Dermatology

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For the past 3 years, comedones, papules, pustules, and nodules had been erupting on the face of a 16-year-old boy. Acne vulgaris had been diagnosed. Topical tetracycline cream and oral tetracycline were used without success.

Four pink nodules appeared in a linear array on the proximal extensor right forearm of a 77-year-old man. The asymptomatic lesions, which ranged from 0.5 to 1.0 cm in diameter, had been present for 2 months.

A 49-year-old woman was admitted tothe hospital with a high fever ofabrupt onset, rigor, headache, myalgias,and profound prostration. Hertemperature was 41ºC (105.8ºF);blood pressure, 60/40 mm Hg; respirationrate, 30 breaths per minute;and pulse rate, 130 beats per minute.

A pruritic, erythematous rash developed in a 6-year-oldboy over 5 days. The rash erupted in crops; the lesions appearedinitially as rose-colored macules, progressed rapidlyto papules and vesicles, and finally crusted (A). The distributionof the lesions-with the greatest concentrationon the trunk-is typical of chickenpox.

A 30-year-old man presented with a few-day history of aviral prodrome, including a low-grade fever, mild headache,muscle and joint aches, and malaise, accompaniedby a vesiculopapular rash. The mildly pruritic eruptionbegan on the head and neck and progressed within 36hours to the trunk and proximal extremities; the palmsand soles were spared.

A 65-year-old man with no significant medical history presented with mild abdominal pain-primarily in the left lower quadrant-and bleeding gums. He had a petechial rash over the entire body and hepatosplenomegaly 10 cm below the costal margin.

A 16-year-old black girl complained of a gradually worsening facial eruption. She had been assured by her family physician that this was caused by an allergy to soap; she applied over-the-counter 1% hydrocortisone cream daily.

An intensely itchy dermatosis developed on the back of a 30-year-old Saudi Arabian renal transplant patient. The patient had never before experienced a similar eruption. He was taking prednisone and azathioprine to prevent transplant organ rejection, as well as amoxicillin for an upper respiratory tract infection.

Painful, erythematous plaques had erupted 4 to 6 weeks earlier on the left upper arm and lower abdominal wall of a 54-year-old woman.

This patient has a 2-year history of red plaque with a yellow atrophic center on the leg, which has ulcerated over the past 3 months.