More articles from The Clinical Picture
- Unraveling a challenging diagnosis: Role of a TNF inhibitor
Painful swelling of the dorsum of the right hand had been diagnosed as chronic cutaneous sarcoidosis with tenosynovitis, treated unsuccessfully with prednisone and methotrexate.
- Skin-colored papules on the cheeks, acrochordons on the axillae
Biopsy revealed dermal follicular structures surrounded by a perifollicular fibrous sheath and a densely fibrous stroma, consistent with a fibrofolliculoma.
- Pigmented lesion on nail bed: Pseudo-Hutchinson sign
The discoloration had been present since the patient was 14, and it had not changed in appearance.
- Spider nevi secondary to alcoholic chronic liver disease
The lesions blanched when pressure was applied centrally and refilled from the center outward when pressure was released.
- Spotty skin pigmentation in Carney complex
Characteristic skin findings and their locations can indicate underlying hereditary lentiginosis syndromes.
- Atypical erythema as a clinical presentation of tinea incognito
The lesions were originally diagnosed as contact allergic dermatitis and treated with topical corticosteroids, but culture revealed Trichophyton rubrum.
- Hampton hump in acute pulmonary embolism
A 50-year-old patient presented with worsening dyspnea and cough with bilateral swelling of the lower extremities, with left-side swelling greater than right-side swelling.
- Lacrimal gland involvement in a patient with sarcoidosis
The differential diagnosis included infection, malignancy, and inflammatory disorders such as immunoglobulin G4-related disease and sarcoidosis.
- A brownish erythematous patch in the nipple-areola complex
Biopsy revealed neoplastic cells throughout the epidermis and granular layer, with abundant pale cytoplasm, intraglandular extension, and chronic inflammation in the papillary dermis.
- Oral hyperpigmentation with weakness and salt-craving
The patient’s primary care physician had attributed the hyperpigmentation on the lower lip and inner cheek to pen ink.