Clinical Quiz

A 70 year old man presents with a growth on his abdomen that is frequently traumatized by clothing. The lesion was first noted approximately 2 years ago and has gradually increased in size. Examination reveals a flesh-colored, polypoid projection with a firm base. Palpation does not elicit tenderness. No similar lesions are noted elsewhere.

A 76-year-old man presents with a growth on his scalp. He denies history of skin cancer and is in good health. The lesion has been present for as long as the patient can remember. The growth is asymptomatic although occasionally traumatized when he combs his hair. Examination reveals a 2cm flesh-colored plaque with filiform projections.…

A 29-year-old primigravida woman presents in her 31st week of pregnancy with an itchy rash on her chest and abdomen first noted 5 days ago. An over-the-counter antihistamine has not provided relief. On examination, the patient is afebrile. She denies malaise, sore throat, and swollen glands.

A 70-year-old man presents for evaluation of a lesion on his left ear that is slightly tender. He first noted it approximately 2 months ago. He denies localized bleeding or other symptoms. He has no history of skin cancer. Examination reveals a 0.4cm papule with a central crust. Scattered actinic keratoses and lentigos are noted on his face.

A 39-year-old man presents with a 3-year history of lesions on his fingers and toes that appear following exposure to cold temperatures. He complains of discomfort and light palpation is painful. The patient denies a history of smoking, systemic disease, or illicit drug use. Examination reveals edematous, erythematous papules of the affected areas.

A 72-year-old woman is referred by her dentist for evaluation of intermittent burning and pain in her tongue and buccal mucosa induced by hot beverages and spicy foods. She takes medication for hypertension. Examination reveals discolored patches of the affected areas and hyperpigmented papules on her wrists and ankles.

A 27-year-old man presents with acute onset of an itchy rash on the extremities and trunk. He is in good health and does not take any oral medications or recreational drugs. He recently returned from a work-related trip where he drove to several different states. Examination reveals numerous erythematous papules on the extremities and trunk.

A 76-year-old woman presents for evaluation of a bothersome lesion of her left buccal mucosa. She neither smokes nor drinks alcohol. The growth was first noted approximately 2 weeks ago and is frequently traumatized when chewing. Examination reveals a firm, flesh-colored, 0.5cm papule.

A 52-year-old man with psoriasis of longstanding duration presents with multiple erythematous, scaling plaques and pitting of nails. His main complaint is that of progressive joint pain, most severe in his hands and lower back. Upon examination of his hands, his second digit is noted to be swollen.

A 9-year-old girl presents for treatment of poison ivy. Upon examination, hyperpigmented macules are observed in the axillae, and her mother reports first noting these several months ago. The macules are asymptomatic. Family history is negative for genodermatoses including neurofibromatosis. The child is of normal development and mentation, and no additional cutaneous abnormalities are observed.