT: “swollen, sore red eye" x 3 weeks

CLINICAL HISTORY: A 64-year-old Caucasian female presents to our clinic complaining of a "swollen, sore red eye" for the past three weeks. In addition to her using over the counter topical antibiotics, her primary doctor placed her on ciprofloxacin 500mg PO QD, currently day 5. Both the patient and her primary doctor are concerned that her condition is worsening despite treatment. Her condition began as a suspected "bug bite" which has just grown to involve the entire eye. Part of the lesion had blistered and some oozing was noted, but no ulceration. The patient denied recent URI, fever, vision changes, ptosis, or photophobia. She described some scant AM discharge from her eye without purulence.

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Unilateral hyperpigmented axillary eruption

Chief Editor — Sat, 26 May 2007 02:57:18 +0000

Presenter: Risa Gorin, DO

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

CHIEF COMPLAINT: Unilateral Hyperpigmented Axillary Eruption

CLINICAL HISTORY: A 71-year-old Hispanic female with a past medical history of insulin-dependent diabetes, and left cerebral vascular accident was referred by her primary care physician for evaluation of a unilateral, hyperpigmented rash located in the right axilla. According to the patient the rash had been present for three weeks. She admitted to using copious amounts of deodorants in the area. The patient denied any symptoms of pruritus or burning. Prior to the presentation, she did not receive any treatment for her rash.

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