Eric J. Lewis, MD


Alezzandrini Syndrome

March 01, 2007

Loss of pigmentation was noted around the left eyeof a 49-year-old man-the same eye in which hehad a detached retina. In addition, the patient'shearing was impaired on that side. These findingswere consistent with the diagnosis of Alezzandrinisyndrome, the major manifestations of which includeunilateral degenerative retinitis, ipsilateral facial vitiligo,poliosis of the eyebrows and eyelashes, and ipsilateralhearing deficits.

Diabetic Vasculopathy

September 14, 2005

Cutaneous manifestations develop in approximately 30% of persons with diabetes. Premature atherosclerosis is a common complication of the disease that can cause peripheral infarction, ulceration, and necrosis.

Erythema Elevatum Diutinum

September 14, 2005

This rare condition affects both men and women. The average age at onset is 53 years. The lesions are deep brownish red to purple papules, nodules, and plaques. Blisters and ulcers also can occur.

Relapsing Polychondritis

September 14, 2005

Relapsing polychondritis, as manifested in one of this 55-year-old man's deformed ears, is a rare, chronic, autoimmune inflammatory disease of cartilaginous structures. The disease also affected the cartilage in this patient's nose, which is the second most common site of involvement. Tissues of the joints, eyes, and blood vessels as well as the trachea and the bronchial tree may also be affected and destroyed.


September 14, 2005

A 61-year-old woman who was receiving dialysis for diabetes-associated end-stage renal disease was hospitalized for care of an abdominal wound that had been debrided and closed. At this time, the patient had several large, indurated, red plaques with central, stellate, black eschars on her abdomen, left buttock, and legs. An early focus of ulceration was noted superior to the stapled incision.

Reactive Perforating Collagenosis

September 14, 2005

A 63-year-old woman who was on long-term hemodialysis because of diabetic end-stage renal disease had a 7-month history of waxing and waning papules and plaques on the front of both legs. The asymptomatic multiple, discrete, slightly erythematous, round to oval lesions ranged from 5 mm to 3 × 4 cm. Several had heaped-up borders and contained central crust and keratotic debris; others were superficial ulcers with central eschars. The lesions improved only slightly following twice-daily application of a superpotent topical corticosteroid preparation.

Erysipeloid in a Man With Joint Stiffness

September 14, 2005

A 55-year-old-man complained of joint stiffness and red, mildly tender plaques on his fingers. He had recently sustained a trauma to the hand while at his job as a fish handler. The condition was diagnosed as erysipeloid-a skin infection caused by the gram-positive bacillus Erysipelothrix rhusiopathiae.

Oral Mucous Cyst

September 14, 2005

The painless lump on this 30-year-old woman's lip is a mucous cyst, or mucocele-the result of mucus retention within a salivary gland due to trauma or obstruction of a duct. This asymptomatic, dome-shaped, translucent, blue-white cyst is usually located on the inner surface of the lower lip or on the floor of the mouth.

Tuberculoid Leprosy

September 14, 2005

A 47-year-old woman from Southeast Asia presented with erythematous, asymmetric, anesthetic, sharply marginated plaques on her lower arms and hands. Because this patient had emigrated from a tropical climate, leprosy was suspected.