Localized Hyperkeratosis

39 yo man with > 15 year hx of localized hyperkeratosis of right great toe. No unusual trauma to area. He's used mostly over the counter emollients without much help.Are you aware of any localized forms of hyperkeratosis?I have started him on Salex cream.Pictured below are his affected right and normal left great to...

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Recent Onset Acne in Young Woman

This 21 yo woman experienced the sudden onset of acne one month ago.No new med. No unusual stresses. She has never had acne like this before.Do you think this is a mild case of pyoderma faciale rather than typical ac...

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BCC Scalp

The patient is a 75 yo man with a three month hisory of a lesion at the vertex of the scalp.Exam: Man with Type II - III skin. 2 x 1.6 cm diameter erythematous plaque scalp. There are some small crusted areas.Biopsy shows superficial BCC.Question: Is Aldara appropriate?C + E will take ages to heal.Excision could n ot be closed without a graft or a fl...

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19 year old student with acneiform eruption

History: 19 year-old man with a 5 year history of acneiform eruption predominately on torso and proximal extremitiesl Some facial involvement, but less than on torso. He is in good health, no history of diabetes or steroid use. No antibiotics for months. In the past he has used benzoyl preoxide ceams and washes, topical retinoids, topical antibiotics and tetracycline and its derivatives. Mome has ever helped.Exam: Healthy young man with Type...

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Atypical Nail Pits

Case for Discussion:This 40 year-old woman presented for evaluation of a nail dystrophy present for 2-3 months.She has a history of Hashimoto's thyroiditis. About 9 months ago she developed vitiligo.Her health is otherwise normalMeds. Synthyroid and ironLab: Thyroid Perox AB 248 (Nl. 0 - 34 IU/ML) ANA < 1:40Physical Exam: Vitiligenous patches left neck and left upper back Around 4 finger nails show a distinctive pitting....

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