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 31 year old man was referred with a six month history of an asymptomatic rash on the right arm. He had no prior skin history and was otherwise well taking no medication. The patient worked as a teacher and enjoyed outdoor sports.
There were multiple small scaly macules in a band-like distribution running down the right arm. Further examination of the skin, scalp, nails and oral mucosa was unremarkable.
What is the diagnosis?
If this rash, with small scaly macules, was more generalised what would be the most likely diagnosis? The answer is psoriasis, which is the diagnosis here. The unusual feature is the distribution, which is referred to as Blaschkoid.
Blaschko's lines (BL) represent a classic pattern of cutaneous mosaicism (two or more genetically different populations of cells existing side by side), occuring in a wide variety of congenital and acquired skin conditions. BL take on the following patterns:
Refer to the chapter on Blaschko's lines 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.
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