Dermatology

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The differential diagnostic possibilities for this tender nodule included hypertrophic actinic keratosis, keratoacanthoma, squamous cell carcinoma, and verruca. The possibility of squamous cell carcinoma dictated removal with histologic examination.

A multiplicity of colors in a pigmented lesion usually dictates the need for a biopsy. In this woman with many nevi and a history of malignant melanoma, biopsy revealed an inflamed blue nevus and was also curative.

The development of eccentric pigmentation within a previously stable pigmented lesion may indicate malignant degeneration, as was the case here. Of all melanomas, lentigo maligna melanoma has the best overall prognosis.

Round plaques like this one, each composed of many small erythematous papules, are classic for granuloma annulare. Large numbers of these lesions and widespread distribution is often associated with diabetes mellitus.

Rashes, like children, come in all shapes and sizes, and they have a variety of causes, ranging from infection to allergic reaction. This week’s photo quiz tests your knowledge of skin conditions in younger patients.

More Than Skin Deep

This week's quiz questions challenge you to dive below the skin’s surface to come up with the correct answers.

Sebaceous hyperplasia are commonly mistaken for basal cell carcinoma. These small papules with a yellowish hue and central dell is typical of the former, for which no treatment is required.

Bowen Disease

Biopsy of this red, scaly patch showed in situ squamous cell carcinoma. Treatment consisted of once-daily topical application of 5% imiquimod until erosion occurred. This off-label treatment affords an excellent cosmetic result.

These small areas of white dyschromia are typical of white superficial onychomycosis, often due to dermatophyte invasion following minor trauma. This form of onychomycosis usually responds well to topical therapy.

This is a prototypical case of acute contact dermatitis to benzoyl peroxide that the patient had been applying for her mild to moderate papulo-pustular acne. Twice-daily application of hydrocortisone 2.5% cream led to prompt resolution of the rash.

An asymptomatic bump; IBD and celiac disease; a gradually expanding spot .... test your clinical skills on a range of disorders in this week's quiz.

The eyes may be "windows to the soul," but they also provide a look at your patients’ overall health and clues to specific disorders. This week’s photo essay will test your ability to identify eye-related problems.

This non-tender, freely mobile, rubbery-feeling nodule is a classic lipoma. Diagnostic contenders include epidermal cyst and cutaneous metastases.

Eccentric and irregular pigmentation prompted a biopsy in this elderly woman with a history of basal cell carcinoma and melanoma. The surprising diagnosis was a heavily pigmented squamous cell carcinoma in situ.

Epidermal Cysts

The puncta, with a black center, clearly identified these as classic epidermal cysts.