Hyperpigmented Skin Patches

Hyperpigmented Skin Patches

A 70-year-old man presents to an urgent care center after becoming concerned about brown hyperpigmented patches on his legs and arms. He says that he thinks some of his teeth are turning gray, but it has been happening so slowly that he is not sure. He reports that he has been in good health recently, especially after starting to take antibiotics last year to treat his rheumatoid arthritis. View the image taken (Figure 1) and …

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67-year-old African American male who developed two asymptomatic lesions on thigh

67-year-old African American male who developed two asymptomatic lesions on thigh

The patient, a 67-year-old African American male, developed two asymptomatic lesions on his thigh 4 months before his visit to the urgent care center. The lesions had faded and recurred twice during the interval from when they first started until his visit. The lesions recurred at the exact location each time. The patient had a past medical history significant for hypertension, asthma, and osteoarthritis. His medications included captopril, propranolol, and albuterol. He used naproxen as …

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2-year-old boy with sudden pain in left leg

2-year-old boy with sudden pain in left leg

The patient is a boy, age 2 years 8 months, who presents with the complaint of pain in the left leg that started five hours ago. There is no history of trauma. On exam, the child looks well and has a temp of 98.96 degrees (axillary) and a pulse of 114. In addition, he has a WBC of 17.7, with 73.7 percent granulocytes. The child\’s leg has no external findings. There is clear pain on …

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Clinical Challenge: October, 2009

  A 57-Year-Old Woman with Acute Pain After a Fall The aptient is a 57-year-old woman who presented to urgent care complaining of severe pain in her right foot, leg, hip, and elbow. She reported that she fell three to four hours prior to presentation while outside walking her dog; she was “tripped up” in the pet’s leash. She presented ambulatory, but was unable to bear any weight on her right leg. Past medical history …

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56-year-old woman with swollen, plaque covered leg

56-year-old woman with swollen, plaque covered leg

The patient is an obese 56-year-old woman who presents with unilateral leg swelling. The area has been weeping for days. On examination, you discover a large erythematous, scaly plaque on the right ankle and lower leg. The patient shares with you that five days earlier she was diagnosed by her primary physician with cellulitis and started on “an antibiotic.” There are no other remarkable findings, and she has no fever. View the photo and consider …

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