Asymptomatic red lesions

Asymptomatic red lesions

Two patients present with asymptomatic red lesions -- a 60-year-old man, whose lesion was present for five years before beginning to bleed, and a 27-year-old man whose lesion doubled in size during a two year period. Can you differentiate between the two?

Bimalar facial rashes

Bimalar facial rashes

A 54-year-old nurse and a 26-year old woman both present with bimalar facial rashes caused by two different things. Can you tell the difference?

Trunk rashes with central clearing

Trunk rashes with central clearing

Two patients present with oval-shaped plaques with central clearing on the trunk. Can you tell the difference?

Growing skin plaques with scale

Growing skin plaques with scale

Two patients present to the dermatology clinic with scaly pruritic lesions on the forearm. Can you differentiate between the two?

Diffuse erythematous papules

Diffuse erythematous papules

A 3-year-old boy and 45-year-old man present separately to the dermatology clinic with similar looking erythematous rashes. Can you differentiate between the two?

Linear pink plaques

Linear pink plaques

Two patients present to the dermatology clinic with pink rashes — one with a hyperpigmented rough patch on the nose, the other with pink papules in a linear pattern on the lateral thigh.

Yellow processes on the face

Yellow processes on the face

A patient presents with a yellow plaque on her left eyelid and a yellow papule on her left cheek. Are the two related?

Yellow papules near the nipple

Yellow papules near the nipple

A woman presents with papules on the areola that had been enlarging for several months. A man presents with protuberant papules with a red, yellow and whitish hue. Can you differentiate between the two?

Newly developed brown papules

Newly developed brown papules

Two patients present with newly developed brown papules. The first patient, a 45-year-old man, presented with a new mole that continues to grow and is associated with occasional pruritus and bleeding. The second patient, a 47-year-old man, presented with a 6-month history of a brown, growing "mole." Can you differentiate between the two?

Discoloration of the eyelid

Discoloration of the eyelid

Two patients present with discoloration of the eyelid. The first patient, a black woman aged 65, presents with velvety plaques and skin tags near hear right area that did not itch, burn or hurt. The second, an 8 year old boy with a family history of atopy, presented with eyelid dermatitis. Can you differentiate between the two?

Growths on the fingers

Growths on the fingers

Two patients present with growths on the fingers. The first patient, black woman aged 45 years, presents with papules on the outside of her pinkies that had been present since birth, had not grown and did not bother her. The second, is a man aged 40 years with a six-month history of a growth on the side of one middle finger. Can you differentiate between the two?

Vascular nodules and papules

Vascular nodules and papules

Two patients present with red lesions. A white infant aged 4 months presented with a three-month history of a red, verrucous nodule on his scalp, that grew from a small papule to a 3-cm nodule. A white man aged 50 years who had developed red papules on his legs, arms, chest and abdomen 20 years earlier, noticed that a group of the papules grew together to form a plaque. Can you differentiate between these two patients' lesions?

Pustular facial eruptions

Pustular facial eruptions

Two patients present with facial pustules, a 35-year-old man and an 18-year old woman. Can you differentiate between these two different dermatologic conditions?

Infant hand and foot blisters

Infant hand and foot blisters

Two patients present with blisters. One has bilateral blister formation on the dorsum of the hands, the other has blisters on the foot, face and diaper regions. Can you differentiate between the two?

Hair loss in an adult and a child

Hair loss in an adult and a child

Two patients present with hair loss. The first, a 55-year-old gay man presented with patchy-scalp hair loss. The scalp did not itch, burn or hurt, and was not scaly. The other patient, an 8-year-old boy with a several month history of hair loss and palpable lymph nodes. Can you differentiate between the two?

Painless, annular lesions

Painless, annular lesions

Two patients present with painless annular lesions. One presented to the dermatology clinic with a two-month history of a ringed rash on his abdomen, and the other patient had a three-week history of a slowly enlarging, pruritic rash on his left arm. Can you differentiate between the two?

Pediatric facial rashes

Pediatric facial rashes

Two patients present facial rashes. One presented to the dermatology clinic with an eight-month history of an asymptomatic progressive rash on his arms and legs, and the other patient had a history of multiple nonmelanoma skin cancers presented with asymptomatic scaly lesions on his hands, arms, and head. Can you differentiate between the two?

Infants with hypopigmented processes

Infants with hypopigmented processes

Two patients present with similar hyperpigmented spots on the skin — one with a series of macules on the cheek, and the other with lesions on his back.

Keratotic palms paired with brittle nails

Keratotic palms paired with brittle nails

A 42-year-old man presented with abnormally thick skin of the palms.

