Dermatology

Latest News


CME Content


Chronic Paronychia

These patients have chronic paronychia. This inflammatory nail bed disorder is usually caused by prolonged exposure to wet environments and repeated minor cuticle trauma. Christopher Montoya, PA-C, of Beaverton, Ore, and Timothy R. Hurtado, DO, of Yongson, Korea, report that the nails of a 33-year-old man's right index finger and ring finger displayed multiple lateral grooves and edema near the eponychium.

A 47-year-old woman who wasseropositive for HIV-1 presented tothe emergency department with severemaculopapular, erythematouseruptions. Her antiviral regimen hadrecently been changed from zidovudine,300 mg bid; lamivudine, 150 mgbid; and saquinavir, 600 mg tid, tolamivudine, 150 mg bid; stavudine, 40mg bid; and nevirapine, 200 mg/d.

The patient might havebeen exhibiting a phenomenon sometimes seen in methamphetamine users that isreferred to as "crank bug bites." Patients claim to see and/or feel bugs on theirbody and attempt to remove them or pick at them until they create open woundsand scabs.

A 34-year-old woman awoke with apainful, crusted ulcer on her upperarm. She has been repairing dry wallin her home but recalls no trauma.The necrotic ulcer features an erythematousborder.

Nongenital cutaneous warts--that is, common, plantar, filiform, and flat warts--are manifestations of the human papillomavirus (HPV). These warts are among the most common dermatologic complaints seen in primary care practices and are among the most common lesions treated by dermatologists.

A nonhealing ulcer recently developedin a painful facial rash that hadworsened over several months. The44-year-old patient is a heavy drinkerwith a history of elevated liver functionlevels. She has had numerousunprotected sexual contacts over theyears.

Ringworm

A 5-year-old boy, who lives on a farm and routinely plays with his pet dogs, presented with these scaly, inflamed macules with a central clearingon the abdomen and forehead.

An 11-year-old boy who was receiving continuous ambulatory peritoneal dialysis because of end-stage renal disease secondary to membranoproliferative glomerulonephritis was hospitalized with hypocalcemia 2 days after subtotal parathyroidectomy. Before the surgery, multiple lesions were noted on the child's thighs (shown here), upper arms, and abdomen. The lesions, some with calcium deposits, were hard and painful. A biopsy of the lesions revealed histologic findings consistent with cutaneous calcinosis.

Asteatotic Eczema

With the onset of winter, dry and scaly skin accompanied by pruritus prompted this patient to seek medical attention.

Erythematous patches and papules on the knuckles; a slowly enlarging papule on a finger; a painful ulcer on the thumb; rough, thickened skin around the metacarpophalangeal joints; symmetric, soft, tan papules....

A 50-year-old woman was concerned about a nonhealing, painful lesion on the medial aspect of the left side of the nasal bridge. The lesion had been present for several weeks. The patient believed that a "cyst" had developed in the area. She had been attempting to remove it manually.

A 49-year-old man presented to the emergency department with hematemesis and 2 episodes of melena. Examination findings included resting tachycardia and melenic stool. Blood pressure was 95/50 mm Hg. Multiple raised, soft, bluish 0.3 to 1 cm lesions were noted on the trunk and extremities.