Journal of Urgent Care Medicine

45-Year-Old Male With Arm Lesion, Headache, and Malaise

A 45‑year‑old male presents to urgent care with headache, malaise, and an arm lesion that appeared three days ago. He reports no recent travel but notes several mice in his New York City apartment. On examination he is febrile (39.4 °C / 101 °F) and dermatologic exam reveals an eschar lesion with surrounding erythema and adjacent erythematous papules on the arm. Numerous scattered papulovesicles are also present on the trunk and forearms. Laboratory studies show mild leukopenia …

21-Year-Old With Heel Lesion

A 21-year-old man presents to urgent care concerned about a painless blackish lesion that had developed on his left heel. On examination, a stippled, deeply violaceous, blackish patch with overlying scale was seen on his plantar heel. He had no history of dermatological disease but mentioned he played in a basketball tournament last week. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on …

A 49-Year-Old with a 4-Week-Old Lesion on Her Toe

A 49-year-old woman presents with a lesion that developed over her right toe over the past 4 weeks. It is painless, but has begun to bleed. On examination, a smooth, pink, friable, eroded nodule is seen on the nail bed. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

26-year-old woman with bleeding lesion

A 26-year-old woman presents to the urgent care center with a bleeding lesion on her finger. The lesion developed in less than a week and was associated with no other symptoms. The patient is on no medications and is otherwise healthy. She reports no prior history of skin disease. View the photo taken and consider what your diagnosis and next steps would be.

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