51 year old female with history of well-controlled hyperten | Figure 1

Case Summary

51 year old female with history of well-controlled hypertension with new onset rash/skin changes. Denies pruritis or pain but states that her legs feel “heavy” with trace pitting edema to BLE. She has no history of vascular issues or known autoimmune disorders. The rash does not blanch with pressure. She walks long distances at her job, but no other changes to anything in her daily life. No history of fever, illness, OTC or new prescription meds.

Case 1

Patient reports having this rash for years. Other than occasional itch, that is mild in severity, patient is asymptomatic, with the exception of a few of the lesions on her knuckles, which are tender to the touch. Patient does feel like sometimes the rash moves. She shares that it may also be worse when wet. Per patient, the rash is only on her hands (nowhere else on her body). She denies contacts with similar rash. Patient received treatment in the past, triamcinolone, but was unable to take it as prescribed and then patient ended up giving the medication to her son for his eczema (he had no PCP). Patient believes her rash is likely eczema, but would like to rule out scabies as she has had exposure in the past and wants to make sure she does not have a chronic version of it. In terms of history, she has no personal history of melanoma or non-melanoma skin cancer. She does have a family history of skin cancers (her sister) and other cancers (breast cancer in the same sister). Patient denies any known autoimmune condition, but does explain that she is prediabetic and takes Metformin and Ozempic.

Case 2

Patient is a previously healthy 18-24 y/o female entering third trimester of pregnancy with no pertinent past medical history presenting with 3 week history of pruritic rash that started on her left wrist area and has since spread throughout her body. Rash appears macular to raised plaques with no central clearing. Rash is pruritic but itching improves with Benadryl. Patient is not on any new medications and denies any changes in environment such as cleaning supplies, new clothes, or detergents. Patient had no issues in previous pregnancy. She does report that her partner also is presenting with a similar rash. She is up to date on her varicella vaccination.

Case 3

35yo female complaining of 36 hr history of pruritic raised rash on both dorsal forearms. Denies any history of new interactions, detergents, oils, or creams. Pt stated that prior to the rash she interacted with her 2 turtles and cleaned their tank. Any ideas?

Case 4

59 y/o Latino female with a pmhx of asthma, hyperlipidemia, A1C 5.8 % presents to the clinic with a new onset "rash" that started approximately 8 months ago. She states it started on her abdomen bilaterally in the left lower quadrant bilaterally and then extended to her brachium and antecubital fossa on both arms. She has some pruritus and a "tickling sensation" occasionally in the affected areas. Denies any burning, stinging or any other sensations. The areas of pigmentation change occurred over the last few months. ROS: negative. Family history: non-contributory. Any help appreciated.

Case 5

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

Case 6

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Case 7

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?

Conclusion

This document summarizes various case studies focused on skin rashes and related symptoms.