Amytrophic (?) Dermatomyositis

Presented by Henry FoongIpoh, MalaysiaHPI: A 82 yr old housewife presented with 6 month history of skin eruptions on her face, neck and hands. They were aggravated with exposure to sun. She was diagnosed with carcinoma of the stomach in 2007 and completed chemotherapy about 3 months ago. While on chemotherapy she noticed weakness in getting up and putting on her shirt. She has improved since then. She has a history of diabetes mellitus, and...

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Lyme Tick

This 60 yo man came in for a skin cancer check. He had a basal cell removed from his forehead two years ago. The exam was negative until I checked his leg and noted a funny looking lesion. On closer examination, I realized it was a tick. It's head was embedded in the patient's leg. I removed the tick and gave the patient 200 mg. of doxycycline. This latter might be unnecessary, but a study published in the NEJM gives support to this fairly...

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Abdominal Sinuses in a 23 yo Man

Three month history of draining sinuses lower abdomen.HPI: This college student developed abdominal pain and bloody diarrhea in August of 2008. A diagnosis of ulcerative colitis was made and a number of theapies were tried (including prednisone and Remicaid). All were ineffective and he had a subtotal colectomy and ileostomy performed in December of 2008. Subsequent to that he continues to have some pain in the rectal stump and is scheduled for...

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Trichoepithelioma

A Dermatologic Vignette.The patient is a 78 yo woman with a few year history of an enlarging lesion on the nasal tip. Excellent health.Eight mm in diameter pearly papule nasal tip. Clinically and dermoscopically BCC.Pathology shows this to be a trichoeoithelioma:Question: Observe, refer to Mohs, radiate?Would surgery be deforming in this site? vs. Is radiotherapy overkill?Reference: There are very few references which address this type of lesion,...

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