Nonhealing hand ulcer turns erythematous

Nonhealing hand ulcer turns erythematous

A woman aged 34 years was referred for treatment of a recurrent, painful, nonhealing ulcer of six months' duration on her left hand.

Scaly papules in sun-exposed areas

Two patients present with scaly papules. One presented to the dermatology clinic with an eight-month history of an asymptomatic progressive rash on his arms and legs, and the other patient had a history of multiple nonmelanoma skin cancers with asymptomatic scaly lesions on his hands, arms and head.

Slightly erythematous, scaly scalp lesion

Slightly erythematous, scaly scalp lesion

A 10-year-old boy referred by his pediatrician presented with a six-week history of a scaly scalp lesion.

Rash on palms and arms and blister on lower lip

Rash on palms and arms and blister on lower lip

A 28-year-old woman presents with a burning rash on her palms and arms. The rash appeared abruptly two days earlier along with numerous flat, pinkish-red lesions.

Nonhealing but painless cheek ulcer

Nonhealing but painless cheek ulcer

A Hispanic man age 23 years presented with a nine-month history of a nonhealing ulcer of his cheek. The erosion began as a small, painless erosion and had gradually enlarged.

Blisters on the lip and in the mouth

Blisters on the lip and in the mouth

A 35-year-old white woman presented with grouped vesicles and superficial crusting on both lips and grouped erosions on the gingiva and hard palate.

Papules caused by insect bites

Papules caused by insect bites

Two patients present with insect bites — one after walking in brush while vacationing and another after doing yard work. Can you differentiate between the two?

Arm lesions spread to the trunk and neck

Arm lesions spread to the trunk and neck

Asymptomatic erythematous papules on the arms, trunk, and neck are first thought to be insect bites in a man with weight loss, fatigue, and dyspnea.

Discoloration of the face, neck and hands

Discoloration of the face, neck and hands

A man taking an alternative medical treatment for periodontal disease presents with a history of skin discoloration.

Dystrophies of the nail

Two patients present with dystrophies of the nail—one with a several-year history of yellowed toenails and the other with grooved thumbnails.

Red lesions on the extremities

Two women present with similar red lesions on the extremities—one thought she had ringworm, and the other became severely ill after getting several vaccinations.

Bilateral netlike rash on the lower legs

Bilateral netlike rash on the lower legs

To combat cold temperatures at work, a woman kept a small heater under her desk. This led to netlike erythema on both lower legs.

Vesicle on the lip after intense sun exposure

Vesicle on the lip after intense sun exposure

A man presents with a six-month history of oral lesions that led to blistering and ulceration following intense sun exposure.

Cutaneous lesions

Cutaneous lesions

Two patients present with similar cutaneous growths—one a series of ulcerative lesions on the lower leg, and the other a painless forearm lesion.

Tender, edematous, red plaques on a woman's hands and feet

Tender, edematous, red plaques on a woman's hands and feet

One month after starting a new chemotherapeutic drug, the patient sought treatment for painful peeling and redness on her hands and feet.

Exposure to moisture leads to palmar rash

Exposure to moisture leads to palmar rash

A woman presents with a painful rash that developed immediately after exposure to water or sweating and disappeared an hour after drying.

Patches of hair loss

Patches of hair loss

Two boys with similar patches of hair loss—one developed six months ago, and the other had been present since birth.

Kitchen work worsens pruritic hand lesions

Kitchen work worsens pruritic hand lesions

A restaurant employee's intensely itching and burning hand lesions worsened after he was assigned to work in the kitchen.

Recurrent erosions on the neck and axillae

Recurrent erosions on the neck and axillae

For two years, a woman had lived with an itchy rash on her axillae and neck that became more symptomatic during the summer.

Enlarging back and shoulder lesions

Enlarging back and shoulder lesions

Two patients with enlarging lesions—one in a man with no history of skin cancer, and the other in a man with significant actinic damage

Rash preceded by fever and cough

Rash preceded by fever and cough

After four days with a high fever, cough, and conjunctivitis, a child is brought to the hospital with an extensive, maculopapular rash.

Scaly plaques spread from head to toe

Scaly plaques spread from head to toe

Five months of treatment with corticosteroids and antibiotics did not relieve the scaly rash on a man's scalp, cheeks, trunk, genitals, and legs.

Red rashes on the lower legs

Two patients present with leg rashes. One rash developed after a woman started taking cefazolin, and the other featured the deposition of hemosiderin.

Vulvar pruritus with no erosions or papules

Vulvar pruritus with no erosions or papules

A woman with no history of sexually transmitted diseases suffers intense vulvar itching. Hypopigmentation was noted with no erosions or papules.

