A woman in her late 30s presented with a three day history of bruising on both hands. The lesions began as pruritic erythema, rapidly progressing to purpura and swelling with mild pain. She had experienced several similar episodes over the past 20 years, occurring up to four …
A 9 year old girl presented with a solitary hairless area on the left side of her scalp that was first noticed when she was aged 3 years but had not progressed over time. The girl was in good health and had no history of trauma, pruritus, or discomfort in the area. On physical examination an oval non-cicatricial (non-scarring) alopecic patch was observed in the left frontotemporal region (fig 1). Dermoscopy showed hairs of variable diameter and length, white hairs, vellus hairs, and empty follicles (fig 2). No fungi were detected on direct microscopic examination.
Fig 1
Oval non-scarring alopecic area in left frontotemporal region
Fig 2
Dermoscopic image showing hairs of variable …
A man in his 20s presented to the dermatology clinic with a one week history of fever, myalgia, and malaise and a five day history of painful lesions on the penis and pubis. The lesions had gradually increased in number and size over 2-3 days, and each developed a central umbilicated necrotic black crust with peripheral oedematous erythema (fig 1). The left inguinal lymph nodes were enlarged and tender. No other lesions were evident on the body or in the mucosal areas. The patient reported several same sex sexual encounters during the previous two months. Serological tests for syphilis and HIV antibodies and polymerase chain reaction (PCR) tests for varicella zoster virus and herpes simplex virus were negative. The patient had no …
A seven week old female infant presented with an asymptomatic pink-red rash on the left cheek, which had been present at birth. The parents reported that the rash had not changed since the infant’s birth. The infant was born at term by a spontaneous, uncomplicated delivery and had normal growth and development. Physical examination showed a pink patch with a perilesional blanching halo, fine or coarse telangiectasia, peripheral small red papules, and no palpable mass (fig 1). Dermoscopy showed multiple red branching, serpiginous or tortuous vessels, and vascular lacunae on a pink background (fig 2).
Fig 1
Pink patch with perilesional blanching halo, fine or coarse telangiectasia, and …
A man in his 60s presented with a six month history of fingernail discoloration. The patient had a 10 year history of hypertension and diabetes. He had been diagnosed with chronic renal failure five years previously and had been receiving regular haemodialysis for end stage renal disease for the past three years. His fingernails showed white proximal nail beds with no lunula and a distal pink transverse arcuate band (fig 1). The toenails were unaffected. Fungal examination of the nail fragments was negative.
Fig 1
Fingernails showing white proximal nail beds with no lunula and a distal pink transverse arcuate band
1. What are the …