Dermatology Grand Rounds https://aocdgrandrounds.com/ Presented by the South Texas Dermatology Residency Program Thu, 31 Oct 2024 16:40:50 +0000 en-US hourly 1 https://wordpress.org/?v=6.6.2 https://aocdgrandrounds.com/wp-content/uploads/2024/10/cropped-Grand-Rounds-32x32.png Dermatology Grand Rounds https://aocdgrandrounds.com/ 32 32 Focal Atypical Lymphoid Infiltrate with CD30 Positivity in a 36-Year-Old Male https://aocdgrandrounds.com/2024/10/25/focal-atypical-lymphoid-infiltrate-with-cd30-positivity-in-a-36-year-old-male/ Fri, 25 Oct 2024 20:54:23 +0000 http://www.aocdgrandrounds.com/?p=1014 Presenter: Victoria Comeau, DO, Alexandria Glass, DO, David Lemchak, DO, Haley Lewis, DO, Caitlin Porubsky, DO

Dermatology Program: PCOM/North Fulton Hospital

CHIEF COMPLAINT:  new growth under the right arm

CLINICAL HISTORY: A 36-year-old Caucasian male presented to the clinic with complaints of a new growth under the right arm that had been present for approximately 2 months and had progressively increased in size. He noted tenderness surrounding the lesion but aside from this, the lesion was asymptomatic. Review of systems was negative for any associated fevers, weight loss, night sweats, chest pain, shortness of breath, gastrointestinal discomfort, rash or edema. The patient had not received any previous treatment, as this was his initial presentation. He was, however, prescribed doxycycline due to concern for possible localized cellulitis. His past medical history was significant for hypertension, which was well controlled with Losartan. He denied any pertinent family history.

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]]> Elderly gentleman with large violaceous plaques on left shin https://aocdgrandrounds.com/2024/10/24/elderly-gentleman-with-large-violaceous-plaques-on-left-shin/ Thu, 24 Oct 2024 16:27:21 +0000 https://aocdgrandrounds.com/?p=2673 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.

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]]> Large, Indurated, and Painful Plaque on the Forehead https://aocdgrandrounds.com/2024/09/30/large-indurated-and-painful-plaque-on-the-forehead/ Mon, 30 Sep 2024 13:56:45 +0000 https://aocdgrandrounds.com/?p=2666 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.

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]]> Patient with chronic painful nodule on left third fingernail https://aocdgrandrounds.com/2024/09/30/patient-with-chronic-painful-nodule-on-left-third-fingernail/ Mon, 30 Sep 2024 13:46:16 +0000 https://aocdgrandrounds.com/?p=2662 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.

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]]> Patient with multiple grouped vesicles surrounding border of a previous surgical scar https://aocdgrandrounds.com/2024/09/30/patient-with-multiple-grouped-vesicles-surrounding-border-of-a-previous-surgical-scar/ Mon, 30 Sep 2024 13:36:22 +0000 https://aocdgrandrounds.com/?p=2651 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.

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]]> Seemingly Innocuous Skin Findings: A Surprising Turn in Clinical Evaluation https://aocdgrandrounds.com/2024/09/26/seemingly-innocuous-skin-findings-a-surprising-turn-in-clinical-evaluation/ Thu, 26 Sep 2024 15:08:52 +0000 https://aocdgrandrounds.com/?p=2642 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

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

CLINICAL HISTORY: 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.

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]]> Progressive Vascular Anomalies and Musculoskeletal Symptoms in an Adult Patient https://aocdgrandrounds.com/2024/09/26/progressive-vascular-anomalies-and-musculoskeletal-symptoms-in-an-adult-patient/ Thu, 26 Sep 2024 14:33:41 +0000 https://aocdgrandrounds.com/?p=2633 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 many dark growths and bruises all over my arm ”

CLINICAL HISTORY: 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. 

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]]> Green-black discoloration of fingernails in a 70-year-old female https://aocdgrandrounds.com/2024/09/24/green-black-discoloration-of-fingernails-in-a-70-year-old-female/ Tue, 24 Sep 2024 20:46:47 +0000 https://aocdgrandrounds.com/?p=2563 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:  "Two of my nails turned black "

CLINICAL HISTORY: 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. 

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]]> Post-Hospitalization Dilemma: Investigating Purple-Brown Plaques on the Chest https://aocdgrandrounds.com/2024/06/16/post-hospitalization-dilemma-investigating-purple-brown-plaques-on-the-chest/ Sun, 16 Jun 2024 15:13:07 +0000 https://aocdgrandrounds.com/?p=2644 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.

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]]> A Rapidly Growing, Tender Nodule on the Foot https://aocdgrandrounds.com/2024/06/12/a-rapidly-growing-tender-nodule-on-the-foot/ Wed, 12 Jun 2024 17:58:40 +0000 https://aocdgrandrounds.com/?p=2597 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

CHIEF COMPLAINT: “I have a painful bump growing on my foot”

CLINICAL HISTORY: A 40-year-old female with a medical history of anemia and hypothyroidism presented to our clinic with a two-month history of a rapidly growing, tender lesion on her right foot. The patient reported no prior trauma to the area and denied experiencing any similar lesions in the past. She also reported no discharge or itching at the site of the lesion. She reported no recent travel, exposure to sick contacts, and has no personal or family history of similar lesions or skin cancer. 

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