Ted Rosen, MD

February 23, 2013

“Stippled” pigment is highly typical of a pigmented basal cell carcinoma. Diagnostic contenders include atypical seborrheic keratosis and superficial spreading melanoma.

February 06, 2013

The morphology of a round, red to purple patch, with or without blistering, is typical of a fixed drug eruption. This entity usually manifests as a solitary spot, but can be multiple. Tetracycline antibiotics and barbiturate sedatives are common causes. This patient had been taking doxycycline.

February 06, 2013

This friable lesion with rapid and destructive growth is classic for granuloma inguinale. This patient was treated successfully with trimethoprim/sulfamethoxazole.

January 28, 2013

Condylomata acuminata this extensive are beyond the capacity of all topical therapies. The area was initially treated by carbon dioxide laser ablation, and residual small foci of infection were subsequently treated with topical 5% imiquimod cream.

January 28, 2013

The combination of itching massive scaling suggests the diagnosis of crusted scabies. This variety of scabies is seen in those who are immunosuppressed or immunocompromised (typically HIV+). Repeated oral doses of ivermectin along with topical permethrin application were required to clear this infestation.

January 18, 2013

A 24-year-old woman sought medical attention because of the acute onset of a very painful vulvar rash. She had never experienced anything similar. Do you recognize these lesions?

January 16, 2013

This teen sought care because of extremely pruritic nodules on the penis and scrotum. He also had mild itching on the wrists and between several finger webs. This distribution of a pruritic dermatosis is classic for scabies.

January 12, 2013

The patient received standard acyclovir dosage for first outbreak genital herpes: 200 mg orally, 5 times daily, for 10 days total. At this point, there is no way to predict how often or how severe future recurrences will be.

December 21, 2012

This painless, indurated ulcer is typical of the chancre of primary syphilis. This patient also had a positive RPR in a titer of 1:32.

December 21, 2012

Any adult with patchy hair loss with preservation of follicular openings should be questioned about sexual exposures. This presentation is not typical of alopecia areata, and the patient is too old for tinea capitis to be a major consideration.