Recurrent Painful Abdominal Rash
| Autor: | Julie C. Philp, Julia G. Ridgeway-Diaz, Jeffrey P. North |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Hyperkeratosis Pain Physical examination Diagnosis Differential Celiac artery Edema medicine.artery Abdomen medicine Humans Telangiectasis Aged 80 and over medicine.diagnostic_test business.industry General Medicine Exanthema medicine.disease Dermatology Rash Surgery medicine.anatomical_structure Fluoroscopy Joint pain Female Radiodermatitis medicine.symptom business Postinflammatory hypopigmentation |
| Zdroj: | JAMA. 314:1390 |
| ISSN: | 0098-7484 |
| DOI: | 10.1001/jama.2015.9308 |
| Popis: | An 80-year-old woman with a history of diabetes mellitus, hypertension, gastric ulcers, celiac artery occlusion, and transient ischemic attacks presentedwith a painful rash on her flank of 2 days’ duration. She denied any history of trauma and had not applied anything topically in this area of skin. She denied fevers, systemic symptoms, joint pain, and skin thickening. Her medications included metformin, lansoprazole, venlafaxine, diltiazem, atorvastatin, oxycodone/acetaminophen, ramopril, reglan, zolpidem, and clopidogrel. Physical examination revealed an 8-cm solitary, erythematousplaquewithvesiculation andcentral erosionon the right lateral area of her abdomen (Figure, A). The remainder of the physical examination was unremarkable. A punch biopsy showed a vacuolar interface dermatitis pattern, but a definitive clinical diagnosiswas not established. Shewas treatedwith clobetasol cream (0.05%), and the plaque resolved in 4 weeks with postinflammatory hypopigmentation. Tenmonths later, thepatientdevelopeda tender, pink, indurated7-cmplaquewith telangiectasias and central ulceration in the same location, with no other cutaneous findings (Figure, B). No precipitating factors could be identified. A punch biopsy showed minimal inflammation, atrophy and hyperkeratosis of the epidermis, and edema, sclerosis, and absence of hair follicles in the dermis (Figure, C). Quiz at jama.com A B |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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