September 2021 - Case of the Month
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 23 year old man presented with a 4 year history of asymptomatic dull erythematous plaques on his left cheek and upper lip. There was no other personal or family history of skin problems. The patient was otherwise well, took no medication and had not been on any exotic holidays.
Unilateral dull erythematous plaques on his left cheek and upper lip, with some areas of fine scale on the cheek and some crusting of the lip.
What is the differential and what investigations would you undertake?
The differential included:
- Cutaneous lupus erythematosus, although a little unusual to be completely one-sided
- Mycobacterial infection, which can be a great mimicker
- Other granulomatous conditions, although the scale would make these less likely
- Tinea appeared unlikely
Blood tests (including HIV) were all negative and so I proceeded to do an incisional biopsy, sending half for histology and the other half for culture (in a pot without formaldehyde). Skin scrapping's were also sent for mycology.
Histology was very suggestive of cutaneous lupus erythematosus. Culture and further testing showed no evidence of mycobacterial infection. The patient was commenced on 0.1% betamethasone cream and given advice on UV-protection. At review 4 weeks later most of the inflammation had melted away.
Refer to the chapter on lupus erythematosus for more information.
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 52 year old man presented with a one year history of skin lesions predominantly on his hands, ears and scalp. He was also complaining of painful swollen fingers associated with morning stiffness. There was no family history of skin or joint problem...
A 72 year old man was referred with a rash, predominantly on the legs. The patient was systemically well and the lesions were only mildly symptomatic. The lesions presented as one to several at a time lasting several weeks. They had not res...
Welcome back to the new look PCDS website, and our first case. This lady was referred as a 2-week wait with a changing lesion on the right temple.
A 15 year old lady was referred for a diagnostic opinion for skin changes presenting in birth, affecting the right upper back, shoulder, antecubital fossa and dorsal wrist. The patient was asymptomatic and otherwise well.
The following pharmaceutical companies have had no involvement in the content of this website or in our conference programmes
