Asymptomatic but cosmetically-bothering bilateral black comedones with some intevening yellowish elastotic papules involved the periorbital regions in approximity to the inner canthi of more than two years duration in a 61-year-old woman.
About three weeks after sexual intercourse with a prostitute the lesion began as a single, painless papule that rapidly became eroded and then transformed into an indurated cartilage-like rounded ulcer on the scrotum. Both VDRL and TPHA were positive. The patient was treated with 2.4 million units benzathine penicillin intramuscularly repeated after one week with excellent response.
A young lady (31-year-old) presented with an idiopathic unilateral cyanosis and swelling confined only to the right hand of more than one month duration. Her history was devoid on any underlying condition. Both vascular and skeletal systems of the neck, right shoulder girdle and upper extremity were norma.
A 23-year-old medical student presented with painless indurated ulcer having slopping border of three months duration. Two small red papules are also seen in the neighborhood of the mother lesion. Three sessions of sodium stibogluconate intralesionally have eradicated the lesions.
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 patient had no anemia with normal iron level and his nails’ deformity has been noticed since childhood.
A middle-aged healthy woman all of a sudden developed an asymptomatic, bilateral, symmetrical purpuric eruption on the cheeks and the extensor surface of the forearms and legs of one week duration. The rash didn’t associate with any systemic symptoms. She had no hematological, connective tissue or other systemic disease. Investigations concerning increased bleeding tendency and connective tissue disorders were normal. However, one day before the onset of the rash she had taken a NSAID (?) for neck ache. Whether this case was due to drug induced purpura or caused by an acute leukocytoclastic vasculitis is a matter of debate specially the patient had refused skin biopsy.
A 48-year-old lady suffered more than three years history of red papules, pustules, erythema and swelling involved the face mainly the butterfly region in addition to conjunctivitis. The course of her rash characterized by periods of relapses and remissions.
A middle-aged woman presented with an asymptomatic off-white creamy coat covered the dorsal surface of the tongue of two weeks duration. Her history was negative except for recently taken oral metronidazole. On stoppage of suspected culprit (Flagyl) the crust had disappeared within 7-10 days. On rechallenging with metronidazole the coat has appeared again. Smear and culture from the coat was negative for candida.
