2011-2012 Academic Year Archives - Dermatology Grand Rounds

Pruritic, purple plaques on the legs and axilla

June 26, 2012

Presenter: Katherine Johnson, D.O.

Dermatology Program: Botsford Hospital

CHIEF COMPLAINT: lower extremity swelling, pruritis, and pain

CLINICAL HISTORY: A 67-year-old Caucasian male presented to the clinic with a chief complaint of lower extremity swelling, pruritus, and pain. He also complained of discoloration of his lower extremities, right arm, and axillae, stating that one of his feet was “turning black”. Over a one-month duration, the patient noticed dark patches developing on his lower extremities, right upper extremity, and axillae. There was associated edema in his lower extremities accompanied by pain and pruritus. The patient visited urgent care, an emergency room, and his podiatrist for the chief complaint. Laboratory studies, radiographs, and an EKG were all found to be normal. The patient’s past medical history included renal transplantation in October 2010, and was maintained on mycophenolate mofetil 1g PO BID, tacrolimus 3mg PO BID, and prednisone 10 mg PO daily. Pertinent family medical history included a brother who was deceased due to malignant melanoma found in the axillae.

Tender plaques of the trunk

June 26, 2012

Presenter: Jonathan Cleaver DO, Cathy Koger DO, Peter Knabel DO, Stephen Plumb DO

Dermatology Program: Northeast Regional Medical Center

CHIEF COMPLAINT: tender and irritated plaque that drains

CLINICAL HISTORY: A 37-year-old Caucasian male presented with a 1-year history of a tender and irritated plaque that would drain fluid located on the left anterior shoulder that drains clear fluid. No previous therapy.

Hyperpigmented blistering lesion in a 13 yo female

May 26, 2012

Presenter: Michael Kassardjian, Helia Eragi, Teresa Ishak

Dermatology Program: Western University/Pacific Hospital Long Beach

CHIEF COMPLAINT: Painful blistering rash on the body

CLINICAL HISTORY: 13 YO Caucasian female had recently arranged a spa day where each individual laid out in the sun after applying lemon juice and other citrus plants/fruits to their body. Few hours after the sun exposure, the patient started experiencing pain erythematous rash on sun-exposed areas as mentioned with sparse blisters. No past medical history, no family history, patient otherwise healthy. No systemic symptoms.

Generalized rash

March 26, 2012

Presenter: Chelsea Lee, DO, Payal Patel, DO, Kimball Silverton, DO

Dermatology Program: Genesys Regional Medical Center

CHIEF COMPLAINT: rash located over her back, chest, neck, face, upper and lower extremities for two weeks

CLINICAL HISTORY: A 71-year-old woman presented to the dermatology clinic with a rash located over her back, chest, neck, face, upper and lower extremities for the duration of two weeks. The symptoms included stinging and pruritus. Her past medical history was significant for hypertension and GERD. She had never experienced a rash similar to this in the past, and she denied any recent changes in her health or lengthy exposure to sunlight. In addition, she denied any fevers, joint pains, a history of skin disease, or photosensitivity. The patient did, however, state that she began terbinafine for the treatment of onychomycosis two weeks prior to the development of the rash.

Multiple friable nodules on back

January 26, 2012

Presenter: Jackie Levin D.O., Ralph Fiore D.O., and Ellecia Cook D.O.

Dermatology Program: Largo Medical Center

CHIEF COMPLAINT: Bumps on back

CLINICAL HISTORY: Patient presented with bumps on his mid to lower back for the past two years. The lesions are painful, draining, and worsening. The lesions were recently incised and drained by primary care provider, and patient was using oral and topical antibiotics. Past medical history significant for hidradenitis suppurativa of the axillae, inguinal, and perianal region in which surgical excision was performed.