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Consultant Vol 43 No 11

Pingueculae represent elastotic degeneration of the substantia propria.They develop on the bulbar conjunctiva of older persons after prolonged exposure to drying, dust, and the UV rays of the sun.

What is the optimal means of preventing exercise-induced
bronchospasm in children with asthma?

A 1-year history of “dents” on her body prompted a 40-year-old African American woman to seek medical evaluation. Her medical history was unremarkable; however, there was a strong family history of severe type 2 diabetes mellitus. The patient denied having received or having self-administered injections into the affected areas. She reported no history of deep, tender nodules at the sites.

A 38-year-old African American man presented with a 10-year history of a solitary “wart” that had not responded to over-the-counter acid treatments. No other lesions were noted on the patient. Based on the clinical appearance, punctate porokeratosis was diagnosed.

A 78-year-old man with a history of asthma, coronary artery disease, chronic obstructive pulmonary disease (COPD), and recently diagnosed prostate cancer was admitted to the medical ICU with exacerbation of COPD. The obtunded patient was unable to provide a history. A 4 × 6-cm firm nodule of unknown duration was noted over the right upper quadrant of the patient’s abdomen. There were no other cutaneous lesions.


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