Dermatology Diagnosis

By M. Joel Morse, DPM
39,676 reads | 0 comments | 01/30/2009
   An 85-year-old Caucasian male presents with a heel ulcer after spending eight weeks in a rehabiltation home following hip replacement surgery. He presently spends much of his time in a lounge chair or in a wheelchair. He has a history of angina, arthritis, aortic valve replacement, prostate cancer with radiation treatment and Parkinson’s disease. He is taking carbidopa-levodopa (Sinemat, Merck), ropinirole (Requip, GlaxoSmithKline) and warfarin (Coumadin, Bristol-Myers Squibb). He is allergic to sulfa.    The patient initially underwent a workup and a debr | Continue reading
By M. Joel Morse, DPM
101,731 reads | 0 comments | 11/26/2008
Key Questions To Consider    1. What essential question does one still need to help make the diagnosis?    2. What is the tentative diagnosis?    3. Can you list at least three differential diagnoses?    4. What features in this condition differentiate it from other conditions?    5. What is the suitable treatment of this condition?

   A 27-year-old Caucasian male presents with a history of a strong smell of the feet for the past five years. He is very active in sports. The p | Continue reading
By M. Joel Morse, DPM
58,854 reads | 0 comments | 09/30/2008
Key Questions To Consider 1. What essential question does one still need to ask to help make the diagnosis? 2. What is the tentative diagnosis? 3. Can you list at least three differential diagnoses? 4. What features in this condition differentiate it from other conditions? 5. What is the suitable treatment of this condition? A 26-year-old African-American female presents with thickening of the skin on the soles and sides of her feet as well as discoloration on two of her toes. She says the discoloration and thickening started eight years ago and has slowly become worse over time. | Continue reading
By G. “Dock” Dockery, DPM, FACFAS
13,177 reads | 0 comments | 09/03/2008
A 37-year-old Caucasian male presents with a chief complaint of a nodular growth on the left calf. He first noticed the bump about two months ago but says he did not think too much about it until recently. At that time, he noticed it was causing mild discomfort when he touched it but the growth was only slightly pruritic. The lesion did not appear to be infected and it did not drain or bleed at any time. He says he checked the rest of his body for any similar looking lesions and found none. Otherwise, he has no other complaints or concerns.

The patient has not changed his diet or | Continue reading
By M. Joel Morse, DPM
29,122 reads | 0 comments | 06/03/2008

A 32-year-old Caucasian female presents to the office with swollen, sore, irritated, itchy toes of both feet and a symmetrical distribution on the tops of the toes.
She notes that the redness started four weeks ago. It was on the third toe initially but is now on other toes as well, according to the patient. There is no scaling or maceration in the interspaces, and no scaling on the rest of the foot.

 

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Joel Morse, DPM
94,647 reads | 0 comments | 04/03/2008

A 43-year-old African-American male presents to the office with an irritated fourth toe with no known trauma to the toe. There is a horny projection of skin coming from the posterior nail fold with a nail-like structure at the tip. It has been present for the past two years and had recently become larger.

The lesion is asymptomatic except for physical inconveniences.
The patient reports that the toe is painful only in shoes. The patient works as a custodian and spends a lot of time on his feet. He has recent onset diabetes of three years but has not been to a podiatrist in the

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Here one can see the girl’s heels two weeks after treatment for her atopic eczema. The author notes that generally, treatment with a topical steroid will be for two weeks and once the rash resolves, then the patient can use maintenance creams.
By William Fishco, DPM, FACFAS
34,210 reads | 0 comments | 02/03/2008

A 4-year-old girl presented to the office with her mother, who was concerned about a skin problem affecting her heels. According to her mother, the patient’s symptoms were present for six months or more. The child’s symptoms included a severe itch that caused constant scratching, pain and cracking of the skin leading to bleeding. Previous home treatment included the application of various over the counter creams including hydrocortisone, antifungals and hand lotions. These treatments did not help. She had no prior treatment by a physician for this problem. Her past medical history was

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By G. “Dock” Dockery, DPM, FACFAS
27,898 reads | 1 comments | 12/03/2007

A 60-year-old Caucasian female patient presents for consultation to the foot and ankle clinic regarding a one-year history of an erythematous, scaly and irregular lesion on the sole of her right foot. She notes the lesion is entirely asymptomatic. She originally saw a primary care physician about the lesion. The physician told her that she had a case of “athlete’s feet” and recommended an over-the-counter (OTC) antifungal cream. After four weeks of treatment with the antifungal cream, the patient showed no improvement.

The primary care physician then re-diag

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By G.“Dock” Dockery, DPM, FACFAS
21,118 reads | 0 comments | 10/27/2007

A 37-year-old Caucasian male presents with a chief complaint of a nodular growth on the left calf. He first noticed the bump about two months ago but says he did not think too much about it until recently. At that time, he noticed it was causing mild discomfort when he touched it but the growth was only slightly pruritic. The lesion did not appear to be infected and it did not drain or bleed at any time. He says he checked the rest of his body for any similar looking lesions and found none. Otherwise, he has no other complaints or concerns. The patient has not changed his diet or eating hab

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By G. “Dock” Dockery, DPM, FACFAS
593,452 reads | 0 comments | 08/03/2007

It is late in the summer when a 29-year-old Caucasian female, employed as a medical assistant in your foot and ankle clinic, presents with a two-day history of red spots on her feet. The red spots became small fluid-filled vesicles, which are present mostly on the soles. She says she has broken one of the small vesicles and it expressed a clear fluid.

The lesions are causing mild discomfort but are not very pruritic. Otherwise, she feels a little fatigued and reports a slightly elevated oral temperature today. Additionally, she reports a mild headache and a slight sore throat. She

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