An Incidental Finding

The patient is an 85 yo man who presented for generalized pruritus which has been present for two years. He has a history of prostate cancer and gastrointestinal bleeding. He's had a few transfusions over the past year or so and was concerned that they caused his itching.He did not complain about his nose. I asked about it and he and his daughter gave this history: Three years ago he was hospitalized for pneumonia. He delvelped an inflammation...

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Tale of Two Lesions

I saw these two patients today. Your comments are most welcome. Path reports will be affixed when available.1) 69 yo man with 1.5 month history of lesion right pinna. The lesion is slowly growing. The patient's son, a family doctor, asked him to make an appointment. This is a subtle lesion that could be a lentigo or a lentigo maligna. Two representative areas were biopsied.2) A 55 year-old priest whose parishioner noted a lesion on his left...

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Hypopigmentation in atopic dermatitis

This is a 7-year-old boy who developed multiple patches of hypopigmentation on the dorsum of the hands for 3 years. He had a history of atopic dermatitis and had severe eczema of the hands prior to development of the hypopigmentation on the hands. According to the mother, he had secondary infection with crusts formation on the hands. The lesions were patchy hypopigmented macules mainly on the dorsum of the hands and feet. There were no family...

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A Case from New Brunswick

A friend from coastal New Brunswick sent this interesting case:Dear Dr. Elpern,The patient is a 91 year-old working lobsterman who was sent in by his GP for evaluation of a large fungating tumour on his left temple. By history, the lesion has been present for 15 years but has only really increased in size in the past 18 months. He's in vigourous good health otherwise.On close examination, the tumour was found to be on a stalk. It's surface measured...

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Probably Lyme

The patient is a 56 year old man in good general health.Six days ago, he developed an erythematous papule on the left abdomen. Over the past week, this has grown into an oval 10 centimeter pruritic erythematous plaque.This is a solitary lesion and the remainder of the cutaneous exam is unremarkable.There is no history of tick bite, but this is an endemic area and the patient has an outdoor life-style.I suspect this is Lyme Disease and that it is...

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