Bryan Anderson

Are You Confident of the Diagnosis? What you should be alert for in the history Patients are usually diagnosed with erythropoietic protoporphyria (EPP) in infancy, with the rare exception of acquired EPP associated with certain types of cancers. EPP patients often present with photosensitivity (burning and stinging sensation when exposed to sunlight), weakness, malaise, easy…

Are You Confident of the Diagnosis? What you should be alert for in the history Swimmer’s ear, more properly termed otitis externa, is a bacterial infection of the extrenal portion of the ear canal. The most frequent etiological agent responsible is Pseudomonas aeruginosa. P. aeruginosa has been found to be present in 1-2% of the…

Are You Confident of the Diagnosis? This chapter will review ecthyma gangrenosum caused by Pseudomonas aeruginosa. There are many other infectious causes of ecthyma, which are reviewed in a separate chapter. Two forms of ecthyma gangrenosum have been proposed. The first is ecthyma gangrenosum occurring secondary to pseudomonal sepsis. The skin lesions are caused by…

Are You Confident of the Diagnosis? What you should be alert for in the history Green nail syndrome is caused by infection with Pseudomonas aeruginosa. Patients likely have a history of prolonged exposure to water or detergents (soaps), or an ungual trauma. Characteristic findings on physical examination On physical examination, there is characteristic greenish or…

Are You Confident of the Diagnosis? What you should be alert for in the history Pseudomonas hot-foot syndrome, a primary skin infection caused by the bacteria Pseudomonas aeruginosa, was first recognized as a distinct entity in 2001. Emersion of the feet in contaminated water causes the sudden onset of painful plantar nodules, 6 to 48…

Are You Confident of the Diagnosis? Characteristic findings on physical examination Patients will typically present with follicular-based papules and pustules of the trunk and lower extremities (Figure 1). Excoriated papules and small erosions may be present due to patient manipulation. Rarely are the head and neck involved, as most individuals do not submerge their heads…

Are You Confident of the Diagnosis? What you should be alert for in the history Neutrophilic eccrine hidradenitis (NEH) is a rare cutaneous disorder that was first recognized and described in 1982. Seventy percent of NEH cases have been observed in patients with acute myeloid leukemia (AML), after receiving chemotherapeutic agents, in particular anthracycline and…

Are You Confident of the Diagnosis? What to be alert for in the history A rare condition, lymphangioma circumscriptum (LC) has been divided into two broad categories, each with its own typical presentation and history. These two categories are classical and localized. In the classical form, the condition’s hallmark vesicles are typically present at birth…

Are You Confident of the Diagnosis? Characteristic findings on physical examination Lichenoid keratosis (LK) is a common benign skin growth that typically presents as an evolving single discrete papule on the trunk or upper extremities of adults (Figure 1). LK occurs almost always as a solitary skin growth; however, two or three lesions can occasionally…

Are You Confident of the Diagnosis? Lichen planus (LP) is a papulosquamous disorder of the skin, mucous membranes, hair, and nails. Depending on subtype and area of involvement, lesions may range from asymptomatic to pruritic and erosive. Patients may have involvement of one or more of the areas listed above. Lesions of the glabrous skin…

Are You Confident of the Diagnosis? Observed expression of the characteristic phenotypes of LEOPARD syndrome (LS) is extraordinarily variable, making an accurate diagnosis difficult. The minimal criteria that must be met for a diagnosis of LS includes multiple lentigines (Figure 1) and 2 or more of the following: cutaneous abnormalities not including lentigines (cafe noir…

Are You Confident of the Diagnosis? What you should be alert for in the history Burkholderia malleli is able to cause two forms of human infection. Farcy is a subcutaneous form of the bacterial infection that presents with small papules and pustules at the site of skin inoculation. These quickly become subcutaneous nodules and fistulae…

Are You Confident of the Diagnosis? Contact dermatitis is a common eczematous skin dermatitis characterized by inflammation, resulting in erythematous and pruritic skin lesions after contact with a foreign substance. Contact dermatitis can be divided into two groups, irritant and allergic. Irritant contact dermatitisis caused by exposure to a foreign substance that causes a nonimmunologic…