Clinical Quiz

Clinical Challenge: Papules On a Young Athlete’s Groin

by Kristy Fleming, MD Two months ago, an otherwise healthy 24-year-old man developed asymptomatic lesions on his groin. He is an avid bicyclist and attributed the lesions to irritation from the friction of his bicycle seat and clothing. The patient was seen by his primary-care clinician two weeks prior and was placed on oral clindamycin…

Clinical Challenge: Hypopigmented macules on a woman’s back

By Kristy Fleming, MDAn otherwise healthy 33-year-old woman presented for a routine annual full-body skin exam. She was concerned about a white area on her mid-upper back. Given the location of the lesion, the patient was not able to see it very well. She was unsure how long the lesion had been present or if…

Clinical Challenge: Mildly pruritic pink papules a patient’s forehead

by Kristy Fleming, MD An otherwise healthy 47-year-old man with type 2 diabetes presented complaining of multiple mildly pruritic pink bumps on his forehead. The lesions had been present for nearly two years, but the patient was unable to identify an inciting factor. He stated that the lesions were cosmetically bothersome, and he believed they…

Clinical Challenge: Painful erosions on the bilateral inguinal folds and intergluteal cleft

A 22-year-old black female with a past medical history significant for inflammatory bowel disease, presented to the emergency department with a two-week history of exquisitely tender erosions on her bilateral inguinal folds, perineum, and intergluteal cleft.The patient presented for medical treatment because the erosions had become too painful to defecate. She was applying a topical…

Clinical Challenge: Painless red bumps on face and body in a man with HIV

by Kristy Fleming, MD A 30-year-old Guatemalan-born male presents to a tertiary-care hospital center complaining of nausea, fever, diarrhea, cough and new asymptomatic bumps on his forehead. The lesions had been present for the last few weeks and he was found to have numerous small erythematous papules scattered on his face, chest, back, arms and…

Clinical Challenge: A 32-Year-Old Man With Multiple Itchy, Malodorous Papules

A 32-year-old man presents with multiple rough, crusted, itchy, malodorous skin papules on the chest, back and forehead.Further examination reveals flat wart-like papules on the dorsa of the feet and hands. The patient’s nails are chipped and have longitudinal ridges. Family history is not available, as the patient was adopted as a child.What’s your diagnosis?Submit…

Clinical Challenge: Painful skin lesions in a 48-year old woman with an upper respiratory infection

A 48-year-old woman with a high-grade fever, conjunctivitis and an upper respiratory infection presents with painful red skin lesions that appeared suddenly on her arms, neck and face. The bumps spread and grew forming tender, painful plaques, some of which blistered and ulcerated. The patient complains of tiredness, achy joints and headaches. Labs reveal elevated…