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Atopic Dermatitis Provider Toolkit

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Dermatology Hot Topics

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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 76-year-old woman seeks your attention for an asymptomatic “red spot” on her neck. She has a history of multiple non-melanoma skin cancers.

Squamous cell carcinoma in situ (Bowen  disease)

Lichenoid keratosis (an inflammatory variant of seborrheic keratosis)

A 76-year-old woman seeks your attention for an asymptomatic “red spot” on her neck. What does this look like to you?

Clinical Topics

What's This "Red Spot"?

The lesion on this 6-year-old boy occupies almost the entire left side of his nose. The mother attributed it to an injury her son had sustained 2½ weeks earlier, when he was hit in the face by a baseball.

Is this lesion the result of an injury, as the boy’s mother suspected, or something else?

Scaly Plaque on the Nose

This 10-month-old boy presents with a red, macular, spreading rash that developed 5 days after he started taking amoxicillin for otitis media.

A. Erythema infectiosum (fifth disease; parvovirus B19)

A macular rash has been spreading for 5 days after the cheerful child started amoxicillin therapy.  What’s the most likely cause?

10-Month-Old With Macular Spreading Rash

A 5-year-old boy with a history of atopic dermatitis since 6 weeks of age, presents with a rash around his mouth that has been present for approximately 1 year. The patient’s mother reports that desonide topical cream was applied to the affected area for about 5 days, which initially resulted in improvement, however the rash returned after this medication was discontinued. The rash also recently improved after the patient took amoxicillin for an infection. She also notes that the patient has been licking his lips more frequently.

On examination there is an erythematous papulopustular eruption restricted to the perioral region, with sparing of the vermillion border. Mild hyperpigmentation is noted on the patient’s neck. There is no active involvement of other areas of the body.

The eruption has been present for 1 year and is restricted to the perioral region. What is included in your differential? 

Rash Around the Mouth of a 5-year-old Child

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?

Ted Rosen, MD

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