Photoclinic

Benign skin lesions can arise in the outer ear as easily as in any other body part frequently exposed to the sun. Seborrheic keratosis may mimic malignant melanoma but is innocuous. Actinic keratosis is premalignant and should be excised, biopsied, and the site of excision monitored vigilantly.

These innocuous lesions of the outer ear may arise spontaneously or after trauma or surgery. Both auricular seroma and pyogenic granuloma usually resolve satisfactorily after minor surgery, though they may recur.

Diagnostic challenge: Two case reports of easily treated and innocuous causes of lesions in the outer ear. Chondrodermatitis nodularis helicis is associated with long cellphone use. Verruca vulgaris is caused, like all other warts, by human papillomavirus.

A 50-year-old woman known to be alcoholic was treated successfully for severe hyponatremia. Subsequently she experienced changes in mental status, decreasing verbal output, dysphagia, behavior changes, and spastic quadriparesis. What went wrong?

A 48-year-old homeless man with no known medical history presented to the ED with lower abdominal pain, constipation, and intermittent hematochezia of 2 week’s duration. His abdomen was soft, non-tender, and slightly distended with normo-active bowel sounds. No masses were detected. But an abdominal x-ray revealed the problem.