Itchy plaque on both elbows since 10 days | Figure 1

Itchy plaque on both elbows since 10 days

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Subtle #Elbow #Epicondylitis



A sixty year old woman presented to the opd with the following complaints:
1-A purplish , non tender, non itching rash on the elbow and shoulder region of the left arm(that developed a month ago)
2-and non tender painful upper arm (from shoulder to elbow) for the last one year
According to her she developed a sudden, non tender, popular rash, on this arm one year ago associated with pain. She took some skin ointment and medication and the papules resolved, but the pain hasn’t resolved yet and earlier this month a rash appeared at the elbow and shoulder region.
There is no comorbidity (HTN, DM, etc)
No family history of similar disease
D/Ds? And treatment?



raised, hyperkeratotic papule on the elbow. Frozen previously and returned after 3 months of absence. Smaller satellite at 3 o'clock. Patient reports scratching at the lesion. Size stable now for several months.



54yo female who presents with erythematous scaly plaque on lumbar area, no lesions on elbow or scalp, refers asymmetric arthralgia.



A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.



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.



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.



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?