58yo female with hyperpigmented papules on arms and palms

Presenter: Olga Demidova, DO; Laura Jordan, DO; Cole Cahill, DO; Schield Wikas, DO; Monte Fox, DO
Dermatology Program: Tri-County Dermatology
Program Director: Schield Wikas, DO
Submitted on: Nov 5, 2016

CHIEF COMPLAINT:  A 58-year-old female presented to the dermatology clinic with complaints of asymptomatic hyperpigmented papules over arms and palms.


Signs and symptoms:  A 58-year-old female was referred to the dermatology clinic by her primary care physician for evaluation of asymptomatic hyperpigmented papules involving her arms and palms. Growths appeared several weeks prior to the initial visit. During the visit, the patient reported mild shortness of breath that is chronic for her and may have worsened in the past few weeks. She denied changes in medications and any recent illness.

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Long standing upper body rash

Presenter: Stephen Colden Cahill, DO, Stephanie Juliet Kang, DO
Dermatology Program: Tri-county Dermatology, Ohio
Program Director: Schield Wikas, DO, FAOCD
Submitted on: Nov 5, 2015

CHIEF COMPLAINT:  Rash on the body


Signs and symptoms:  In August, a 37 year-old Caucasian female (Fitzpatrick skin type 2) with a past medical history of depression, DJD and spinal stenosis, presented for consultation regarding a five year pruritic rash over her face, neck, chest, shoulders and arms. She was seen one month ago by her primary care physician, who performed lab work which showed an elevated CRP 31.3 (normal 0-5mG/L), normal CBC w/diff and negative ANA. She was place on a 7 day prednisone taper and OTC loratidine. Her symptoms had mild short term relief and then promptly returned. She reports suffering from similar lesions over the last five years which have waxed and waned in intensity. She denies any new recent medications or herbal supplement additions. She cannot specifically associate the lesions with sun exposure. She denies any systemic symptoms, other then low back pain which has been an ongoing issue for several years. She is an active one ppd smoker and occasional social drinker, denies any elicit or recreational drug use.

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Spreading rash from left wrist

Presenter: Maren Gaul DO, Nathan Jackson DO
Dermatology Program: Western Reserve Hospital/Tri-County Dermatology
Program Director: Dr. Shield Wikas
Submitted on: Nov 2, 2014

CHIEF COMPLAINT:  17 year-old Caucasian Female presented with complaint of spreading rash from left wrist (present for 11 months) to bilateral upper and lower extremities in last week since biopsy of wrist.

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