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 37 year old presented with an 8 month history of a gradually expanding asymptomatic lesion on his lower abdomen that had not responded to potent topical steroids. There was no other skin history and the patient was otherwise well.
A solitary smooth white plaque with surrounding erythema.
What important question and aspect of examination I have not alluded to? What is the differential?
There is quite a long differential of white patches/plaques as per the diagnostic table.
Given the inflammation the differential included morphoea, inflammatory vitiligo, sarcoid (one of the great mimickers), and tuberculoid leprosy - the important questions where that of foreign travel and was the lesion anaesthetic? The answers were both no, which would very much point away from leprosy.
A biopsy confirmed the diagnosis of inflammatory vitiligo, Inflammatory vitiligo with raised borders (IVRB) is a rare subtype of vitiligo described as having a rim of raised erythema at the periphery of the depigmented patches. The aetiology is poorly understood, and there are few reports of successful treatment.
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.
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