A 39-year-old man presented with an asymptomatic, ruberry firm lobulated nodule involved the middle finger. Clinically, it fits the diagnosis of giant-cell tumor of the tendon sheath (giant-cell synovioma or localized nodular tenosynovitis). The cause is unknown and usually presents in mid-life. The nodule is usually asymptomatic, but in occasional cases there may be pain, numbness or stiffness of the digit. There is a strong association with osteoarthritis. The lesions do not regress, and they can persist for many years.
All posts by Nameer Al-Sudany
Xanthelasma
A 65-year-old woman presented with asymptomatic, bilateral, yellowish flattened plaques involved both inner canthi of three years duration. The fasting plasma levels of lipids were normal and there was no family history of xanthomatosis, hyperlipidemia or early ischemic heart disease.
Pyogenic granuloma
A 25-year-old pregnant lady presented with a small dome-shaped bright red papule involving the upper eyelid near the eyebrow. The lesion has developed within few days of hair epilation and rapidly enlarging till reaching about 0.5 cm diameter in three weeks. Pyogenic Granuloma is a common benign acquired haemangioma that often occurs shortly after a minor injury or infection of the skin. Typically the lesion grows rapidly for a few weeks before stabilizing as an elevated, bright red papule, usually not more than 1 to 2 cm in size; it may then persist indefinitely unless destroyed. PG often affects children or young adults and the hands, fingers, and face, especially the lips and gums, are the most common sites.
Impetigo contagiosum
A 3-year-old boy presented with multiple, erythematous, oozy and crusted patches with honey-coloured crustation in periorificial distribution mainly around the nose and mouth of 4 days duration. Impetigo contagiosum is a common superficial bacterial skin infection usually caused by group-A beta-haemolytic streptococci and/or Staphylococcal aureus. It commonly occurs in children and can involve any body area especially the periorificial sites of the face. One week course of oral cephalexin plus fusidic acid cream resulted in cure.
Palmar psoriasis
A 30-year-old female suffered pruritic, erythematous, scaly plaques with some fissuring of both palms of more than one year duration. The rash involved mostly the thenar and hypothenar eminences. No other body area, scalp or nail involvement.
Idiopathic onycholysis
A middle-aged lady presented with onycholysis involved all fingernails of one year duration. History and examination excluded any underlying cause (psoriasis, eczema, lichen planus and drugs) and family history was negative.
Idiopathic Koilonychia
All fingernails are spoon-shaped, the shown index finger is an example. Most cases of koilonychia are usually due to iron deficiency anemia however this 35-year-old man had normal iron level (idiopathic koilonychia) and his nails’ deformity has been noticed since childhood.
Pellagra
A 35-year-old alcoholic man presented with sunburn-like rash confined to the extensor surface of both forearms and the sides of the neck. Good and early response obtained on starting therapy with multivitamin supplement containing oral niacin.