Flesh-colored nodules on the shins and feet

Flesh-colored nodules on the shins and feet

A middle-aged woman with Graves' disease presented with asymptomatic, firm, nonpitting, flesh-colored nodules and plaques on her legs and feet.

Hypopigmented patches on the body

Two young girls with hypopigmented patches—one on the right buttock, the other on the knees, fingers, and ankles.

Rapidly growing tumor on the forearm

Rapidly growing tumor on the forearm

Six weeks after it appeared, the small red bump on this man's right forearm had become an erythematous crater-shaped nodule

Shiny, waxy patches on the shins

Shiny, waxy patches on the shins

A woman with a history of type 2 diabetes presented with asymptomatic, shiny, waxy, round patches on her shins that turned from red to yellow.

Atrophic rash in a hepatitis C patient

Atrophic rash in a hepatitis C patient

Plaques develop on the face, trunk, and hands of a man with hepatitis C.

Painful tightening of the skin on the legs

Painful tightening of the skin on the legs

A 62-year-old man with a painful erythematous rash on the shins

Purple eruptions

Purple eruptions

Two patients with purple lesions and no other abnormal skin findings.

Erythematous truncal plaques

Erythematous truncal plaques

Two patients with erythematous trunk plaques—the first developed eight months earlier, and the other 15 years ago.

Pressure-induced bumps and erythema

Pressure-induced bumps and erythema

A man presents with complaints of itchy and uncomfortable red bumps on his skin at sites of pressure. The lesions typically dissipated after one hour.

Topical treatment turns ulcer pruritic

Topical treatment turns ulcer pruritic

A woman develops severe itching and burning two days after application of topical bacitracin and a compression bandage to a venous stasis ulcer.

Vesiculobullous eruptions

Two patients present with similar vesiculobullous eruptions. One was preceded by painful mouth sores, the other had no oral involvement.

Cold blue fingers in a Coloradan

Cold blue fingers in a Coloradan

After moving to Colorado, a woman notices painful blue discoloration of her fingers on exposure to the cold.

White areas on the face of a teenager

White areas on the face of a teenager

Fearing a bacterial infection, a teenager seeks treatment for white facial patches.

Reminders of sun exposure

Sun exposure is the common link between these two conditions. Can you tell them apart?

Persistent plaque with severe intermittent pruritus

Persistent plaque with severe intermittent pruritus

Intermittent itching accompanies a persistent leg plaque.

Nonhealing painless ulcer on the sole

Nonhealing painless ulcer on the sole

For three years, the patient lived with an enlarging painless ulcer on the sole of his foot. The lesion occasionally drained liquid but never became red or tender.

Brown bumps that evolved into verrucous plaques

Brown bumps that evolved into verrucous plaques

The asymptomatic rash on a young woman's chest and back appeared to be spreading. Hyperpigmented papules had become larger verrucous plaques.

Can you identify these similar scalp nodules?

Two women present with growing scalp nodules. One patient reported recent unintentional weight loss.

Coalescing purpuric plaques

Can you distinguish between two purpuric plaques on patients' legs?

Tongue plaque with offensive odor

Tongue plaque with offensive odor

The patient is concerned about a recent increase in his foul-smelling tongue discoloration.

Irregular purplish blue markings on the limbs of a newborn

Irregular purplish blue markings on the limbs of a newborn

Blue markings on the arm and leg of a newborn were first thought to be bruises from a traumatic delivery.

Target lesions in a patient with acne

Target lesions in a patient with acne

Numerous red target lesions develop on the extremities of a young woman being treated for acne.

A pair of generalized red rashes

Two men present with red rashes—one started on the back and spread to the upper arms, and the other was limited to the chest.

Facial plaques in aging men

Two aging men develop similar-appearing asymptomatic facial plaques.

Enlarging vesicular peeling of the palms

Enlarging vesicular peeling of the palms

Peeling originating on the fingertips progresses to the palms of an African-American teenager following a 10-day course of ciprofloxacin.

Enlarging purple pruritic nodules on the dorsal neck

Enlarging purple pruritic nodules on the dorsal neck

One month after a painful neck rash, an HIV-positive man develops pruritic purple lesions at the same site.

Severe pruritic rash, fever, and malaise

Severe pruritic rash, fever, and malaise

An itchy rash is accompanied by facial edema in a young girl with a past history of osteomyelitis.

Discrete areas of hair loss

A 40-year-old woman and a 3-year-old boy experience similar patterns of hair loss—one of sudden onset and the other present at birth.

Bilateral pruritic papules on a woman's axillae

Bilateral pruritic papules on a woman's axillae

Skin-colored papules develop on the axillae of an African-American woman.

