84 yo man with Pemphigus

This 84 yo man was seen around weeks ago with an erosive bullous process on torso, head and neck of 4 months duration. He was on no meds by mouth and in good general health.My initial impression was pemphigus vulgaris vs. impetigo. The skin culture showed many coag + staph, and the bx showed an acantholytic bulla. The DIF was positive for intracellular IgG.He was treated with dicloxacillin 250 mg qid and prednisone 20 mg tid.He cleared quickly....

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40 yo woman with scarring alopecia

The patient is a 40 yo woman with an eight year history of scarring alopecia. Her ANA is + at 1:160 - all other labs are normal. No other cutaneous findings or systemic disease other than "fibromyualgia."She has been treated with 200 mg of plaquenil b.i.d. for a number of years. This has not been of much help.The patient is quite concerned about her scalp. She's going through a divorce and worries about her appearance.Questions?1) Any value to...

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Melanonychia in a Six Year-Old Child

Presented byDr. Chee Meng Loh RMGSingaporeE mail: bliss88@singnet.com.sgThe patient is a six year old Chinese girl who developed a dark pigmented longitudinal band on the nail of her right index finger about 1 year ago. It started as a narrow, light brown band and grew in darkness (black in centre of band, and lighter shade of brown at edge of band) and width. The band is now about 3 mm in width. It has not changed in the past 3 months.There is...

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