Monthly Archives: July 2019

Actinic Keratosis: What is it?

Also known as Solar Keratosis, Actinic Keratosis are in situ dysplasias reslting from sun exposure.  Those individuals with light skin are particularly predisposed and the most common sites of involvement are the exposed surfaces of the face–ears, balding scalp, dorsal hands and forearms.  The amount of damage can be profound, as shown on this first… Read more »

Nummular Eczema

Nummular eczema is also known as nummular dermatitis or discoid eczema.  The word “nummular” comes from the Latin word meaning coin.  These patients have multiple coin shaped plaques involving the skin.  Known triggers include:  Any damage to the skin, such as insect bites, scrapes, scratches or chemical burns; reactions to inflammation (atopic dermatitis or stasis… Read more »

Basal Cell Carcinomas

Basal Cell Carcinoma (BCC) is the most common form of skin cancer.  It is locally aggressive and generally does not metastasize.  They often are pearly plaques, and have been described as “rodent ulcers” such as the first image demonstrates with a classic central area of ulceration and rolled pearly margins. The second image is a… Read more »

Contact Dermatitis: Henna Tattoos

Henna tattoos are popular.  They originated out of the Hindu and Middle Eastern cultures utilizing detailed intricate patterns that can be applied directly using a topically applied gel that stains the skin upon drying…it is not a permanent tattoo.  The temporary nature of the tattoo is what makes it attractive to many.  The staining agent… Read more »

Dermatology Detective…Contact Dermatitis

Sometimes you have to become a detective…  A patient presents with these very itchy, blistering lesions involving the anterior portions of both ankle regions.  He notes they have been going on for some weeks, ever since he purchased some new tennis shoes.  He denied any known contact allergies and denied any extended sun exposure to… Read more »

Disorders of the Stars…

Take a look at Kate Bosworth’s picture.  Do you see anything that might be….a bit unusual? Take your time… For those of you that don’t know her, she was in The Horse Whisperer, she is probably best known for her role as a teenage surfer in Blue Crush. Do you see it? And the answer… Read more »

Acne Rosacea

Rosacea is characterized by persistent erythyema of the face, particularly the cheeks and nose.  It occurs most commonly in light skinned individuals, women greater than men, with onset between the ages of 30-50.  There are factors that can promote or exacerbate rosacea–extremes of temperature (very hot or cold), alcohol (W.C. Fields classic example of alcohol… Read more »

Another Unknown…

These are fun.  This is another unknown for you.  Patient presents for evaluation of these discolorations and patches involving her hands and extending down her arms.  On further questioning she just returned from a fun summertime vacation from Cabo.  Hmmmm.  She notes that she was taking Doxycycline to treat acne.  She did note having lots… Read more »


Just for fun:  40 year-old white male was noted to have this unusual pattern on his back.  Any ideas?  This is for medical residents, dermatology residents, or just interested parties…Choices are:  Reticulated pigmented anomaly (Dowlin-Degos)  Reticulate pigmentation of Dohi (Dyschromatosis symmetrica)  Reticulate acropigmentation of Kitamura  Dermatopathia pigmentosa reticularis  Self Tanner     Answer:  Patterns are important… Read more »

Drug Eruptions: Dilantin & Radiation Associated TEN

Dilantin & Radiation Associated Toxic Epidermal Necrolysis (TEN):  This is a patient at Walter Reed Army Medical Center.  The patient had metastatic breast cancer to her brain and was experiencing severe seizures.  She was treated with Dilantin to control the seizures.  Treatment at the time included cranial radiation.  We were asked to see her when… Read more »