Segmental Pityriasis Rosea

Abstract: 32 yo woman with seven week history of a dermatitis on l. chest and breast.HPI: Her dermatitis began with a single erythematous plaque on the left breast. Within one to two weeks, it spread to the present extent (almost all was on the upper chest and breast). She had used a topical imidazole cream without relief. No new medications.O/E: There are discrete and confluent scaly erythematous papules and small plaques on left chest and breast....

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Periocular Dermatitis in a Child

Melanie Austin, a pediatrician asks:"This is a 4 y/o with 10 day history of this rash around only her right eye. No eye discharge. The rash is not bothersome - mother describes at times it looks worse. H/o eczema, keratosis pilarisI don't recognize the rash and I didn't want to start and topical steroids due to proximity to eye. Mom denies any make up or topical treatments at home...What are your thought?Thank...

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Dialysis Patient with Atypical Ulcers

Abstract: 77 y.o.woman on dialysis with skin ulcers for over a yearHPI: The patient is a 77 yo woman with diabetes and ESRD on hemodialysis for a number of years. She had a diagonsis of porphyria cutanea tarda over four years ago, but no lab studies are available and it's unclear if this was a clinical or laboratory diagnosis. For over a year she has had painful skin ulcers which are located on the abdomen, scalp, breast and hands. These do not...

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Isotretinoin: Rare Side-Effects

Isotretinoin (Acutane, RoAcutane, Sotret, Claravis, Amnesteen) is a true wonder drug that has revolutionized the treatment of severe cystinc acne since its introduction in 1980. Over twenty million people have used it. There are some rare idiosyncratic reactions. We welcome comments here from patients, their families and practitioners.The index case is a is an outgoing 16 yo girl with severe cystic acne with scarring. She was started on isotretinoin 30 mg per day (0.5 mg/kg per day) after routine lab tests were normal. She was on no other medications...

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25th Hot Spots Program

For More Information see Hot Spots BlogSpecial Tuition for all VGRD Memb...

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Erosive Diaper Dermatitis

Here is a tough one:Abstract: Thirteen yo boy with 6 month history of erosive diaper dermatitis.HPI: The patient is a 13 yo boy with Down's Syndrome. As an infant he had Hirschprung's disease corrected by surgery. Subsequently, he has had problems with bowel movements and at this time is still incontinent of stool. He needs diapers to prevent soiling. Six months ago, he was diagnosed with Crohn's Disease. Since his colonoscopy, he has developed...

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