Joe Monroe, PA-C

September 14, 2005

A 62-year-old woman presented with an itchy, annular eruption on her face of 3 months' duration. A topical antifungal was prescribed, but the slow response to therapy prompted a switch to a topical corticosteroid (triamcinolone 0.1%). The lesion not only failed to clear but became larger.

September 14, 2005

A 16-year-old boy removed a small sliver of wood from the palm of his hand with a pocket knife. However, the fledgling “surgeon” created a small puncture wound during this operation. Over the next month, a small, moist, friable papule grew at the site.

September 14, 2005

A 30-year-old woman had an extensive psychiatric history of anxiety and depression. She was concerned that the numerous lesions on her body might be signs of possible infection or infestation. The patient was undergoing treatment for multiple addictions to drugs, primarily methamphetamine (“crank”).

September 14, 2005

After 4 days of fever and a very sore throat, an 18-year-old man requested medical treatment. The patient's speech was barely intelligible because of the fullness in his throat. He was able to communicate, however, that he had great difficulty swallowing because of the throat pain and fullness.

September 14, 2005

A 40-year-old dental assistant requested a prescription for antibiotics to treat the acute outbreak of painful, deep blisters that had recurred on her index finger. Prior eruptions of similar lesions had been diagnosed as staphylococcal infections and were treated with antibiotics.

September 14, 2005

A 70-year-old man first noticed this skin condition when he returned from the South Pacific at the end of World War II. Over the years, the rash has itched only occasionally; however, during a recent spate of hot weather, the eruption became highly pruritic. Applications of an over-the-counter 1% hydrocortisone ointment exacerbated the condition.

September 14, 2005

A pruritic lesion on the arm of a 26-year-old woman had grown to 22 cm while she was "treating" the eruption with a topical corticosteroid.

September 14, 2005

A 6-year-old African American boy is referred for evaluation of “cellulitis,” which had persisted for several weeks. The condition had failed to respond to oral antibiotics prescribed by another practitioner.

September 14, 2005

A 10-year-old girl complained of slight fatigue and malaise. A 6-mm tense blister had developed on the dorsum of her right foot, lesions had arisen on the palms, and a pinpoint, whitish ulcer had erupted anterior to the frenular attachment.

September 14, 2005

For more than 20 years, a 55-year-old man had a faintly erythematous, papulosquamous rash with arciform borders on his groin and waistline. The rash had been treated with a variety of medications. Topical and oral antifungals and antibiotics and topical corticosteroids had been used but to no avail. No laboratory tests had been performed.