32 year old fair skin female. No significant PMH r/t suspic | 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

You can view up to 4 cases without signing up.

Patient Description: 32 year old fair skin female. No significant PMH r/t suspicious area. Pt presented to wound clinic for dehiscence of c-section, area noted during wound vac application. Pt reports multiple blistering sunburns during childhood and teenage years. Pt verbalized mother with a history of both BCC as well as SCC.

Case Report

  1. Atypical presentation of breast skin ulcer.
    Pt. is 50 yr. old female, presents to Urgent Care with c/o of finding this while in the shower. She doesn’t complain of pain, but says it’s “a little tender and sore”, upon palp.

    • Hx of hyperlipidemia, GERD, clinically obese BMI (ht - 5”6 wt -200).
    • No diabetes, HTN, auto-immune.
    • Hx of Hidradenitis in right groin/vulva area in 2012, wide excision performed, with development of sinus tract during wound care. Sinus tract has been actively draining since 2012, but her surgeons state it’s too risky to perform another surgery. She is not on any medical management for HS. No other recurrence of HS anywhere since.
    • Wound does not present with any odor or drainage. A thick yellow slough in center of wound is slightly weepy upon agitation with culture swab. No induration, no suspicious lumps/masses upon breast exam. Pt. has not had mammogram yet.
    • No family Hx of breast cancer. Pt is afebrile, and doesn’t c/o pain. Wound Cx reveals 2+ normal skin flora and rare Proteus Mirabilis.
    • Photos shown are first day thru current, starting with first pic. Bactrim DS is being continued after susceptibility to Bactrim was confirmed. Pt. referred to wound care, and mammogram recommended after wound care consult. This is an atypical wound. Proteus Mirabilis seems odd and uncommon in this location. What are your thoughts?

  2. Patient follow-up.
    Follow pic from previous post. Pt sustained laceration during prep op. Right med LE. HBO daily, wound vac @125 continual. Twice weekly wound care, debridement, Coban 2. Wound filling in nicely, just waiting for the depth at 11 o'clock to fill in, then onto skin sub!

  3. Chronic wound in back.
    Woman, 54 years old. She has a chronic wound in back. The wound is in the area of solar exposure. Diagnosis?

  4. Nonvascular wound.
    Nonvascular wound present for 2 years. Treated with triamcinolone by various providers. Negative for vascular disease. Intensive itching worse when covered. Pt states it started as a red raised patch similar to the area shown in photo #2. Pt has no chronic diagnosis.