17-Year-old girl with a 7-month history of small, red papules on her arms and thighs. Rash is not painful or itchy. Otherwise in good health.
Alexander K. C. Leung, MD
A 16-year-old boy with asymptomatic, hyperpigmented, hairy lesion on his left upper back. The pigmentation, first noted 5 years earlier, had progressively spread across his torso. The coarse and dark hair confined to the hyperpigmented area had appeared at age 13 years. Medical history uneventful. Review of systems showed no abnormalities. No family history of similar skin lesions.
This darkly pigmented lesion on the left arm of a 27-year-old man had been present since birth and had slowly enlarged over the past 2 months. Two days earlier, another physician had diagnosed a wart and treated the lesion with liquid nitrogen, which caused erythema of the surrounding skin.
A 50-year-old woman had a 6-month history of severe generalized itchiness and fatigability. There was no associated fever, abdominal pain, or joint pain. A cholecystectomy had been performed 20 years earlier. She had no family history of hypercholesterolemia or liver disease.
A 52-year-old man presented with asymptomatic papules on his scrotum. The lesions had first appeared 1 year earlier. He had not sustained local trauma to the scrotum, and his medical history was unremarkable. There was no family history of similar skin lesions.
A 45-year-old man sought medical advice after suffering for 6 months with recurrent pain and a purulent discharge at the sacrococcygeal region. Two weeks before this consultation, an abscess on the patient's right buttock had been drained by another physician. The patient had type 1 diabetes mellitus for 5 years; his medical history was otherwise unremarkable.
The parents of this 5-month-old boy were concerned that his eyes were
turned in toward the nose. The infant was otherwise healthy. Physical findings
were normal. In particular, when a light source was projected onto the
eyes, the light reflex was centered in both eyes.
This black lesion had been present on the upper back of a 5-year-old girl since birth. The lesion had gradually enlarged to its current size of 1.5 cm. In the past year, 3 satellite black macules had developed in the surrounding area.
Concerned about their son's progressive hair loss during the last 6 months, his parents brought the 2-year-old into the office. The clinical appearance of hair loss extending in a band configuration around the temporal-occipital scalp margin confirmed the diagnosis of ophiasis.
A boy was born to a gravida 2, para 1, 26-year-old woman at 37 weeks' gestation. The pregnancy had been complicated by gestational diabetes.