Presenter:  Francisca Valenzuela, MD, Thomas L Davis, MD, Michael Hohnadel, DO

Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program

CHIEF COMPLAINT: violaceous plaques on left leg

CLINICAL HISTORY: A 91-year-old gentleman with a history of hypertension, gastroesophageal reflux disease, and vitiligo presented to the clinic with two large violaceous ulcerated plaques on his left lower leg. The patient stated that a papule had formed four months prior after a ground-level fall, and it had continued to grow over the last few months, starting to bleed within a few weeks of his appointment. He denied experiencing pain, itchiness, fatigue, or other B symptoms, such as fever, weight loss, or night sweats. The patient also denied recent travel, smoking, using illicit drugs, drinking alcohol, or taking any new medications. His family history was notable for a deceased brother who had an unknown type of cancer. Current medications included carvedilol, doxazosin mesylate, isosorbide mononitrate, omeprazole, loratadine, clopidogrel bisulfate, losartan, benzonatate, and folic acid.

Presenter:  Francisca Valenzuela, MD, Thomas L Davis, MD, Michael Hohnadel, DO

Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program

CHIEF COMPLAINT: Large red protruding lesion on forehead

CLINICAL HISTORY: A 60-year-old female with no past medical history presented to the clinic with a large red lesion on her forehead and frontal scalp. The patient stated that it began as a small nodule approximately six months prior to her visit and had grown quickly, causing discomfort. She reported no history of head and neck surgeries or procedures. Notably, she had been seeing an oncologist for a couple of months due to anemia of unknown origin, and the oncology team referred her to dermatology for further evaluation of the large plaque.

Presenter:  Francisca Valenzuela, MD, Thomas L Davis, MD, Michael Hohnadel, DO

Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program

CHIEF COMPLAINT: painful nodule on finger nail

CLINICAL HISTORY: A 79-year-old female with no significant past medical history presented to the clinic with a painful nodule on her left third fingernail that had been present for 10 years. The patient reported that the nodule had been slowly growing and became very painful when she submerged her hand in cold water. For the past two years, she had been treated by a midlevel provider who diagnosed her with onychomycosis and a bacterial infection of the left third fingernail. Despite multiple courses of doxycycline and ciclopirox, she noted no improvement in her condition.

Presenter:  Francisca Valenzuela, MD, Thomas L Davis, MD, Michael Hohnadel, DO

Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program

CHIEF COMPLAINT:  “I have persistent growths on my back around a prior surgical scar”

CLINICAL HISTORY: A 23-year-old male with no significant past medical history presented to our clinic with multiple grouped lesions on his back surrounding a previous scar. The patient and his parents reported that he has had these spots since childhood, though they could not confirm whether he was born with them. They also did not remember the specific surgical procedure that created the scar during his childhood. The patient was worried about the spots, as they had recently begun to bleed. He denied any personal or family history of skin cancer.

Presenter: Valeria González-Molina, MD, Thomas L Davis, MD, Rick Lin, DO

Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program

CHIEF COMPLAINT:  “I have dark patches on both sides of my chest”

CLINICAL HISTORY: A 66-year-old Hispanic male presented to our clinic with a one-year history of mildly pruritic, purple to brown plaques located on both inframammary folds. The patient reported that the lesions first appeared one week after being hospitalized for a urinary tract infection complicated by sepsis. Initially, the lesions developed on the right inframammary fold and subsequently spread to the left side. He denies involvement of mucosal surfaces or nails. His medical history included diabetes, gout, hypertension, and dyslipidemia. He had a surgical history of a benign scrotal mass. He reported taking Novolog, Synjardy, allopurinol, lisinopril, metoprolol, and atorvastatin. The patient denied use of  over-the-counter medications and reported no known drug allergies. He was a non-smoker, denied alcohol use, and was currently retired.