Category: 2023-2024 Academic Year

Presenter: Eric Sandrock, DO, Thomas L Davis, MD, Rick Lin, DO
Dermatology Program:  South Texas Dermatology Residency Program, Bay Area Corpus Christi Medical Center
Program Director: Rick Lin, DO MPH

Submitted on: March 20, 2024

CHIEF COMPLAINT:  “multiple papules on buttocks“

CLINICAL HISTORY:

Signs and symptoms: A 6-year-old female presented to our clinic with a four-month history of asymptomatic flesh-colored papules along the intergluteal cleft. The patient’s mother denied any other involved areas. The patient denies any pain, tenderness, or itching of the lesions. The patient has a past history of intellectual delay, right lower extremity hypertrophy, syndactyly of the 2nd through 4th toes on the right foot, venous malformation involving the right lower thigh, knee, and proximal calf, and lichen striatus of the left lower extremity. The papules had been previously treated with over-the-counter cryotherapy without noticeable improvement. The patient follows closely with a vascular malformation clinic in San Antonio for her diagnosis of Klippel Trenaunay Syndrome. Past surgical history includes syndactyly release of the 4th toe. The patient denies constipation, diarrhea, fevers, chills, trouble sitting or standing, unwanted sexual activity, or use of fragrance wipes. No one in the household has similar lesions.

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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
Program Director: Rick Lin, DO MPH FAOCD

Submitted on:  March 20, 2024

CHIEF COMPLAINT:  “I have a rash all over my body and felt sick the past few days”

CLINICAL HISTORY:

Signs and symptoms: An 18-year-old Hispanic female presented to our clinic with diffusely spread, erythematous plaques and pustules covered by crusts, which had evolved over the past eight months. She denied any mucosal involvement but reported significant symptoms over the last three days, including difficulty walking, fever, skin tenderness, malaise, arthralgia, and headaches. Notably, no one else in her household exhibited similar lesions. The patient denied recent travel, sick contacts, alcohol use, illicit drug use, or smoking.

Of note, she had been admitted to the hospital one week prior to this visit due to concerns about a burn or drug reaction. During her hospitalization, she was started on high-dose oral steroids and was currently taking 10 mg of prednisone daily. Additionally, she had been applying over-the-counter Caladryl lotion to her entire body. The patient denied any known allergies to medications.

Continue reading “Rash Decisions: A Case of Persistent Pustules and Plaques in a Young Female”

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
Program Director: Rick Lin, DO MPH FAOCD

Submitted on: September 20, 2023

CHIEF COMPLAINT:  “I’ve been noticing random bruises appearing on my body “

CLINICAL HISTORY:

Signs and symptoms: A 30-year-old Latin American female with a medical history of anxiety, hypotension, hypothyroidism, fibromyalgia, and arrhythmias presented to our clinic with episodic spontaneous bruising on both thighs, which had been occurring since February 2022. She reported pain upon palpation but did not have any other systemic symptoms. The patient denied any new medications or recent traumatic events. Her only surgical history included the placement of a cardiac loop recorder two years prior. She had no history of smoking, alcohol use, or illicit drug use. She denied any family history of bleeding or thrombotic disorders, skin cancer, or liver disease. Current medications included midodrine, fludrocortisone, levothyroxine, and diclofenac, and there were no known drug allergies.

Continue reading “Spontaneous Bruising in a Young Female Patient”

Presenter: Paul Vance, DO, Thomas L Davis, MD, Michael Hohnadel, DO
Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program
Program Director: Rick Lin, DO MPH FAOCD

Submitted on: September 24, 2023

CHIEF COMPLAINT:  “I have a spot growing in size on my left hand”

CLINICAL HISTORY:

Signs and symptoms: An 11-year-old Hispanic female presented to our clinic for evaluation of a growing dark spot on the palm of her left hand. The patient states that the lesion has been present for the past several months and seems to be getting bigger. The patient endorses occasional itchiness, but no pain. No one else in the household had similar lesions. The patient denies any surgical history, medication use, allergies, recent travel, or personal or family history of skin cancer.

Continue reading “Hyperpigmented Patch Mimicking Melanocytic Lesions”

Presenter: Eric Sandrock, DO, Thomas L Davis, MD, Rick Lin, DO
Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program
Program Director: Rick Lin, DO MPH FAOCD

Submitted on: September 20, 2023

CHIEF COMPLAINT:  “I have a hard lump on my finger “

CLINICAL HISTORY:

Signs and symptoms: A 10-year-old male with no significant past medical or surgical history presents to our clinic for a solitary lesion overlying the distal left index finger. He describes it as “hard” and stated it has been present and stable for the past year. He denied any trauma to the area, restriction in range of motion, or tenderness to palpation. He denied any recent weight loss, fevers, or chills. He denied any personal or family history of similar lesions or skin cancer.   

Continue reading “Exploring a Rare Chronic Nodule in the Extremity”