Robert P. Blereau, MD

September 14, 2005

A patient arrives at your office complaining of severe pain associated with small lesions in his mouth. He tells you that similar painful sores had erupted in the past, but they healed and disappeared.

September 14, 2005

Skull x-ray films were taken after this 62-year-old nursing home resident fell and hit his head. The radiographs revealed only a sharply demarcated radiolucent area, mainly over the right parietal bone. Osteoporosis circumscripta was diagnosed.

September 14, 2005

This lesion on her knee had been present for 5 years, reported a 22-year-old woman. It was not related to any trauma, and its size had not changed, but occasionally it became darker or lighter.

September 14, 2005

Although tinea versicolor is fairly common, its appearance on the face and neck is unusual, notes Robert P. Blereau, MD of Morgan City, La. His patient, a 30-year-old woman, exhibits the pale, rounded, fine-scaled lesions typically found on tanned or dark-skinned persons.

September 14, 2005

During a routine physical examination of a healthy 7-year-old African-American boy, this striking-and puzzling-hyperpigmentation was noted on his palms.

September 14, 2005

A 1-cm, tan-brown lesion had developed years earlier at the posterior helix of a 61-year-old man's right ear. Central ulceration and crusting were noted on the papule. The patient sought medical evaluation when the lesion became nodular and began to flake.

September 14, 2005

A 65-year-old woman presents with a 1-cm raised, light brown, circular, nodular lesion on the top of her head, which has progressively enlarged during the last 6 months.

September 14, 2005

The numerous superficial, rounded, red-based ulcerations on the left buttock of a 3-year-old girl are characteristic of bullous impetigo. The varnish-like crust on the largest lesion is also typical of this skin infection.

September 14, 2005

A 55-year-old man claims that the clubbed appearance of his fingers had been present “as long as I can remember.” This patient has hereditary clubbing of the distal phalanges of all fingers; his toes are similarly affected.

September 14, 2005

After a galley door slammed shut on his right wrist, a 37-year-old deckhand sought medical attention. He had no history of previous injury to the wrist. On examination, he had 50% of normal range of motion, and there was palpable tenderness and bony swelling at the dorsum of the wrist.