Robert P. Blereau, MD

September 14, 2005

This 20-year-old woman with Down syndrome has bilateral keratoconus, a common, noninflammatory, paracentral corneal ectasia that is occasionally hereditary. Symptoms vary from none to severely blurred vision. Opacity of this patient's right cornea developed after her eye had teared excessively for 1 day, during which time she continually rubbed it.

September 14, 2005

A 91-cm (3-ft) fall into a bilge sparked significant pain in the left knee of a 41-year-old man who landed on his left leg. Three days later, physicians found minimal effusion in the knee and medial collateral ligament tenderness.

September 14, 2005

A right parietal cephalhematoma was first noted on this 2-week-old girl 2 days after her birth. Robert P. Blereau, MD of Morgan City, La, explains that a cephalhematoma is caused by bleeding under the outer periosteum of a newborn's skull bone, usually the parietal bone, and becomes evident as a swelling by day 2 or 3 after delivery. The swelling is confined to the involved bone and, therefore, does not go past the suture lines or the midline of the skull.

September 14, 2005

The variable appearance of palatal petechiae is demonstrated by these two cases, presented by Robert P. Blereau, MD of Morgan City, La. The petechiae appear as discrete pinhead lesions in a 10-year-old boy, whereas they are manifested as minute hemorrhagic areas in a 30-year-old woman.

September 14, 2005

The mother of a 5-year-old girl who was frightened by the appearance of a flat 'freckle' in her daughter's eye was reassured by the diagnosis of a benign conjunctival nevus.

September 14, 2005

Sudden pain and a pulsatile swelling of the right upper medial thigh concerned an 80-year-old woman. Coronary angioplasty had been performed through this site 5 weeks earlier.

September 14, 2005

The left hand of a 45-year-old man was affected with the characteristic intact bullae and dried, crusted, ruptured bullae of bullous impetigo.

September 14, 2005

Basal cell carcinomas, the most common form of skin malignancy, are slow growing and rarely metastasize. They are seen most frequently in men over age 50, and more than 90% occur on sun-exposed areas of the head and neck. Cure rates approach 100%.

September 14, 2005

An obese 17-year-old boy sought treatment of an apparent abscess of the umbilicus. Hot soaks, black salve, and oral cephalexin were prescribed. Although there was some drainage, the lesion persisted and the patient returned for further evaluation.

September 14, 2005

Redness and swelling of the left cheek, chin, and ear bothered a 51-year-old man. The initial diagnosis was cellulitis and/or allergic dermatitis; oral amoxicillin/clavulanate, 500 mg tid, and a low- to medium-potency corticosteroid cream, alclometasone, were prescribed. Within 1 to 2 days, pimples emerged in the reddened areas and rapidly crusted.