Adult Immunization

Anaphylaxis

Food Allergies

Seasonal Allergies

Allergy

Atrial Fibrillation

Heart Failure

Hypertension

Lipid disorders

Cardiology

Clinical Technology

Atopic Dermatitis

Psoriasis

Rosacea

Dermatology

Adrenal Disorders

Diabetes

Thyroid Disorders 

Endocrinology 

C Difficile Infection

Celiac disease

GERD

Inflammatory Bowel Disease

Irritable Bowel Syndrome 

Gastroenterology

Hepatitis

MASLD/MASH

Hepatology

Coronavirus

HIV AIDS

Hepatitis C

Influenza

Pneumonia

Sexually transmitted infections

Infectious Disease

Chronic Kidney Disease

Nephrology

Alzheimer Disease/Dementia

Cerebrovascular Diseases

Epilepsy

Headache

Mental Health

Migraine

Parkinson Disease

Sleep Disorders

Neurology

Obesity Medicine

Fibromyalgia

Pain Management

Pediatric Immunization

Pediatrics

ADHD

Anxiety

Depression

Eating Disorders

PTSD

Panic Disorder  

Psychosis

Substance-related Disorders

Psychiatry 

Asthma

COPD

Cystic Fibrosis

Interstitial lung disease

Pulmonary hypertension

Pulmonology

Gout

Lupus

Osteoarthritis

Psoriatic arthritis

Rheumatoid Arthritis

Rheumatology

Breast Cancer

Cervical Cancer

Colorectal Cancer

Lung Cancer

Melanoma

Prostate Cancer

Renal Cancer

Skin cancer

Screening

Menopause

Osteoporosis

Pregnancy and Birth

Women's Health

News

All News

Editorial Podcasts

Practice Management

Video Interviews

Media

Around the Practice

Between the Lines

ConsultantLive

Frontline Insights

Institutional Insights

Primary View

Provider Toolkits

Screening Series

Conferences

Conference Coverage

Conference Listing

Product Theater Recaps

Resources

Interactive Posters

Product Profile

Publications

Subscribe

CE/CME

Patient Care Online offers clinical news and resources for primary care clinicians, focusing on disease states, guidelines, and trends to improve care.

About Us

Advertise

Contact Us

Editorial Board

Terms and Conditions

Privacy

Do Not Sell My Information

Patient Care Online – Primary Care News and Clinical Resources

Facebook

LinkedIn

Clinical Focus

Allergy & Immunology

Endocrinology

Men’s Health

Psychiatry

Women’s Health

Business Focus

Billing and Collections

Career Planning

Coding and Documentation

Concierge Medicine

Cybersecurity

EHRs

Investing

Patient Relations

Personal Finance

Remote Patient Monitoring

Staffing

Technology

Telehealth

Value-based Care

Spotlight

VMS and Menopause

Atopic Dermatitis Provider Toolkit

Adult Immunization Provider Toolkit

Dermatology Hot Topics

1rem

Authors

A39-year-old man is brought to theemergency department (ED)after his car struck a tree. He experienceda transient loss of consciousnesswith a 3-minute episode of retrogradeamnesia at the scene of the accident,despite wearing a seat belt andshoulder harness. He was disorientedto date and place.

Diagnostic Images, Treatment Issues

This 15-year-old has a pruritic, flat-topped, monomorphic papular rash on his face and arms for the past 6 days. He takes no medications, has not been sick recently, and has not been exposed to poison oak.

A.  Papular acrodermatitis of childhood (Gianotti-Crosti)

This monomorphic papular rash is unrelated to medications, recent sickness, or exposure to poison oak. It developed about 6 days earlier. 

Clinical Topics

Teen With Itchy Papular Rash on Face and Arms


This intensely itchy, blistering rash on the forearms and upper chest of a 13-year-old girl occurred after a day at the beach. The girl had polymorphic light eruption (PMLE), the most common abnormal reaction to UV light.

A. PMLE classically presents as a papular or papulovesicular eruption on the arms and anterior chest

B. The reaction usually begins 12 to 24 hours after an initial exposure to light of a suddenly increased intensity

C. Some parts of the body are severely involved while similarly exposed areas are paradoxically spared

D. The rash resolves after 7 to 10 days, often leaving whitish scarring

What are the characteristics of this blistering rash caused by exposure to UV light? 

Intensely Pruritic Rash After Sun Exposure in a Tween Girl 

A 42-year-old man presents with a pruritic rash characterized by pink, scaly plaques with a few crusted erosions on the elbows

knees, lower back, and buttocks. Review of systems was negative, although there was a strong positive family history of celiac disease. He took no medications and was otherwise healthy.

A pruritic, scaly rash appeared on this 42-year-old man's elbows, knees, lower back, and buttocks. Can you ID? 

Elbow Erosions 

A 67-year-old woman noted the appearance of several non-tender, rock-hard, purple-colored nodules on her legs. Her medical history was significant for distant non-Hodgkin lymphoma.

A 67-year-old woman noted the appearance of several non-tender, rock-hard, purple-colored nodules on her legs. Her medical history was significant for distant non-Hodgkin lymphoma. The violaceous color and configuration of the skin lesions suggests which of the following? 

Hard Purple Nodules: Your Dx?

A 47-year-old man presents c/o swelling in extremities-hands x1 week; legs, x1 month. Marked tumescence is seen in the hands and pitting edema is noted on lower legs. PMH: HTN, T2DM, hyperlipidemia; S/P cholecystectomy. Meds: HCTZ; lisinopril; amlodipine; insulin. See differential diagnosis below.

VIDEO: Note marked tumescence in patient’s hands, pitting edema in lower extremities. Does PMH contribute? Dx?

A 47-year-old Man with Peripheral Edema 

A 3-year-old boy is seen for unilateral swelling on the left side of the face, in front of and behind the left ear. Findings on examination of ears, oral cavity, and teeth are normal. He is afebrile (temp, 37°C [98.6°F]), cooperative, and in no distress. He is otherwise healthy. Past medical history includes 1 MMR vaccination.

The child is bright and alert and has no fever. The swelling is on the left side of the face only. Find other clues to a diagnosis in the accompanying video.  

3-Year-Old Boy With Unilateral Facial Swelling 

James Bolene, MD

Articles

Latest Updated Articles