2013-2014 Academic Year Archives - Dermatology Grand Rounds

Multiple flesh colored papules on face and trunk

June 27, 2014

Presenter: Sarah Croft DO, Jill Salyards DO, Brandon Shutty DO

Dermatology Program: Nova Southeastern University/Largo Medical Center

CHIEF COMPLAINT: multiple pruritic “bumps” on his back

CLINICAL HISTORY: A 52-year-old Caucasian male presents for an initial evaluation with multiple pruritic “bumps” on his back that seem to be increasing in number over 2 years time as well as new lesions on the cheeks that he cuts while shaving. Topical emollients do not relieve symptoms.

Multiple asymptomatic “white” patches

June 27, 2014

Presenter: Alexandra Grob, DO, Kristi Hawley, DO

Dermatology Program: Oakwood Southshore Medical Center

CHIEF COMPLAINT: multiple asymptomatic “white” patches present since birth

CLINICAL HISTORY: A 14-year-old Caucasian female presented with multiple asymptomatic “white” patches on her forehead, bilateral arms, and legs, present since birth. She states the patches have grown in proportion to her growth, and that “brown spots” gradually began to form within and around these areas. She states her father and paternal grandfather also have similar clinical findings. A review of systems was negative for hearing impairment, ocular abnormalities, or recurrent infections. She denies any previous treatment.

Ulcerative lesions in returning travelers

May 27, 2014

Presenter: Shana Rissmiller, DO, Sarah Ferrer, DO, Emily Matthews, DO, Jamie Groh, DO

Dermatology Program: West Palm Hospital/ Palm Beach Consortium for Graduate Medical Education

CHIEF COMPLAINT: An evolving ulcerative lesion on the left forearm

CLINICAL HISTORY: A 51-year-old Colombian male presented to the office with an approximately 3-week history of an evolving ulcerative lesion on the left forearm. He first noticed the lesion shortly after returning from a 2-month recreational stay in Colombia. He denied any known trauma or arthropod assault. The lesion reportedly began as a non-pruritic erythematous papule. Over the course of the subsequent weeks, the area enlarged, ulcerated, and became crusted. He denied fever, chills, or abdominal pain.

Pruritic, painful callus on the toe

March 27, 2014

Presenter: Ashley Feneran, D.O., Sital Patel, D.O., Kevin Cooper, M.D.

Dermatology Program: University Hospitals Richmond Medical Center

CHIEF COMPLAINT: A new-onset callus on the left third toe

CLINICAL HISTORY: 40-year-old Caucasian female with no significant past medical history who presents with a new-onset callus on the left third toe. Initially, the patient complained of pruritus and pain at the site which worsened over time. Eventually, the site drained purulent exudate. Three 7-day courses of levofloxacin 500mg daily prior to presenting to dermatology. Prior to the development of the lesion, the patient admits to traveling to Kenya to perform in rural outreach projects. A bone scan was negative for osteomyelitis.

Rash with occasional small blisters

March 27, 2014

Presenter: Sean Branch, D.O., Ryan Owen, D.O., Luis Soro, D.O., Christian Oram, D.O., Stephen Hemperly, D.O., and Kelly Reed, D.O.

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

CHIEF COMPLAINT: rash with occasional small blisters

CLINICAL HISTORY: A 79-year-old male complained of a rash with occasional small blisters. The generalized rash began 4 months ago and was mildly pruritic. Small blisters appeared to rupture easily and leave behind superficial erosions. There was no history of any new or changing medications prior to the onset of his rash. Triamcinolone 0.1% cream helped somewhat. The rash improved with a course of oral corticosteroids but returned once the medication was completed. The patient could not tolerate methotrexate or azathioprine.