Dermatology

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These asymptomatic plaques developed on the legs of a 59-year-old woman with diabetes mellitus and pulmonary sarcoidosis. Biopsy showed a granulomatous infiltrate of epithelioid histiocytes and multinucleated giant cells surrounded by lymphocytes “layered” throughout the dermis. What’s your diagnosis?

A 6-year-old boy had a 1-month history of an intensely pruritic “rash” on the left dorsal foot and left lower leg. He had a recent history of walking barefoot on a beach in south Florida where dogs are allowed. What's your diagnosis?

This week’s quiz questions challenge you to determine the cause of an infant’s “strange breathing” based on a chest film, to come up with the most common cause of chronic cough in children, to be a dermatologic detective, among other things.

A 4-year-old, previously healthy girl presented with large, tense bullae involving up to 40% of her body surface area. Her parents described a 12-day history of itchy, papulovesicular lesions that had progressed into large blisters. Your dx?

A toddler from Nigeria, whose parents remained there ill with AIDS, presented with a fever and a widespread itchy eruption. Tests for HIV infection were positive. Which systemic etiologies can be ruled out when such an eruption presents?

Erythema migrans, the characteristic rash of Lyme disease, often has a bull’s-eye appearance. Which of the following additional factors can help the diagnosis?

A 60-year-old Caucasian man with a history of invasive squamous cell carcinoma of the lung presents with the lesions shown. Metastases to the skin can be a clinical finding in many malignancies.

This firm exquisitely tender mass developed after the 77-year-old woman fell a few days earlier. She had a history of an embolic cerebral stroke, for which she takes warfarin. Your Dx?

This chronic, autoimmune, subepidermal disease mostly affects older persons. Marked by spontaneous remissions and exacerbations, it manifests with tense blisters that usually start on the arms and legs. Your dx?

A 9-year-old boy presented with a 1-week history of pruritus and rash on his elbows, knees, back, and legs. He had recently run through a field of tall grass but denied any other exposure history. Your Dx?

This 66-year-old black woman presented with a 2-year history of a painless skin eruption. She stated that her skin had “changed overnight” while she was caring for her mother who had been hospitalized. Your diagnosis?