Sunita Puri, MD

September 14, 2005

A 60-year-old man presented with redness, swelling, and pain on his right lower leg of 3 day's duration. He recalled being scratched by underbrush while hiking in the woods a few days earlier; the patient denied other recent trauma or insect bites.

September 14, 2005

During the last 3 months, scars had developed on the sternal area of a 25-year-old black woman. She recalls having punctured an acne pustule at the site just before the scar began to develop.

September 14, 2005

The parents of a 6-year-old boy with a generalized rash sought medical care for the child. The outbreak began 2 years earlier on the boy's abdomen and spread over the entire body; oral antihistamines had been prescribed for the itching. The patient had no history of allergy, insect bite, fever, or GI symptoms. His vital signs were normal.

September 14, 2005

A 35-year-old dental assistant sought treatment of an itchy, painful rash on her hand that had erupted 5 days earlier.

September 14, 2005

Disturbed by a pruritic rash of 5 days' duration on his chest, neck, and back, a 35-year-old man sought medical advice. The patient had no other symptoms.

September 14, 2005

A pruritic rash developed on the feet of a 40-year-old woman 2 days after she had worn a new pair of shoes for a few hours. The erythematous, papular, scaly eruption was more prominent on the right foot.

September 14, 2005

The upper and lower eyelids of a 6-year-old girl were stuck together after she accidentally splashed superglue in her left eye. The patient did not complain of pain; the eyeball was able to move freely under the lids.

September 14, 2005

The mother of this 5-month-old boy was concerned about the large birthmark in the infant's diaper area. This lesion is a bathing trunk congenital melanocytic nevus, writes Dr Sunita Puri of Decatur, Ala.

September 14, 2005

A 65-year-old man had a 10-year history of deformity of the hands, pain, and nodules on the fingers. His serum uric acid level was 9 mg/dL. The suspected diagnosis of chronic tophaceous gout was confirmed by the finding of birefringent monosodium urate needle-shaped crystals in the joint fluid and the patient's significant response to colchicine within 12 to 24 hours of the start of therapy.

September 14, 2005

A rash on both palms concerned a 35-year-old hairdresser, who said she always wears vinyl gloves while working. She recalled using a new hair coloring product on a client a few days earlier. Within 24 hours of applying the substance, the rash began to erupt; it worsened over the course of 2 days.