Leg Ulcer in a Heart Transplant Patient

The patient is a 49 yo man with a one month history of a very painful leg ulcer.He is 8 years s/p heart transplant.His medications include: CsA, CellCept, Pred, Diltiazem, Ranitidine.There was no history of trauma and no similar ulcers in the past. He works at a supermarket and is on his feet all day long at work.This ulcer is periodically painful. He has had leg edema for over a year.The examination shows an 8 mm in diameter ulcer with as slightly...

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Retroauricular Dermatitis

The patient is a 25 year old registered nurse with a few month history of a painful and pruritic process in the right retroauricular area. She also has mild scalp pruritus and some increased scaling of the scalp.The exam shows a superficial erosion in the right retroauricular sulcus.Bacterial Culture: Positive for Many Staph aureus - resistant to Pen and ErythroPt. Started on mupirocin creamNote: She is an obstetrical nurse and has contact with...

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Periocular Dermatitis

The patient is a 35 year old man who has had a right-sided eyelid dermatitis for around eight months. He was given a moderate strength topical steroid for this by his primary care physician and has been using it off and on since. When the process flares, he applies it again.There are discrete erythematous papules around the upper and lower lids on the right side. The left eyelids are clear.The clinical picture suggests a steroid-induced periocular...

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A Hunter in Deer Season

The Hunter as Hunted[Your comments are welcomed]This 72 year old man was deer hunting on December 2, 2006. He remembers sitting on a log for 45 minutes and feeling as if he was being bitten. Later that day, his hunting companion removed three ticks from him. He presented on Monday, December 5 for an evaluation. The picture is taken from his left hip. The tick was gently removed and photographed with a paper clip. Since the tick was attached...

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