Dermatology

The patient knew that he had psoriasis, but failed to connect onychodystrophy to his underlying skin disease.

A biopsy confirmed that the white mucosal discoloration and scattered small erosions were the result of lichen planus. Eradication may be attempted with potent topical steroids or oral steroids.

This man wore a personal heart rate monitor/transmitter while running, and had become allergic to the thiuram chemicals used to make the synthetic elastic band. A topical corticosteroid resolved the problem.

Bruising is a sign/symptom to be taken seriously. This patient abused alcohol; his vitamin C deficiency confirmed the diagnosis of scurvy. This patient is also at risk for pellagra and beri beri.

Despite the fact that this lesion is NOT in a sun-exposed skin site, the clinical features are typical for a basal cell carcinoma.

Pitted keratolysis is caused by pedal hyperhidrosis and subsequent overgrowth of bacteria that produce proteinases that dissolve keratin and lead to pit formation.

Most bruising episodes are directly related to trauma, medication, or herbal supplements. When no no clear etiology is prsent, "spontaneous" bruising should be considered an urgent problem.

Each of these lesions proved to be infiltrative basal cell carcinomas. Denial is a strong defense mechanism and it can lead patients to avoid seeking medical attention for long periods, as was the case here.

A small punch biopsy showed basal cell carcinoma with focal hypermelanosis. The underlying erythema and punctuate superficial dark black pigmentation strongly suggested a dysplastic nevus or even a melanoma.

This was presumed to be an ectoparasite bite when the patient reported that she had a new pet kitten. A myriad of diagnostic possibilities exist, including the start of a drug eruption or viral infection, early allergic contact dermatitis, or first manifestation of an autoimmune bullous disease.

These hypopigmented well demarcated round patches with an atropic center are typical of porokeratosis, which can appear at any age.

The easily visible 5 mm-long insect, is a classic bedbug (Cimex lectularis).

A biopsy is the only way to determine if this is a primary cutaneous neoplasm or a cutaneous metastasis from a visceral carcinoma.

This woman is allergic to an ingredient in her favorite lipstick.

A biopsy is mandatory since the diagnosis includes melanoma. This blue-black macule proved to be a blue nevus.

Mammography showed a dense fine mass which, on fine needle aspiration, showed intraductal carcinoma.

A painful and/or tender subungual lesion should suggest a “glomus tumor”-- a benign growth seen more commonly in women than in men and most frequently under the fingernail.

A number of clues suggest that this pigmented lesion is a seborrheic keratosis, including its rough surface, truncal location, and age of the patient (59 years).

Man with pruritic, edematous eruption of the upper and lower eyelids.

This itchy, scaly rash extending from the underarm onto the upper arm was tinea corporis.

The tense bullae shown here and the chronicity of the disease should suggest the diagnosis of bullous pemphigoid.

The almost black nature of the lesion arouses suspicion for melanoma. A conservative excisional biopsy revealed this to be a traumatic tattoo, however.

An 80-year-old-woman was seen as an inpatient hospital consult. A persistent pruritic eruption had developed acutely on the legs.

These burning red patches around the mouth, known as perleche, are aggravated by aging. Learn how to treat it.

A 67-year-old woman noted the appearance of several non-tender, rock-hard, purple-colored nodules on her legs. Her past medical history was significant for distant non-Hodgkin lymphoma.

A 40-year-old man sought advice regarding therapeutic options for an asymptomatic, “red spot” on the flank. Review of systems was entirely negative.

A 56-year-old woman noted the abrupt onset of several very painful ulcerations located on her back. The patient had known (and active) Crohn disease, clinical depression requiring ongoing psychiatric care, and borderline diabetes mellitus.

A 32-year-old woman presents with a swollen, painful fourth digit on the right hand. While housecleaning, a traumatic erosion developed on the ipsilateral hyponychium.

A 78-year-old man sought medical attention after noting a non-tender, subtle “hole” in his forehead. The firm lesion was asymptomatic.

A 63-year-old woman presented for medical attention relating to the acute onset of an intensely pruritic, oozing eruption along the hairline, behind the ears and on the upper face. This eruption followed the first use of a new shampoo product