2013-2014 Academic Year Archives - Page 2 of 4

65-year-old gentleman with erythematous induration of the skin on his back

January 27, 2014

Presenter: Donna Tran, DO

Dermatology Program: Western University / College Medical Center

CHIEF COMPLAINT: hardening of back

CLINICAL HISTORY: A 65-year-old gentleman presented to our dermatology clinic with complaints of hardening of his back. Painless, progressive hardening of his upper back present for years. He denied any associated symptoms. Denied any previous treatment. Past medical history was significant for insulin-dependent diabetes mellitus.

Rapidly expanding necrotic plaques in an elderly woman

January 27, 2014

Presenter: Cathy Koger D.O., Steve Plumb D.O., Chris Cook D.O., Doug Richley D.O.

Dermatology Program: Northeast Regional Medical Center

CHIEF COMPLAINT: rapidly expanding necrotic plaques of her lower extremities

CLINICAL HISTORY: An 84-year-old Caucasian female presented with rapidly expanding necrotic plaques on her lower extremities that had developed over the past two months. The lesions, characterized by a reticulated pattern, were ulcerated, measuring approximately 15 cm, and extremely painful to the touch. They exhibited a firm, indurated texture and were accompanied by cord-like subcutaneous swellings. The patient had not received any previous treatment for these lesions. She resided in a local assisted living facility, where she received symptomatic care as needed. Her past medical history included hypercholesterolemia, for which she was prescribed Simvastatin, as well as a history of atrial fibrillation that required Warfarin. Notably, she had no prior history of skin cancer or other cutaneous issues.

A 53-year-old male with pruritic red papules

December 27, 2013

Presenter: Scott Thomas DO, John Young MD, Angela Bohlke MD

Dermatology Program: Silver Falls Dermatology/Western University of Health Sciences

CHIEF COMPLAINT: Itchy bumps on body

CLINICAL HISTORY: A 53-year-old male presented to the clinic with complaints of itchy bumps on his body, which had been present for approximately a year and a half. He reported no associated systemic symptoms, recent travel, known exposure to tuberculosis, or prior occurrences of similar symptoms. The patient denied having received any previous treatment for his condition. His social history was unremarkable, and his past medical history was significant only for idiopathic myelofibrosis, for which he had recently started chemotherapy one week prior.

Facial “acne” that has been present for entire life

December 27, 2013

Presenter: Chris Hixon, DO

Dermatology Program: Lewis Gale Hospital Montgomery

CHIEF COMPLAINT: Facial “acne” that has been present her entire life

CLINICAL HISTORY:A 23-year-old female presented to our dermatology clinic seeking treatment for worsening facial “acne,” a condition she has experienced for her entire life. During her initial visit, she was found to have diffuse closed comedones and flesh-colored papules on her forehead and lateral cheeks, along with areas of “ice pick” and atrophic scarring, as well as focal post-inflammatory hyperpigmentation (PIH). Her previous treatments included over-the-counter Clean & Clear Blackhead Eraser, Tazorac 0.05% cream applied nightly, Minocycline 100 mg daily, Doxycycline 150 mg daily, and Tretinoin 0.025% cream applied nightly. Notably, her dermatological history revealed a family history of acne, with both her and her father affected. She reported no chronic medical conditions, but her family history included instances of seizures.

Sudden purpuric rash on the lower legs

November 27, 2013

Presenter: Nathan Jackson DO, Brittany Carter DO

Dermatology Program: Tri-County Dermatology

CHIEF COMPLAINT: New onset rash on the legs and feet x 4 days

CLINICAL HISTORY: A 45 year-old Caucasian Female presented with complaint of new onset rash on the legs and feet of 4 days duration. Patient notes initially lesions started as red bumps on the bilateral lower extremities and then developed into “blisters” that had prominent pruritus and burning component. These lesions were painful and accompanied by noticeable swelling. She does feel she had “hives” one week prior to the rash. This was her initial assessment. Medical history included an essential tremor for which she has taken Propranolol for several years. Surgical history included a cholecystectomy, Caesarean section x 2, hysterectomy and tubal ligation (was non-contributory). She has an allergy to latex for which she has not had recent exposure. Most recent events were a “spider bite” two to three weeks prior at which she did not seek treatment. She has no recent infections, exposures to new drugs or chemicals, or other ROS such as arthritis, arthralgias, or systemic involvement except as listed above.