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DERMATOLOGY CASE CHALLENGE: An itchy, evanescent rash
A 41-year-old white man presents with a 6-month history of a generalized pruritic erythematous eruption that comes and goes and that spares the face, palms, soles, genitals, and scalp. He notes that the rash is worse with hot showers and exercise and that tight clothes are bothersome.
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Scaly red plaques on dorsal part of hand
A 64-year-old woman has had a several-year history of minimally pruritic, scaly lesions on the scalp, trunk, and extremities. Shortly after the onset of the eruption, she noticed morning joint stiffness and pain, which progressed to severe joint deformity.
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Skin tightens, then darkens and thickens, in a 7-year-old
A healthy 7-year-old girl is brought to your office for evaluation of tight skin on the left leg and abdomen of two months' duration. Because the skin appeared purple and swollen at first, her mother believed that this was bruising from playing soccer. Over the following month, however, the skin became dark and thickened. The patient has no history of trauma or other significant illness.
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DERMATOLOGY CASE CHALLENGE: A diabetic patient with longstanding, expanding pretibial plaques
A 37-year-old woman presents with plaques of 1 year's duration on her lower legs that appear to be expanding. The patient has a history of poorly controlled diabetes mellitus requiring insulin but is otherwise well and taking no other medications. The clinician suspects granuloma annulare, cellulitis, sarcoidosis, xanthomas, necrobiosis lipoidica diabeticorum, and necrobiotic xanthogranuloma.
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