Robert P. Blereau, MD

January 01, 2005

Brown pigmentation of the medial 60% of the left iris was noted in a 40-yearoldwoman. The remainder of the iris was blue, as was the entire right iris.She stated that she had a “spot” of brown in the left iris at birth. The pigmentedarea had gradually enlarged until puberty and had not changedsince then. Her vision was normal.

September 16, 2004

When palatal petechiae are present along with exudative tonsillitis and cervical adenitis, and test and culture are positive, a Strep diagnosis is more secure.

July 01, 2004

Hyperpigmentation is seen on the cheeks and eyelids of a 36-year-old woman.She became hyperthyroid at age 19 years, with accompanying exophthalmosand hyperpigmentation, following the birth of her first child. Thyroidectomywas carried out at that time, and the patient has been receiving thyroid replacementtherapy ever since. The hyperpigmentation, an uncommon accompanimentof hyperthyroidism, has persisted.

June 01, 2004

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

June 01, 2004

For 2 months, an asymptomatic rash had been present on the upper arms of a 16-year-old boy of normal weight. The rash, as seen on the patient’s right arm, consisted of abundant fine papules. He had no other lesions.

April 02, 2004

A 16-year-old girl was bothered byankle pain and “red spots” on herlower legs. These symptoms clearedin a few days without treatment. Sixweeks later, after returning from anall-day outing at a fair, she noticedthat the spots had reappeared (A)and hemorrhagic lesions had developedon the right ankle (B) and leftheel (C). After removing her shoes,the teenager felt severe pain in bothankles, particularly the right.

April 02, 2004

Sudden pain and a pulsatile swellingof the right upper medial thigh concernedan 80-year-old woman (A).Coronary angioplasty had been performedthrough this site 5 weeksearlier.

March 02, 2004

Large, reddish tan, asymptomatic patches recently developedon the trunk of a 36-year-old man. Five years earlier,a similar outbreak had resolved after a 10-day course oforal ketoconazole; this episode was the first recurrence.

February 01, 2004

A new lesion recently arose on the right flexor forearm ofa 67-year-old man. The 1-cm, pruritic, pink, circular, slightlyraised lesion was perfectly homogeneous with no centralclearing.

February 01, 2004

A 49-year-old man was concerned about a right flexor forearmlesion that had been increasing in size for 6 weeks.The light pink, well-demarcated, 5-cm, circular lesion featuredslight peripheral elevation with ulceration, crusting,and a relatively clear central area. A culture of materialfrom the lesion was negative for fungi. A potassium hydroxideevaluation was not performed.