Painful rash in 15 year-old female

Presenter: Leslie Mills, DO
Dermatology Program: West Palm Hospital/PBCGME
Program Director: Robin Shecter, DO
Submitted on: May 2, 2016

CHIEF COMPLAINT:  A 15-year-old female presented to the Emergency Department with a painful rash involving her face, neck, and ears.

CLINICAL HISTORY:

Signs and symptoms:  The patient first noticed tenderness and pressure involving the face with subsequent edema that was most pronounced in the periorbital region after returning from Georgia 4 days prior to admission. The lesions began as intensely pruritic, erythematous papules and vesicles that quickly ulcerated with clear-yellow drainage. Associated symptoms included ocular pain. She denied oral lesions, fever or chills. She denied recent trauma, sick contacts, arthropod assault or exposure to animals, outdoor activities, or new products.

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Pruritic rash with proximal muscle weakness

Presenter: Duggan C., Jajou P.
Dermatology Program: Beaumont Hospital Trenton
Program Director: Steven Grekin DO
Submitted on: Apr 29, 2016

CHIEF COMPLAINT:  Patient is a 64-year-old female who presented to the clinic with a pruritic rash that started on her left wrist and then spread to her right arm, chest, scalp, and posterior neck.

CLINICAL HISTORY:

Signs and symptoms:  She denied any recent sun exposure. Patient admits to some difficulty arising from a seated position as well as fatigue while combing her hair.

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Burning and stinging red nodules on the dorsum of hands

Presenter: Jessica Vincent, DO
Dermatology Program: OhioHealth O’bleness Hospital
Program Director: Dawn Sammons, DO, FAOCD
Submitted on: Apr 13, 2016

CHIEF COMPLAINT:  A 57 year old male presented to the current authors complaining of burning and stinging red nodules on the dorsum of his hands for about 1 year.

CLINICAL HISTORY:

Signs and symptoms:  He also admitted to persistence of an episodic rash over the lower legs and bilateral flanks he had originally presented with 7 years prior.

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A 40 year old female with left sided facial swelling and lip swelling

Presenter: Huyenlan Nguyen, DO, Elise Grgurich, DO
Dermatology Program: Lehigh Valley Health Network/PCOM
Program Director: Stephen M. Purcell, DO
Submitted on: Feb 29, 2016

CHIEF COMPLAINT:  A 40 year old female with left sided facial swelling and lip swelling

CLINICAL HISTORY:

Signs and symptoms:  The most recent episode occurred one month ago and was associated with swelling of the face and lips. She feels the self-limited flares are related to stress and denies any associated new medications or provoking foods. She occasionally has numbness on the left side of her face that she attributes to her history of Bell’s palsy.

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