Skin Irritation of Arms, Face, Ears, and Legs

Presenter: JoAnne M. LaRow. D.O.
Dermatology Program: Northeast Regional Medical Center/KCOM
Program Director: Lloyd J Cleaver, D.O.
Submitted on: Dec 15, 2005

CHIEF COMPLAINT:  Skin irritation of arms, face, ears, and legs of two weeks duration.

CLINICAL HISTORY:

Signs and symptoms:  Initially pt noted skin irritation on her face. She saw here primary physician for this. The eruption gets itchy when pt is overheated. When asked pt states that she has had arthralgias. She complains of fatigue, but is post-partum with twins. She is not breast feeding.

Previous Treatment:  Erythromycin 333mg one PO TID for ten days. Pt completed this treatment four days before presentation to our office. Also applying Triamcinolone 0.1% cream BID-TID

Other information:  Pt is 15 weeks post-partum. She delivered twin girls via c-section 2/7/03. Her pregnancy was complicated by hypertension in the third trimester. After delivery she was started on Lisinopril 20 mg QD (started April 2003)

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Diffuse Scaling over Trunk, Neck and Extremities

Presenter: Tara H. Lawlor, D.O.
Dermatology Program: Lehigh Valley Hospital-Muhlenberg/PCOM
Program Director: Stephen Purcell, D.O.
Submitted on: Apr 29, 2005

CHIEF COMPLAINT:  “Dry skin all my life”

CLINICAL HISTORY:

Signs and symptoms:  Diffuse scaling over trunk, neck and extremities

Previous Treatment:  Over the counter emollients (Eucerin®)

Other information:  Patient has a nephew with similar skin findings. His birth history was unremarkable with no prolonged labor or failure to progress and he had no history of undescended testes. Urology and ophthalmology exams were both within normal limits.

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Large, Itchy Bumps All Over the Body

Presenter: Nilam Amin DO PGY-3, Marcy Alvarez DO PGY-2, Raymond Ramirez DO PGY-2
Dermatology Program: New York United Medical Center, New York
Program Director: Cindy Hoffman, D.O.
Submitted on: Jan 16, 2005

CHIEF COMPLAINT:  60 years old Hispanic Male with Large, Itchy Bumps All Over the Body x 3 days

CLINICAL HISTORY:

Signs and symptoms:  Intense pruritus and pain at lesion sites
Denies burning, discharge, fever or other constitutional
symptoms

Previous Treatment:  topical corticosteroids, blinded biologic trial drug for psoriasis (name unknown), phototherapy, and etanercept (Enbrel®)

Other information:  This patient was diagnosed with chronic plaque psoriasis in 1989. He had been treated with multiple different regimens without significant improvement. Three months prior to his presenting complaint, he was treated with etanercept 25 mg SQ injections BIW. He discontinued etanercept after two months of treatment secondary to complaint of severe headache. The patient presented to our clinic five months after discontinuation of the injectable biologic. He denies other psoriasis treatments between the time of discontinuation and the outbreak of his eruption. He denies household contacts with similar complaints, recent travel, or prior episodes of similar lesions.

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Growth on the Left Foot

Presenter: Suleman Bangash, Chief Resident and Carissa Summa, Second Year Resident
Dermatology Program: New York United Medical Center, New York
Program Director: Cindy Hoffman, DO, FAOCD
Submitted on: Jan 1, 2005

CHIEF COMPLAINT:  Growth on the Left Foot

CLINICAL HISTORY:

Signs and symptoms:  Lesion was slightly tender to palpation

Previous Treatment:  None

Other information:  The patient had a past medical history significant for Milroy’s disease (Congenital Lymphedema). She reported that the lesion began as a brown patch and slowly enlarged to a dome-shaped nodule over several years. She also reported multiple similar, but smaller lesions on her upper and lower extremities and trunk. The patient was only taking Hydrochlorothiazide for the lower extremity edema.

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