60 yo female with 2 week history of purulent vesicles on the | Figure 1

%27%3e%3cg%20id=%27Group-14%27%20transform=%27translate(13.000000,%20103.176124)%27%3e%3cg%20id=%27Group-Copy-5%27%20transform=%27translate(0.000000,%20182.676124)%27%3e%3crect%20id=%27Rectangle-8%27%20fill=%27%23E2E0DE%27%20x=%270%27%20y=%270%27%20width=%2736%27%20height=%2736%27%20rx=%2718%27%3e%3c/rect%3e%3cpath%20d=%27M28,27.6503435%20C28,22.127496%2023.5228474,17.6503435%2018,17.6503435%20C12.4771525,17.6503435%208,22.127496%208,27.6503435%20M18,16.3472505%20C20.8165136,16.3472505%2023.099749,14.0640151%2023.099749,11.2475015%20C23.099749,8.43098783%2020.8165136,6.1477524%2018,6.1477524%20C15.1834863,6.1477524%2012.9002509,8.43098783%2012.9002509,11.2475015%20C12.9002509,14.0640151%2015.1834863,16.3472505%2018,16.3472505%20Z%27%20id=%27Combined-Shape%27%20fill=%27%23FFFFFF%27%20fill-rule=%27nonzero%27%3e%3c/path%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/svg%3e)

Deleted account

Clinical Case

60 yo female with 2 week history of purulent vesicles on the palmar surfaces of the hands bilaterally. Persisting, no involvement of mouth, feet, buttocks. Denies UTI/STD complaints, denies URI complaints, denies fevers or chills, denies contact with chemicals or possible allergies. Admits to mild pruritus. Diagnosis?

Related Cases

25 year old male presents with rash on medial aspect of left lower leg. + erythema and pruritus. Denies tenderness, bleeding, discharge. Patient reports multiple spots of a similar rash on the same extremity that come and go over the past three years. Multiple hyperpigmented areas on same region (previous areas of rash) appearing purple in color. Patient denies taking any medications or applying anything topically.
PE: varicose veins on left lower extremity (also medial aspect).
Pmh: denies
Meds: denies
allergies: nkda
FHx: denies
PSHx: denies
SHx: social EtOH use (1-2x / month), never smoker, 2 cups of coffee daily.
Diagnosis/ treatment?

A 53-year-old man comes to the health unit reporting the appearance of pruritic erythemato papular rash in the palm of his hands yesterday. He reports that before there was a purulent lesion in the hand, that is in treatment with silver sulfadiazine. Has a history of Diabetes, in bad control, alcoholism, smoking and bowel tumor (diagnosed 3 years ago, it was excised, but reports hematochezia), in follow-up with gastroenterology. It reports previous hypuricemia with a similar rash on the hand. It denies other systemic signs, denies unprotected sex, denies penile lesions. Laboratory tests were requested: uric acid, serology for syphilis, HIV, and lab review. What are the diagnosis and treatment?

60 years old, male.
He has been a smoker for more than 40 years, smoking about 20 cigarettes per day. He was an alcoholic for a long time but stopped drinking alcoholic beverages 10 years ago. He denies medications use, denies allergies, and denies previous surgeries.
His complaint is related to dyspnea. He reports respiratory discomfort with moderate exertion, such as climbing a small slope. He also says that he wakes up at night with shortness of breath and needs to remain standing and walk around for the episode to improve. He reports having productive cough, mainly in the morning.
On physical examination: blood pressure 120/90 mmHg, heart rate 98 bpm, oxygen saturation 89% on room air, respiratory rate 20 breaths per minute. On auscultation, there is a global reduction of vesicular breath sounds. Cyanosis in extremities (image) and digital clubbing (image) are visible.
What do you think about this clinical case?

Raynaud's phenomenon in 30yo woman. No complaints of pain, only numbness. Reportedly triggered by cold and compression. Family history positive.