2014-2015 Academic Year Archives - Dermatology Grand Rounds

Rapidly progressive erythema

May 27, 2015

Presenter: Portela D., Laffer M

Dermatology Program: Oakwood Hospital – Southshore

CHIEFCOMPLAINT: Erythematous papules and patches progressing from head to chest and upper arms after sunburn

CLINICAL HISTORY: A 50-year-old Caucasian male presented with a three-day history of mildly pruritic erythematous papules and patches progressing from his head to his chest and upper arms after experiencing a sunburn during work. The patient complained of a pruritic erythematous rash from his scalp to the mid trunk. Additionally, there was erythema and hyperkeratosis of his hands and feet. The patient’s primary care provider had been treating the patch with a mid potency topical corticosteroid. The patient had a family history significant for psoriasis. He has a past medical history significant for hypertension, treated with atenolol. A review of systems was negative for constitutional symptoms.

Scalp nodule in a transplant patient

May 27, 2015

Presenter: Natalie Edgar DO, Dawnielle Endly DO, Joseph Dyer DO

Dermatology Program: Largo Medical Center / NSUCOM

CHIEF COMPLAINT: Scalp nodule enlarging over 5 weeks

CLINICAL HISTORY: A 49-year-old Caucasian male presented with a scalp nodule enlarging over 5 weeks. The nodule was intermittently bleeding but non-tender to palpation. No previous treatment. Past medical history was pertinent for cystic fibrosis necessitating bilateral lung transplants in 2009. Current medications included mycophenolate mofetil 1.5 g twice daily, tacrolimus 1 mg twice daily, and prednisolone 5 mg daily. He had no history of visceral malignancy.

Recurring hyperpigmented patches

April 27, 2015

Presenter: Christina Steinmetz-Rodriguez, DO

Dermatology Program: West Palm Hospital/PBCGME

CHIEF COMPLAINT: A 32-year-old Hispanic male presented to the dermatology clinic with recurring hyperpigmented patches on his face over the past year that was transient.

CLINICAL HISTORY: A 32-year-old Hispanic male presented to the dermatology clinic with recurring hyperpigmented patches on his face over the past year that was transient. Lesions would erupt in the same location on his face each time on a monthly basis and resolve in 6 to 7 days. Denied any prior medical history and reported no medication use including over-the-counter medications.

Lower extremity lesions in a female with Graves’ disease

April 27, 2015

Presenter: Cherise Khani, DO

Dermatology Program: St. Barnabas Hospital

CHIEF COMPLAINT: Swelling of bilateral lower extremities x 2 years and “raised circles on right shin and toes” x 9 months

CLINICAL HISTORY: A 44 year-old female presented with swelling of her bilateral lower extremities x 2 years, and “raised circles on right shin and toes” x 9 months. Lesions of the right lower extremity were associated only with mild intermittent pruritus. The patient denied pain, numbness, or paresthesias of affected area. She was diagnosed with Graves’ disease in 2009 and successfully treated with radioactive iodine. Resultant hypothyroidism has been well controlled with levothyroxine, without recurrence of symptoms. The patient had a recent surgical excision of masses on right and left great toes, as well as degenerated sesamoid bone of the right foot. The surgical pathology demonstrated benign fibroconnective tissue, showing a myxoid-mucoid background.

Painful, recurrent, bleeding ulcers

April 27, 2015

Dermatology Program: Botsford/McLaren/MSU

CHIEF COMPLAINT: Many-year history of painful, recurrent, bleeding ulcers on her bilateral feet

CLINICAL HISTORY: An 18-year-old female with a history of acne and eczema presented with a many-year history of painful, recurrent, bleeding ulcers on her bilateral feet. She stated that she gets blister-like lesions on especially when on her feet a lot during sports seasons. She had never received treatment for the lesions. Review of systems was negative for any malaise, recent illness, shortness of breath, fatigue, weight loss, or weight gain, and positive for hyperhidrosis of the feet. She was otherwise healthy.