Facial mass

Presenter: Alice Do, DO, Brian Kopitzki, DO, Chris Buatti, DO
Dermatology Program: Genesys / Michigan State University
Program Director: Kimball Silverton, DO
Submitted on: Feb 18, 2008

CHIEF COMPLAINT:  Facial mass.

CLINICAL HISTORY:

Signs and symptoms:  A 73 year-old Caucasian woman presented with a 20 year history of violaceous masses of the left periocular area and left chest that have waxed and waned. These lesions were asymptomatic. 10 years ago, the lesions were biopsied and diagnosed as a low-grade B cell lymphoma without systemic involvement, and no chemotherapy was indicated at that time. Over the years, the lesions continued to wax and wane, but recently, the lesions have gotten larger.

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Pruritic plaques in the axillae

Presenter: Nicole Bright, DO (resident), Sharon Zellis, DO, Tanya Ermolovich, DO
Dermatology Program: Philadelphia College of Osteopathic Medicine/Frankford Hospital
Program Director: Tanya Ermolovich, DO
Submitted on: Feb 1, 2008

CHIEF COMPLAINT:  A patient presents with a pruritic rash in the axillae.

CLINICAL HISTORY:

Signs and symptoms:  A 70 year old female presents with a several month history of hyperpigmented pruritic lesions in bilateral axillae.

Previous Treatment:  None.

Other information:  Her past medical history is significant for arthritis, thyroid disease, diabetes, and hypertension. Her medications include pioglitazone, calcium, valsartan and a thyroid medication. She denies any changes in her soap or laundry detergent. The patient’s lesions persist despite switching brand of deodorant. She denies dryer sheet usage but uses a scented fabric softener. She also has no known drug allergies.

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Pruritic erythematous rash after sun exposure

Presenter: John P. Minni, DO and Dwayne D. Montie, DO
Dermatology Program: Columbia Hospital
Program Director: Layne D. Nisenbaum, DO
Submitted on: Jan 1, 2008

CHIEF COMPLAINT:  My son gets a rash when he goes outside.

CLINICAL HISTORY:

Signs and symptoms:  7yo male with several month history of a pruritic red rash which occurs minutes to hours after sun exposure (Figures 1-3).

Previous Treatment:  Topical low potency steroids without success.

Other information:  Patient’s mother later related that the patient suffers from frequent cold sores.

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Persistent plaques after bone marrow transplant

Presenter: Risa Gorin, DO
Dermatology Program: St. Barnabas Hospital Dermatology Department, Bronx, New York
Program Director: Cindy Hoffman, D.O.
Submitted on: Sep 30, 2007

CHIEF COMPLAINT:  NC is a 19 yr old Hispanic male with a seven year history of a persistent rash. The lesions began on his proximal extremities and increased in number and size over time. The lesions began one year after allogeneic bone marrow transplant for acute myelogenous leukemia. However, he stated that he was not taking any immunosuppressants when the rash started. The lesions were occasionally pruritic and unresponsive to super-high potency topical steroids.

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Reddish-brown macules

Presenter: Andrea Costanza, DO, Nanda Channaiah, DO, Kevin Belasco, DO, Kevin Dehart, DO, Aaron Bruce, DO and Roger Sica, DO
Dermatology Program: NOVA Southeastern University – Suncoast Hospital
Program Director: Richard Miller DO, FAOCD
Submitted on: Jan 30, 2007

CHIEF COMPLAINT:  We present a 25 y/o female with a history of adolescent onset rash and progressively worsening symptoms.

CLINICAL HISTORY:

Signs and symptoms:  Upon review of history, patient admitted to recurrent episodes of headaches, fainting spells, flushing, pruritus, palpitations, wheezing, abdominal pain, and vomiting within the last year. Her skin lesions periodically become raised, erythematous, and pruritic, which are exacerbated with “asthma attacks.” Exercise and naprosyn worsen her symptoms and induce acute attacks. Neurocardiogenic syncope was also noted on medical history.

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