August 1st 2025
Your daily dose of the clinical news you may have missed.
Inflammatory Seronegative Arthritis
September 14th 2005The 83-year-old woman whose hands are shown in photograph A had a severe flare of arthritis in the metacarpophalangeal and proximal interphalangeal (PIP) joints after corticosteroid therapy for her asthma was stopped. The clue to the diagnosis of psoriatic arthritis is in her fingernails, which show both pitting and onycholysis.
Ten days before presenting for evaluation, a 69-year-old man began to experience neuralgic pain and noticed the eruption of painful erythematous macules and papules on the right side of his chest. Within 24 to 72 hours, vesicles and pustules arose at the site. One week after onset, several of the lesions dried and crusted.
Congenital Sensory Neuropathy Type IV (Congenital Insensitivity to Pain with Anhidrosis)
September 14th 2005A 6-year-old girl presented with a huge ulcer on her right heel, seen here, that began as a minor laceration when she stepped on a rock several months earlier. On the left heel, there was a similar lesion in the process of healing that had also followed a minor injury. Her feet and hands were dry and hyperkeratotic.
Basal Cell Carcinoma on Face of a 54-Year-Old Farm Worker
September 14th 2005When this lesion was seen on the face of a 54-year-old farm worker, cutaneous melanoma was the immediate concern. Accordingly, a full-thickness excisional biopsy was performed. (Curettage and shave biopsy are contraindicated for a suspected melanoma.)
Localized Discoid Lupus Erythematosus
September 14th 2005Many disorders that scar the skin also affect the scalp. Systemic lupus erythematosus, when associated with high fever and extensive systemic involvement, can cause a diffuse anagen effluvium. Hair loss caused by localized discoid lupus erythematosus (DLE) is more common. DLE may affect the scalp, where it is seen as circumscribed areas of often irreversible hair loss.
Chronic Discoid Lupus Erythematosus
September 14th 2005Numerous plaques, some with yellow crusting and central scarring, had erupted primarily on the face and neck of a 46-year-old man. A single lesion had developed on his left elbow as well. The lesions were initially diagnosed as impetigo, but they failed to resolve after 2 courses of oral cephalexin.
Eruptive Xanthomas in a 32-Year-Old Man
September 14th 2005A 32-year-old man presented with a yellow, papular rash on the buttocks and extensor surfaces. His medical history included diabetes mellitus, alcoholism, obesity, and polysubstance abuse. Laboratory results disclosed a serum triglyceride level of 5,793 mg/dL.
Tinea Manuum and Tinea Unguium
September 14th 2005For about 4 months, a very dry, diffuse, fine scaly, asymptomatic eruption covered the palms of a 28-year-old man; several fingernails were dystrophic bilaterally as well. Before the onset of this condition, bilateral onychomycosis of the toenails had been diagnosed.