Dermclinic

For 9 months, a 39-year-old woman has had a pruritic rash on the posterior portion of one thigh. She had consulted another physician, who prescribed a medication that she does not recall, but there was no improvement.

These asymptomatic bumps that developed on the groin area of a 16-year-old girl after her first sexual exposure are molluscum contagiosum. Central umbiliication distinguishes these lesions from warts.

During a routine checkup, a 14-year-old girl inquires about a large red spot on her right ankle. The asymptomatic, erythematous area overlying the malleolus has been present for several months.

An itchy facial rash of 1 week's duration prompts a 72-year-old woman to see her primary care provider. She reports that redness and scaling had developed on her cheek, and that vitamin E oil she applied to the area seems to have made it worse.

An obese 60-year-old woman presents with a chronic malodorous, itchy rash in her groin.

A 45-year-old man presents with a 4- to 5-year history of an intermittent, asymptomatic, red, circular rash on his trunk. Trials of antifungal creams have not been successful. The patient is otherwise healthy and takes no medications.

During a routine skin examination, a papule of several years’ duration is noted on the upper lip of a 71-yearold man. The patient states that the lesion has been slowly enlarging; it does not bleed even during shaving.

A 33-year-old woman presents with an asymptomatic facial rash for which she has been using mometasone cream regularly. Initially, she had a small patch of acne on one cheek that quickly cleared with this cream. However, the rash has been worsening for the past year.

For several months, a 51-year-old African American woman has had an asymptomatic erythematous papule on the nose. She is otherwise healthy.

A pruritic rash under the left breast has bothered a 67-year-old woman for the past month. She takes an antihypertensive and is otherwise healthy.

For several weeks, a 33-year-old man has had an asymptomatic lesion on the head of the penis. He has had a new sex partner in the past few months but is unaware of any health problems she may have. What is the likely cause of this lesion?

A 35-year-old man presents with a scaling rash on the penis of several weeks’ duration. Which of the following would you include in the differential?

Is this penile rash the result of lichen planus? Candidiasis? A dermatophyte infection? Seborrhea? Psoriasis? Click here for the answer.

For 2 months, a 27-year-old man has had this worsening rash on the head of the penis. He denies any history of trauma. What do you suspect?

Case 4: An obese 59-year-old man presents with a chronic malodorous, itchy rash in his groin.