Jonathan S. Crane, MD

September 14, 2005

A 35-year-old man had a 5-year history of progressive hair loss characterized by follicular inflammation with destruction of the follicle and consequent permanent alopecia. Almost the entire scalp was involved. A few pustules were seen on examination, but the clinical picture was mostly one of scarring and irreversible hair loss.

September 14, 2005

A 69-year-old man with a long history of lymphedema secondary to repeated cellulitis sought medical care for mildly pruritic, nontender, purple nodules that had erupted on the bottom and side of one foot 6 months earlier. Scale surrounded the nodules.

September 14, 2005

The mother of a 7-year-old boy with cardiofaciocutaneous syndrome sought treatment for the cutaneous aspects of her son's disease. Dry skin and keratosis pilaris of the upper outer arms were noted.

September 14, 2005

An otherwise healthy 34-year-old woman was concerned because of the abrupt onset of rapid hair loss, accompanied by scaling of the underlying skin. The disorder had begun 3 months earlier, and the right parietal and temporal areas were now red and swollen and had adherent scale. An antinuclear antigen titer was negative. Biopsy revealed changes consistent with lichen planus of the scalp, also known as lichen planopilaris and lichen planus follicularis.

September 14, 2005

During a camping trip, a 7-year-old boy sustained a 1.5-cm laceration down to the bone above the left eyebrow. The laceration was clean and linear; it bled freely. The patient did not lose consciousness.

September 14, 2005

Asymptomatic facial and truncal papules began developing several years before this 55-year-old man sought medical care. The lesions were slightly yellowish or reddish, and many had a central punctum. Biopsy revealed a microscopic picture consistent with sebaceous adenoma.

September 14, 2005

The coppery hyperpigmentation on the front and sides of a 47-year-old woman's neck, sparing a large area on the anterior surface, had been present for many years. She had no itching, burning, or other symptoms associated with the discoloration. Questioning revealed that she used perfume liberally on her neck and had been a sun worshipper in years past.

September 14, 2005

An area of mottled skin developed on the back of a 55-year-old woman who has had arthritis for several years. She often applied a heating pad to her middle and lower back for relief from arthritic pain.

September 14, 2005

A patchy, macular, erythematous area developed on the dorsum of a 63-year-old woman's left foot 4 months ago. Because the lesion was asymptomatic and she was otherwise healthy, no workup was instituted at that time. The affected area subsequently became ulcerated, tender, and painful. The patient now had a 1.2-cm ulcer covered by a dried, hemorrhagic crust and surrounded by a livedo reticularis–like pattern. The entire area was extremely tender.

September 14, 2005

A red papule developed on the scalp of a 52-year-old man who had a history of adenocarcinoma of the lungs. The patient was a former cigarette smoker.