Stephen Purcell DO Archives - Dermatology Grand Rounds

A man with vegetative plaques and oral erosions

March 17, 2018

Presenter: Carl Barrick, DO and Tanya Ermolovich, DO

Dermatology Program: Lehigh Valley Health Network/PCOM

CHIEF COMPLAINT: vegetative plaques right axilla, umbilicus, bilateral inguinal folds and scrotum with extension to anus

CLINICAL HISTORY: 34 year-old Caucasian male with vegetative plaques right axilla, umbilicus, bilateral inguinal folds and scrotum with extension to anus. The patient presents with ulceration and crusting of his nose and lips for six weeks. He has had thick, crusted lesions and swelling of his scrotum for three months. The lesions are asymptomatic although the ulcerations in his mouth are painful. He admits to feeling well without fevers, chills, dysphagia, diarrhea, abdominal pain, or joint pain. No previous treatment to lesions.

A 40 year old female with left sided facial swelling and lip swelling

February 27, 2016

Presenter: Huyenlan Nguyen, DO, Elise Grgurich, DO

Dermatology Program: Lehigh Valley Health Network/PCOM

CHIEF COMPLAINT: Left-sided facial swelling and lip swelling

CLINICAL HISTORY: A 40-year-old female with left-sided facial swelling and lip swelling. The most recent episode occurred one month ago and was associated with swelling of the face and lips. She feels the self-limited flares are related to stress and denies any associated new medications or provoking foods. She occasionally has numbness on the left side of her face that she attributes to her history of Bell’s palsy. She was treated with a course of prednisone and responded well.

Nodule on the vertex of the scalp

February 27, 2015

Presenter: Stephen Hemperly, DO

Dermatology Program: Lehigh Valley Health Network

CHIEF COMPLAINT: 1-year history of a nodule on the vertex of the scalp

CLINICAL HISTORY: Our patient is a 71-year-old Caucasian male who presented with a one-year history of a nodule on the vertex of the scalp. The lesion had become soft and tender during the week prior to the presentation. He admitted to headaches and a buzzing sound in his head. He denied all other neurologic symptoms. The patient was given amoxicillin from a primary care physician and was referred to us for excision of a presumed inflamed cyst.

Rash with occasional small blisters

March 27, 2014

Presenter: Sean Branch, D.O., Ryan Owen, D.O., Luis Soro, D.O., Christian Oram, D.O., Stephen Hemperly, D.O., and Kelly Reed, D.O.

Dermatology Program: Lehigh Valley Health Network/Philadelphia College of Osteopathic Medicine

CHIEF COMPLAINT: rash with occasional small blisters

CLINICAL HISTORY: A 79-year-old male complained of a rash with occasional small blisters. The generalized rash began 4 months ago and was mildly pruritic. Small blisters appeared to rupture easily and leave behind superficial erosions. There was no history of any new or changing medications prior to the onset of his rash. Triamcinolone 0.1% cream helped somewhat. The rash improved with a course of oral corticosteroids but returned once the medication was completed. The patient could not tolerate methotrexate or azathioprine.

Atypical vascular lesion arising in an area of previous radiation treatment on the breast

June 26, 2013

Presenter: Christian W. Oram, D.O.

Dermatology Program: Lehigh Valley Health Network/Philadelphia College of Osteopathic Medicine

CHIEF COMPLAINT: Lesion on the right breast

CLINICAL HISTORY: The patient presented in October 2010 with a pink to purple asymptomatic plaque on the right medial breast. The lesion had developed in an area of previous radiation treatment for breast cancer. Since the lesion arose in an area of previous radiation treatment, a biopsy was obtained. The lesion remained asymptomatic and stable in size for approximately one year. No treatment was pursued and watchful waiting was implemented, with the intent to biopsy any new or changing areas. At approximately twelve months, within the span of two weeks, the lesion grew four times in size and became tender. This prompted re-biopsy due to the aggressive clinical nature of the lesion.