All Ears: Can You Identify These Lesions?
October 1st 2006An 80-year-old man has had an asymptomatic, flesh-colored swelling on his right ear for 4 to 5 months. In the center is a 1-mm white scab pointing downward from the helix. At times, the patient shaves a white spicule that grows in this crusted area. He sleeps on his right side and does not use a cell phone.
Pituitary Macroadenoma With Hemorrhage
September 14th 2005After being hit on the head during a football game, a 16-year-old experienced several seconds of complete vision loss in the left eye. A few days later, he noticed the onset of blurred vision in the same eye, which progressively worsened over several weeks.
Mongolian Spots and Hyperpigmentation
September 14th 2005Large, blue-black, macular areas over the buttocks and presacral regions were present at birth in this black child. Significant hyperpigmentation of the genitals also was evident. Scrotal hyperpigmentation is not an uncommon finding in a black newborn. However, the intensity of the penile hyperpigmentation in this baby is unusual.
Streptococcal Cellulitis of the Leg
September 14th 2005A 71-year-old man, who had recently returned from a month in Europe, complained of left lower leg swelling and pain of 1-week's duration. For many years, this obese patient had chronic venous insufficiency of both legs and chronic osteoarthritis of the knees that severely limited his ability to walk. The patient was admitted to the hospital with extensive cellulitis of the left lower leg.
Ophthalmic Zoster: Common Manifestation in the Elderly
September 14th 2005Periorbital, forehead, and nasal erythema, crusting, and pain typical of herpes zoster affected a 90-year-old woman. Reactivation of the latent varicella zoster is more common in the elderly and is attributed to impaired immunologic mechanisms.
Pingueculae: Atypical and Typical
September 14th 2005Pingueculae-yellow lipid deposits-may develop on the bulbar conjunctiva after several years of exposure to drying, dust, and the UV rays of sunlight. They represent elastotic degeneration of the substantia propria and are not seen in infants or children. These lesions usually are evident on the nasal aspect of the conjunctiva; they are innocuous and require no treatment.
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.
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.