Dear Pre-VGRD,Thank you for allowing me to present this difficult case.The patient is a 60-year-old journalist, who presents for evaluation of genital pain that has been present for about six months. He has been in his usual state of health. No new sports or traumas. His medications include atorvastin, buproprion and the generic omeprazole. He has an annoying, painful sensation on the ventral shaft of the penis. He has noted some hyperpigmentation there and occasionally the skin here gets red. He thinks this lasts for a few hours but he is...
Wednesday, May 24, 2006
Thursday, May 18, 2006
Photosensitive dermatitis from bleaching creams
My friend, David Elpern MD, a dermatologist from Williamstown, USA sent this note to me. "NY TimesMay 14, 2006A Vision of Pale Beauty Carries Risks for Asia's WomenBy THOMAS FULLERMAKHAM KHU, Thailand - Neighbors gawk and children yell, "Ghost!" The manager of the restaurant where Panya Boonchun worked simply told her she was fired.The cream that she applied to her face and neck was supposed to transform her into a white-skinned beauty, the kind...
Wednesday, May 17, 2006
Onycholysis
The patient is a healthy 58 year old woman with a 3 year history of onycholysis. Fungal culture has grown out Candida zeylanoides. Bacterial culture negative.Topicals have not been of help. (imidazoles and thymol in chloroform)Would fluconazole be of value?Should the nail be avulsed?Who has had success treating this kind of probl...
Thursday, May 11, 2006
Pellagra in Alcoholics
In Iraq, pellagra is only seen in sporadic cases in patients with alcoholism. I describe here a case of pellagra in 30 year old man who used to drink alcohol one litre a day of a local beverage called ARAK. In addition, his nutrition was poor. He developed a typical rash of pellagra in photosensitive area, some lesions are bullous together with beefy tongue. The rash resolved quickly after vitamin replacement but recurred when he resumed alcohol...
Monday, May 8, 2006
Nail Bed Carcinoma
The patient is s 70 yo man who was seen today for a three year follow-up of micrographic surgery for a sqaumous cell carcinoma of the nail bed. There is no evidence of recurrence and the results are cosmetically excellent.I had another patient with a similar lesion. He was a VA patient and they did not approve him for microgrpahic surgery. He had the distal part of his thumb excised. Bizarre that health insurance trumps the interests of the ...
Thursday, May 4, 2006
Folliculitis and Hair Loss
The patient is a 30 year-old man with a 2 year history of folliculitis and mild hair loss. He has erythematous papules and a few pustules scattered over the scalp. Cultures have been negative. Biopsy showed only inflammation c/w folloculitis. Minocycline has been of marginal help, but process recurrs when he stops. He has an occasional papule on his cheeks but no signs of rosacea. His hair is globally thin.Question: Is this folliculitis decalvans?...
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