Nasal Lesion in a Child

The patient is a 30 month old girl with a 15 month history of a papule on the left ala nasi. Her father has Hereditary Leiomyoma Renal Cell Carcinoma syndrome (HLRCC) and the patient is positive for the gene. The question is whether this papule is a possible sign of the HLRCC syndrome or an unrelated entity.The tumor is 3-4 mm in diameter and has been growing very slowly. The child is in good general health otherwise. The lesion is red in color,...

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Paronychia in a Child

The patient is an eight year-old girl with a three week history of paronychial inflammation. Mild pain at onset and now. No history of trauma or finger sucking. She was first seen by her pediatrician around ten days after onset and told it was improving and to give it time. No improvement after ten days; given a ten day course of cephalexin and urged to do warm soaks. No improvement noted. Seen in Dermatology Clinic October 26, 2007. Examination:...

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Hand Bullae in the Setting of Hemodialysis

Presented by Tucker Slingerland, M.D. Chief Resident in Family Practice at the University of Vermont.HPI: A 76 year old woman with multiple medical problems including chronic hemodialysis, hypertension, hypertriglyceridemia, and type II diabetes mellitus presents for a second opinion on bullous lesions involving the dorsal hands, fingers, tips of ears and scalp. She had been told she had "porphyria," given sparse information about her condition,...

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