A Common Entity

How many times have you experienced this?The waiting room is full and a patient comes in, settles down comfortably and says, "I won't take up much of your time today, I see how busy you are. So I wrote down a few questions." Thus spake a healthy 55 year old man as he sat down and pulled out this post-it from his pocket. "La Maladie du Petit Papier," I thought with resignation. PubMed has only five references to this entity we all know. The first...

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Mystery from Micronesia

We received this note from a physician in Hawaii. Your thoughts will be appreciated."Two years ago, I was shown photos of a severe skin condition which afflicted more than 80 persons on the tiny atoll of Satowan in Chuuk. Now, more than 100 persons on Satowan are affected and about 10 on the neighboring atoll of Lekinioch. Affected persons develop thick, pink plaques, usually on the arms and legs – this appearance resulted in the nickname “Spam.”...

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Stranger than Fiction

Abstract:50 yo man with unusual facial eruptionPresented by:DJ ElpernHistory:This 50 yo man develops an eruption on his left malar eminence annually. This occurs after his late December deer hunting trip. He is exposed to cold air. Does not take any new meds at that time. The eruption has a burning sensation.Exam:Annular plaques with central pallor and peripheral dusky red color left malar. No other similar lesions.Clinical Photos:"X"marks the...

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Alopecia

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Imiquimod + 5FU

Abstract 62 yo man with SCIN of finger. Failed Imiquimod and responded to combination of 5% 5FU + ImiquimodPresented by: D.J. Elpern, Williamstown, Massachusetts, USAHistory This 62 yo man had a 15 year history of a plaque on his left index finger. He had been told it was a wart in the past.Exam 2.0 cm in diameter verrucous plaque.Clinical PhotosLab and Path Because of long history a biopsy was done to r/o SCC. The path showed in situ squamous...

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Deadly Allopurinol Hypersensitivity Syndrome

The patient was a 59-year-old man who presented with 3-week history of generalised skin eruptions associated with high fever. He was well previously and was started on allopurinol for asymptomatic hyperuriacemia. About 3 weeks later, he started feeling unwell and giddy. Then he developed a generalised erythematous eruptions on the lower legs which then spread to the trunk and face. He was admitted at the general hospital but discharged five days...

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Unique Drug Eruption

This 83 yo old man has chronic renal failure with a creatinine of 18 (!!) but does not need dialysis yet. His hemoglobin has been maintained with Procrit for the past four years. Because of a low transferrin saturation (30 %), his nephrologist added a new form of iron infusion around 2 months ago. (This was in another state and I don't have the name of the product) Within two weeks he started developing a generalized pruritic eruption. He stopped...

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VGRD 2.0

"And gladly wolde he lerne and gladly teche" ChaucerWelcome to VGRD 2.0This updated version of VGRD will allow more interactive postings by dermatologists. Virtual Grand Rounds in Dermatology (VGRD) was formed in 2000 to serve as a place for dermatologists the world over to meet one another and share interesting and challenging patients. One may want to ask a question about diagnosis or therapy, present an interesting clinical photo or post a photo or photomicrograph. We are a group of clinical and academic dermatologists who believe that this...

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