A 25-year-old lady presented with burning, well-circumscribed, red scaly rash with fine fissures involved the chin of 5 days duration. The patient gave history of applying a topical cream containing Tretinoin + Hydroquinone + Mometasone, two days after she developed this rash. Tretinoin was the most suspected culprit. Stopping this topical preparation and twice daily application of Betamethasone valerate ointment gave dramatic improvement.
All posts by Nameer Al-Sudany
Lichen amyloidosis
History
Lichen amyloidosis is characterized by closely set, discrete, brown-red papules that often show some scaling and are most commonly located on the legs, especially the shins, although they may occur elsewhere. Through the coalescence of papules, plaques may form on the legs. These plaques often have verrucous surfaces and then resemble hypertrophic lichen planus or lichen simplex chronicus. Usually the lesions of lichen amyloidosis itch severely. The presented patient has had typical lesions of lichen (papular) amyloidosis on her shins of more than 2 years duration. The lesions caused great troublesome to the patient through severe itching and cosmetic appearance.
Seborrhoeic keratosis
History
A 34-year-old woman complained of an asymptomatic, solitary, large, ugly-looking, darkly-pigmented warty nodule with greasy papillating surface involving the breast of two years duration. The lesion has been removed by shave excision under local anesthesia.
Secondary cutaneous plasmacytoma
History
A 35-year-old man presented with an asymptomatic, solitary, mushroom-like, firm, red, slightly crusted nodule on the abdominal wall of 3-4 months duration. He had no other complaint. Excisional biopsy revealed secondary plamacytoma (biopsy showed nodular and diffuse collections of plasma cells with varying degrees of pleomorphism and atypia). Further assessment by an oncologist with relevant investigations a hidden asymptomatic multiple myeloma was discovered.
Molluscum contagiosum
History
A 50-year old unlucky woman presented with asymptomatic but disfiguring multiple skin-colored to pinkish papules and nodules involved the face specially the nose and chin of 9 months duration. Many lesions were giant in size and may resemble BCC or Trichoepitheliomas.
Multiple leiomyomas
History
A 30-year old male presented with multiple skin-colored to pinkish nodules of10 years duration. Upper lesions were itchy whereas lower lesions were painful and tender. A syrian dermatologist had treated some of the lesions with laser (type of laser ?) and many lesions recurred with itching. O/E upper lesions (recurred ones) were firm to hard to palpation while lower lesions were smooth to ruberry in consistency. Skin biopsy revealed leiomyomas whereas recurred lesions were in fact keloidal scars (complicated laser therapy).
Squamous cell carcinoma
History
A 65-year-old man presented with a painless exuding ulcer with an irregular purplish border and granular base on the abdomen of 6 months duration. There was no associated systemic disease and it didn’t respond to many topical and systemic antibiotics. Biopsy revealed SCC.
Melasma
History
A 36-year-old lady presented with more than two years history of hyperpigmentation involved the butterfly area of the face that had not respond to hydroquinon, topical corticosteroid and topical adapaline used singly and in combination. The patient claimed that 3 sessions of Nd-YAG laser have exacerbated her melasma.