64-Year-Old With Facial Lesion

64-Year-Old With Facial Lesion

A 64-year-old man presents to urgent care with a lesion on his face for the last 2 months. On examination, a shiny, eroded, blue-black nodule was seen on his right cheek. He is a postal worker.  Histopathology examination showed aggregates of melanin and melanocytes within sheets of basaloid keratinocytes with peripheral palisading and surrounding clefts within a fibromyxoid stroma containing melanophages. View the image above and consider what your diagnosis and next steps would be. …

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56-Year-Old With Cancer and Developing Rash

56-Year-Old With Cancer and Developing Rash

A 56-year-old woman presents to urgent care for a rash that developed on her hands, ears, and nose over the last couple of months. She has a recent diagnosis of esophageal cancer. On examination, hyperkeratotic plaques were seen on the palm and fingers, and scaly papules were seen on her helices and nose. Her nails displayed subungual hyperkeratosis, onychodystrophy, and onycholysis along with erythema and edema on her nail folds. View the image below and …

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42-Year-Old With Stinging Sensation

42-Year-Old With Stinging Sensation

A 42-year-old woman presented to urgent care early in the morning saying that she felt a stinging sensation on her arm while she was cleaning her basement the previous day. She thinks it might be a bite but didn’t see anything. She had subsequent marked pain at the site and over the past few hours developed nausea and muscle aches. On physical examination, the patient had a temperature of 101.3°F (38.5°C). There were reddish-brown reticulate …

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