Skin fusion on the fingers and toes of an adolescent girl

Skin fusion on the fingers and toes of an adolescent girl

A patient seeks treatment for trauma-induced blistering and scarring.

Axillary papules and plaques

Differentiating two similar-appearing cases of axillary papules and plaques

Linear serpiginous eruptions on the extremities

Linear serpiginous eruptions on the extremities

Linear leg lesions that "move"

Similar-appearing vesicles

Two women, the first bedridden with high fever and the second otherwise healthy, present with a vesicular rash.

Differentiating cutaneous dells

Two men present with cutaneous heel lesions. Similar growths appear on the patients' hands as well.

Itchless, pigmented macules

Itchless, pigmented macules

Can you distinguish between these two facial lesions with similar characteristics?

Months-long facial rash with constant burning sensation

Months-long facial rash with constant burning sensation

An asthmatic woman experiences a recalcitrant burning facial rash that spares the lips.

Areas of varying pigmentation in a young boy

Areas of varying pigmentation in a young boy

A black boy with a family history of pigmentary problems presents with white patches on his trunk and legs.

Scaly erythematous patches following a throat infection

Scaly erythematous patches following a throat infection

A girl was brought by her mother to the dermatology clinic with a two-week history of a scaly rash.

Perinasal papules

Two men with papules on the nose, cheeks, and forehead.

Two plaque-type eruptions

Two plaque-type eruptions

Painful lesions on a man's axilla and groin and a woman's breast. Can you guess the correct diagnosis?

Exacerbation of asymptomatic flat facial lesions

Exacerbation of asymptomatic flat facial lesions

A young woman is concerned about multiple smooth bumps on her face.

Tender, rupturing pustule on the chin

Tender, rupturing pustule on the chin

A man complained of mild-to-moderate sensitivity in his lower incisor whenever he chewed for the past year. Four months ago, a painful tender swelling developed on his chin.

Intractable bilateral leg swelling and recurrent infections

Intractable bilateral leg swelling and recurrent infections

A man presented with a one-year history of progressive bilateral swelling and recurrent infections of the lower extremities. Maggots were observed in the skin crevices.

Painful pedal erythema

Two elderly men present with painful red rashes on their feet and lower leg. One patient had a history of gout, the other essential thrombocytosis.

Increasing scalp rash blamed on a haircut

Increasing scalp rash blamed on a haircut

Were an African-American man's scalp bumps caused by his barber?

Painful pedal lesions

Painful pedal lesions

An 18-year-old student and a 72-year-old woman bear similar pedal lesions that interfere with walking.

Peculiar violaceous, atraumatic rash

Peculiar violaceous, atraumatic rash

A man with a history of chest pain, light-headedness, and diaphoresis noted a bruise that had appeared spontaneously on his chest.

Discrete yellow lesions on the eyelid

Discrete yellow lesions on the eyelid

A woman has had discrete yellow areas on her eyelids for several years. During that time, the lesions had been slowly expanding.

Thick ridges and valleys found on a newly shaved scalp

Thick ridges and valleys found on a newly shaved scalp

A 58-year-old African-American man was alarmed to find that his freshly shaved scalp had many "ridges and valleys."

A pair of solitary nodules

A pair of solitary nodules

One man had a nodule on his palm, and another had one on his leg. Both lesions were painless, but the diagnoses were very different.

Elderly woman's thick warty lesion

Elderly woman's thick warty lesion

A 70-year-old white woman presented with a "mole" that had been growing on her right cheek for the past five years.

Asymptomatic red plaque on the hand of a diabetic patient

Asymptomatic red plaque on the hand of a diabetic patient

A 35-year-old Caucasian woman with diabetes mellitus was referred to us for evaluation and assessment of a slowly enlarging lesion that had first appeared on her hand eight weeks earlier.

Two erythematous leg rashes

Two erythematous leg rashes

Two women with considerable comorbidities present with lower leg trouble.

Papules and renal disease

Asymptomatic hyperkeratotic papules affect two women.

Nuchal plaques

Two cases of neck plaques—one that gets more pruritic at night and one that worsens after a visit to the barber.

Pigmentation on the legs of a young female athlete

Pigmentation on the legs of a young female athlete

A 17-year-old female developed diffuse blue-gray pigmentation of both shins over a two-month period.

A tender finger papule, fever, and abdominal pain

A tender finger papule, fever, and abdominal pain

A 54-year-old man complained of fevers and abdominal pain. Four days earlier, he had noted intense left upper-quadrant abdominal pain that was worse with inspiration and a throbbing pain in the distal left fifth digit.