2012-2013 Academic Year Archives - Dermatology Grand Rounds

Enlarging growth on the foot of a teenage boy

June 26, 2013

Presenter: Holly Kanavy, DO

Dermatology Program: St. Barnabas Hospital

CHIEF COMPLAINT: growth on the bottom of his left foot

CLINICAL HISTORY: 14 yo Caucasian male presented with growth on the bottom of his left foot for 3-4 months. He also endorses pain with ambulation. Previously, he had a series of curettages by podiatry, however the lesion continued to enlarge. Patient has a history of chronic macrocytosis and reticulocytopenia (bone marrow biopsy at age 10 revealed a non-clonal chromosome 15 deletion: 45 XY del(15)(q11.2)), developmental abnormalities, and Autism / Asperger’s disease.

Atypical vascular lesion arising in an area of previous radiation treatment on the breast

June 26, 2013

Presenter: Christian W. Oram, D.O.

Dermatology Program: Lehigh Valley Health Network/Philadelphia College of Osteopathic Medicine

CHIEF COMPLAINT: Lesion on the right breast

CLINICAL HISTORY: The patient presented in October 2010 with a pink to purple asymptomatic plaque on the right medial breast. The lesion had developed in an area of previous radiation treatment for breast cancer. Since the lesion arose in an area of previous radiation treatment, a biopsy was obtained. The lesion remained asymptomatic and stable in size for approximately one year. No treatment was pursued and watchful waiting was implemented, with the intent to biopsy any new or changing areas. At approximately twelve months, within the span of two weeks, the lesion grew four times in size and became tender. This prompted re-biopsy due to the aggressive clinical nature of the lesion.

Axillary pigmented papule in African-American

May 26, 2013

Presenter: Emily Kate Matthews, D.O.

Dermatology Program: PBCGME

CHIEF COMPLAINT: axillary pigmented papule

CLINICAL HISTORY: Patient presented with an enlarging pigmented papule of left axilla and chronic headaches. Multiple BCCs on the face and neck were surgically excised. A history of odontogenic keratocysts at age 15.

Dry and itchy skin for four and half months

April 26, 2013

Presenter: Vienna Lowenbraun, D.O.

Dermatology Program: Genesys

CHIEF COMPLAINT: diffusely “dry and itchy” skin.

CLINICAL HISTORY: A 74-year-old Caucasian male presented with complaint of four and a half months of diffusely “dry and itchy” skin. He noted that the skin changes began suddenly; first noticing the dryness on his arms, and within several days notice that it had become diffuse. He stated that he first noticed the changes two weeks after using a degreasing agent to clean his refrigerator coils and was concerned that the solvent was the source of his xerotic and pruritic skin. Several weeks prior to presenting to our clinic, he sought care at his primary care physician’s office for the same complaints. His primary care physician diagnosed him with having xerosis and was advised to apply Aquaphor twice daily.

Woman with red brown bumps on thighs and back

April 26, 2013

Presenter: Hamblin, T., DO; Brindise, R., DO; Laffer, M., OMS-IV; Grekin, S., DO

Dermatology Program: Oakwood Southshore Medical Center

CHIEF COMPLAINT: pruritic “sun spots” on both lower extremities

CLINICAL HISTORY: A 33-year-old Caucasian woman noticed in 1999 the appearance of pruritic “sun spots” on both lower extremities. She associated the appearance of the lesions with taking antibiotics that she received for strep pharyngitis. She did not remember the name of the antibiotics but did recall that the packaging specified the need for sun avoidance while taking them. She was, however, exposed to several hours of sun each day while vacationing during this time, and noticed the development of the lesions within one week of being on the medication. She subsequently presented to our clinic in June of 2007. She notes that she consulted dermatology out of curiosity regarding the lesions as well as for guidance regarding the severe pruritus associated with them. She noted that the pruritus was much worse with activity and in the winter season, but improved when the involved areas were exposed to sunlight. Review of systems was negative for flushing, lightheadedness, dizziness, anaphylaxis, nausea, vomiting, diarrhea, and bone or muscle pain. The patient’s medical history was unremarkable. Family history was negative for any chronic cutaneous disorders or other related findings.