Category: 2024-2025 Academic Year

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 18, 2024

CHIEF COMPLAINT:  “A new pimple grew on my arm “

CLINICAL HISTORY:

Signs and symptoms: A 67-year-old male with a medical history of hypertension, coronary artery disease, non-melanoma skin cancers, lower esophageal adenocarcinoma, and intracranial arteriovenous malformations, presented to our clinic to discuss biopsy results from a lesion on his left cheek. The biopsy confirmed the presence of a nodular and pigmented basal cell carcinoma. During this visit, the patient also reported a new papule on his left proximal forearm, which he indicated had been present for only a few weeks. He denied any bleeding or discomfort associated with the new lesion.

The patient’s surgical history includes a coronary artery bypass graft (CABG) procedure involving four vessels, as well as previous excisions for skin cancers: a basal cell carcinoma on the right shoulder that underwent Mohs micrographic surgery and a squamous cell carcinoma on the left forearm that also received Mohs treatment. His current medication regimen includes Nexium and Hydrocortisone, and he denied any allergies to medications. The patient reports no pertinent family history. He denies smoking, illicit drug use, or alcohol consumption.

Continue reading “Seemingly Innocuous Skin Findings: A Surprising Turn in Clinical Evaluation”

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 18, 2024

CHIEF COMPLAINT:  “I have many dark growths and bruises all over my arm ”

CLINICAL HISTORY:

Signs and symptoms: A 50-year-old male presented to our clinic with pain in his right hand and forearm that had been intermittently treated as cellulitis with oral antibiotics. The patient reported that he was born with a hemangioma on the right forearm, which has been growing in size and number over time. He denied trauma to the area and joint pain, but endorsed a limited range of motion affecting his daily activities. He also reports easy bruising. He denied any systemic symptoms, including fever, chills, shortness of breath, weight loss, and fatigue. He denied any history of recent travel or sick contacts. No other household members had similar lesions. His only pertinent surgical history was an excision of two subcutaneous lesions of the right antecubital fossa 20 years ago. The only medications the patient reported taking was gabapentin 300 mg BID. 

Continue reading “Progressive Vascular Anomalies and Musculoskeletal Symptoms in an Adult Patient”

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
Program Director: Rick Lin, DO MPH FAOCD

Submitted on: September 18, 2024

CHIEF COMPLAINT:  “Two of my nails turned black “

CLINICAL HISTORY:

Signs and symptoms: A 70-year-old female with no past medical history presented to our clinic with greenish-black discoloration of two fingernails on the right hand. She states she first noticed the color change three months ago after removing nail polish. She further states she goes to the nail salon regularly and was instructed to soak her nails in vinegar. She saw her primary care provider two weeks ago and was started on oral terbinafine. She reports no improvement in the discoloration. Patient denies pain, swelling, and discharge. She also denies a history of smoking, alcohol use, illicit drug use, or recent travel. Patient states she has no personal or family history of skin cancer. 

Continue reading “Green-black discoloration of fingernails in a 70-year-old female”