A Change of Pace

The patient accompanied her "mother" to the office. She is a 12 yo chihuaha with autoimmune thyroid disease and extensive alopecia areata. I was aksed what could be done and injected large areas of her skin with intralesional triamcinalone. Unfortunately, there is no billing code for this - the dog lacked health insurance. (Actually, I deferred treatment until I hear from my august colleagues)Note tail alopecia in Fig. 3Fig 1Fig 2Fig. 3Ref:A...

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Asymptomatic Blanching Palmar Eruption

Asymptomatic non blanching eruption A 14-year-old, otherwise healthy boy presented with an asymptomatic red blanching eruption on the palms that developed about one week earlier. Soles were not involved. No inciting factor including drugs or illness could be recognized. Rest of the physical examination and routine blood and urine tests were unremarkable. What conditions can give rise to this eruption and how should we work it up ?Shahbaz...

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Case for diagnosis (Alberta, Canada)

Day #1 this guy helped deliver a breech calf by c-section which was so traumatic that the calf was still-born and then the following day he helped butcher a cow. On Day #3 he noted swelling of his left index finger and by Day #4 it blew up to look like these pictures. The more I read about orf the more I feel that this is likely the case. The risk factors are there and the time of year and setting is classic. Anyway, what do the viewers think?...

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