Erythema Migrans with Pustules

This 27 yo woman was sent from the E.R. with a 5 day history of a solitary 20 cm annular plaque on the right hip. It looks classical for erythema migrans (EM) of Lyme disease. Her three year-old daughter had a tick on her skin 2 weeks ago, but she has no history of tick bite. The patient is well otherwise.Photos taken June 24, 2008Clinically, this is Lyme disease, but no reports in literature of pustules. There is one from China with vesicles...

Read More

Ranula

Abstract: 16 mo girl with mucous cyst of lower lip.HPI: This 16 mo Chinese girl presented for evaluation of a lip lesion that has been present for two months. It waxes and wanes in size. The lesion does not appear to bother her. Her mother speaks little English and is very worried about this lesion.O/E: 6 mm translucent cyst lower lipClincal Photo:Lab/Path: N/ADiagnosis: Mucous Cyst (Ranula)Questions: How would you approach this patient? I...

Read More

Man from Mauritius

Presented by Dr. Philip Li Loong, Quatre Bornes, MauritiusAbstract: 27 year old man with four year history of a papular eruption.HPI: This man's lesions began on the face four years ago and later developed in the groins and axillae. Initially macules, they became papular and much more numerous. At onest, they were felt to be verruca plana. Cryotherapy was tried without success.O/E: The lesions are 2 - 3 mm in diameter brown to yellowish papules....

Read More