Charles E. Crutchfield III, MD

September 14, 2005

A 61-year-old man with a history of squamous cell carcinoma was concerned about a tender nodule on his ear. He complained of exquisite tenderness with pressure, such as when lying on the affected side at night.

September 14, 2005

A 24-year-old man presented for evaluation of pruritic vesicles on both feet. Ten days earlier, dyshidrotic eczema had been diagnosed by another physician who prescribed triamcinolone ointment. The patient reported that the foot eruption worsened after the topical medication was applied.

September 14, 2005

A recent outbreak of small-plaque and guttate psoriasis was confined primarily to the arms of this 32-year-old woman. The slightly scaly, brick-red, linear plaques and clusters consisted of 3- to 10-mm papules, some of which were surrounded by a faint whitish ring. It was quickly ascertained that many of these lesions corresponded to areas where the patient had been scratched by her cat.

September 14, 2005

Referral for biopsy was made because a 6-mm, red and black, dome-shaped papule on a 43-year-old woman's left groin resembled a melanoma. The patient had numerous cherry hemangiomas on her trunk-bright red, 2- to 5-mm papules that are among the most common vascular anomalies.

September 14, 2005

Concerned about this unsightly and painful lesion, a 34-year-old man asked to have it removed. The patient first noted this eruption on his back several months before. This lesion is an infundibular cyst.

September 14, 2005

A 57-year-old man with a history of venous stasis leg ulceration wondered about the “white spots” on his leg.

September 14, 2005

After more than 15 years of wondering what the “white specks” on his legs were, a 64-year-old man consulted his physician. The patient was taking medication to control hypertension; he was otherwise healthy.

September 14, 2005

Mongolian spots are benign, congenital blue-gray macules or patches commonly found in Asian, black, and Hispanic infants (and in 5% of white infants). They are most often located in the sacrogluteal area and the upper back. The lesions may be solitary or multiple, vary in color intensity, and frequently enlarge until about age 2, when they gradually fade and disappear. Approximately 5% persist into adulthood.

September 14, 2005

The dark red plaques seen here developed rapidly under both arms of this markedly obese 43-year-old woman. The lesions spread concentrically, forming necrotic ulcerations with overhanging borders, and there was surrounding violaceous discoloration. No other areas of the patient's body were involved, and she was otherwise in good health.

September 14, 2005

A 66-year-old man presented with numerous cutaneous tumors. He had dementia and thus was unable to provide an accurate history.