Reading Assignment:

Habif: Clinical Dermatology, 5th Ed

Chapters 3, 4, 5, and 8

Objectives:
1. The student will understand the terminology used to describe rashes and lesions.
2. The student will be able to differentiate and diagnose common rashes and lesions seen in the
primary care setting.
3. The student will be able to treat common rashes and lesions seen in the primary care setting.
Cases:
Case 1 A 13 month old girl is brought to the pediatrician for an itchy rash on her arms, legs,
and cheeks. The rash appeared gradually several weeks ago but appears to be worsening. Her
skin has always seemed dry and her parents apply baby lotion to her skin regularly. She has had
no fevers or recent illnesses. On exam, her rash is scaly, crusted, pink patches on the flexor
surfaces of her arms and legs. Her cheeks are red and excoriated. The remainder of the exam is
normal.

Discussion Questions:
1.
2.
3.
4.
5.

What
What
What
What
What

is the most likely diagnosis?

is the pathogenesis of this condition?
conditions would you include in the differential?
is the most appropriate long term treatment?
is the most appropriate treatment for a flare up of this condition?

Case 2 A 9 year old Boy Scout is camping in Northern Arizona with his scout troop. They
returned from a hike about 3 hours ago when the child begins to complain of itching and burning

on his legs. He also notes that his face and arms are beginning to feel the same way. His past
medical history is remarkable for failure to thrive, developmental delay, and a seizure disorder.
He currently takes no medication. His arm is shown in the photo below.

Discussion Questions:
1.
2.
3.
4.

What
What
What
What

is the most likely diagnosis?

is the pathogenesis of this condition?
conditions would you include in the differential?
is the most appropriate treatment?

Case 3 - A 42 year old male presents to the office with a pruritic, planar polyangular purple
papules. On close inspection, using oil over the lesions, the surface shows a lacy reticular
pattern.

Purple polycyclic lesions

Oil accentuates the lacy white striae.

1. What is the most likely diagnosis?

2. What are the histologic features?
3. What type of infection has been associated with this diagnosis?
4. What conditions would you include in your differential diagnosis?
5. What is the most appropriate treatment?

Case 4 A 28 year old graduate student presents to the primary care physician with complaints
of a rash on the extensor surfaces of the elbows and knees. There is no significant past medical
history and the patient otherwise feels well. The patient takes no medications and is allergic to
penicillin. Please see photos

Discussion Questions:
1.
2.
3.
4.
5.

What is the most likely diagnosis?

What is the pathophysiology of the condition?
How is the diagnosis made?
What complications are associated with this disease?
What is the treatment of this disease?