Charles E. Crutchfield III, MD

September 14, 2005

Five days after beginning aggressive treatment with intravenous corticosteroids for inflammatory bowel disease, this 26-year-old man noticed the sudden eruption of this mildly pruritic rash.

September 14, 2005

This contorted hand of a 49-year-old man demonstrates Dupuytren's contracture, a disorder first described by Baron Guillaume Dupuytren in 1831. Although the condition may occur as a completely independent abnormality, it is commonly associated with chronic liver disease, diabetes mellitus, epilepsy, palmar fasciitis, carpal tunnel syndrome, rheumatoid arthritis, pulmonary tuberculosis, and alcoholism. This patient had a history of alcohol abuse.

September 14, 2005

Loss of pigmentation is noted around the left eye of a 49-year-old African-American man-the same eye in which he has a detached retina. In addition, the patient's hearing is impaired on that side.

September 14, 2005

Severely limited vision plagues this 27-year-old woman with aniridia, the bilateral absence of the iris of the eye.

September 14, 2005

The lesions seen here developed shortly after a 54-year-old woman started psoralen plus UVA (PUVA) therapy for psoriasis. This is acne estivalis, an uncommon actinic, acneiform eruption. The firm, red, monomorphic papules are most commonly found on the shoulders, arms, neck, and chest. Histologically, they resemble steroid acne. Lesions develop in the spring, peak in the summer, and resolve in the fall without scarring.

September 14, 2005

Seen here are a 38-year-old Native American woman and her 20-year-old daughter, each of whom has had a relapsing eruption for several years. Pruritic, red to red-brown plaques develop on their faces and necks and on the dorsal surface of their hands. Scattered brown and hypopigmented macules as well as some scaling and slight erythema appear on their lower lips. The women stated that the eruptions flare each spring and gradually improve throughout the rest of the year. The daughter's lesions were more acute at this time and had developed during the preceding 3 days.

April 02, 2004

A 57-year-old man with a history of venous stasis leg ulcerationwondered about the “white spots” on his leg. Thecondition is atrophie blanche, which manifests as smooth,ivory-white macules and plaques of sclerosis stippled withtelangiectasia that often are surrounded by mild to moderatepigmentation.

February 01, 2004

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

November 01, 2003

For 3 years, a linear plaque had been slowly developing on the left palm of a 47-year-old woman who had difficulty in opening and closing her hand. There was no contributory family history.

June 01, 2002

Cutaneous manifestations develop inapproximately 30% of persons withdiabetes. Premature atherosclerosisis a common complication of thedisease and can cause peripheral infarction,ulceration, and necrosis.