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Make the Diagnosis

A 50-year-old white female presented with painful, pruritic, tense bullae and blisters on the bilateral palms of her hands that had been present for 3 days. Physical examination of the feet revealed no lesions. The patient had recently injured her ankle and was using crutches with rubber padding on the handles.

 

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Images courtesy Dr. Donna Bilu Martin

 

 

A 64-year-old male presented with a past medical history of esophageal squamous cell carcinoma (treated with chemotherapy and radiation therapy in 2003) and metastatic disease to the brain (2005). He was recently admitted to the hospital for chemotherapy and radiation for a new, proximal, poorly differentiated, small-cell esophageal carcinoma.  The patient noticed new red spots that appeared on his abdomen, groin area, and upper thighs that were tender to the touch. Initially he was afebrile, but later developed fever and chills. On physical exam, he had several erythematous, slightly indurated papular nodular lesions on his left abdomen, right inguinal region, and bilateral upper thighs that were all tender to palpation.

 

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Photo courtesy of Dr. Susannah McClain

    

 

 

A 32-year-old man with no significant past medical history presented with a 1-month history of a pruritic rash on his bilateral axilla. He had treated the rash with over-the-counter hydrocortisone cream with no improvement.

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Images courtesy Dr. Donna Bilu Martin

 

A 17-year-old female with a past medical history of atopic dermatitis presented with a 1-month history of pruritic papules on her neck. The lesions were spreading. She reported recent contact with children.

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Photo courtesy of Dr. Donna Bilu Martin

    

 

A 35-year-old female with a history of recurrent herpes simplex virus presented with a 2-day history of asymptomatic target lesions on her hands, arms, and feet. She reported an outbreak of HSV the week prior to presentation.

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Photo courtesy of Dr. Donna Bilu Martin

    

 

A 40-year-old man with no significant medical past presented with a 1-week history of an annular pruritic rash on his left cheek. The right cheek was unaffected. He had treated the rash with over-the-counter hydrocortisone cream with no improvement.

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Photo courtesy of Dr. Donna Bilu Martin

    

 

A 52-year-old white woman with acute myeloid leukemia is hospitalized for induction chemotherapy. Seven days after admission, she developed a painful, firm, erythematous plaque with an overlying hemorrhagic bulla near her gluteal cleft. The patient was "profoundly neutropenic." Her vital signs were stable.

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Photo courtesy of Dr. Donna Bilu Martin

    

 

A 44-year-old male presented with a 3-year history of asymptomatic, red-brown, hyperpigmented nodules and plaques on his face, neck, arms, and upper back. He also had hoarseness, dry cough, wheezing, joint aches, and fatigue. Angiotensin-converting enzyme (ACE) level was elevated.

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Photo courtesy of Dr. Donna Bilu Martin

    

 

A 53-year-old woman with a long history of eczema presented with diffuse, pruritic, 1-3 mm lichenoid, waxy, firm, yellowish papules on her forearms and anterior legs that were present for 6 months.

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Image courtesy Dr. Donna Bilu Martin

    

 

An 8-year-old boy with a history of mild atopic dermatitis, keratosis pilaris, and molluscum contagiosum presented with a 1-week history of a pruritic rash on his right upper arm. There was hypopigmentation and mild erythema following the design of a black henna tattoo that had been placed 1 day prior to the rash.

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Image courtesy Dr. Donna Bilu Martin

 

A 51 year-old-male presented with asymptomatic violaceous, indurated plaques on his left and right cheeks. He also had follicular plugging in the right ear.

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Images courtesy Dr. Donna Bilu Martin

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