2016-2017 Academic Year Archives - Page 4 of 4

Bilateral hand and feet nail changes unresponsive to antifungal

July 27, 2016

Presenter: Caitlin Porubsky, DO, Carmen Julian, DO, Irina Milman, DO

Dermatology Program: PCOM Mednet/North Fulton Hospital Medical Campus

CHIEF COMPLAINT: Changes in fingernails and toenails

CLINICAL HISTORY: A 65-year-old Caucasian female with a history of Ulcerative Colitis (UC) presented with nail changes on bilateral hands and feet. The patient started noticing nail changes about 18 months prior to presenting in the office. The patient previously saw a podiatrist, who performed nail clippings that showed onychomycosis. The patient was treated with a two-month course of oral itraconazole, yet her nail symptoms continued to worsen. Subsequently, 18 months prior the patient was started on infliximab for her UC. She continued on this therapy while nail changes progressed.

Painful, non-healing ulcer

July 27, 2016

Presenter: Jeffrey Kushner

Dermatology Program: Saint Joseph Mercy Health System

CHIEF COMPLAINT: Ulcer on her right breast x 3 weeks

CLINICAL HISTORY: A 63-year-old woman presented with a three-week history of an ulcer on her right breast. The ulcer was painful and non-healing. Application of topical mometasone cream provided no improvement. Past medical history included poorly differentiated invasive ductal carcinoma of the right breast status post lumpectomy, localized radiation therapy, and adjuvant chemotherapy with docetaxel and cyclophosphamide. Her final radiation treatment was one year prior to the onset of symptoms and was complicated by acute radiation dermatitis.

Non-radiating right upper quadrant abdominal pain

July 27, 2016

Presenter: Leeor Porges DO, Pamela Sheridan DO

Dermatology Program: Broward General Medical Center

CHIEF COMPLAINT: dark spots on torso and extremities

CLINICAL HISTORY: A 17-year-old girl admitted for evaluation of non-radiating right upper quadrant abdominal pain which had been present for 3 days. The further exam showed unique skin lesions and extracutaneous findings. Family history includes a mother with multiple cafe au lait macules.