Dermatology Journal Club “DJC”

https://t.me/DermATOMAL

Case scenario 💡: A 45-year-old female patient, Sarah, presents to the dermatology clinic with multiple, discrete, firm papulonodules on her forearms, upper back, and buttocks. These lesions have developed over the past year and are associated with intense itching, leading her to scratch frequently. Sarah reports that the lesions have become more widespread and are impacting her daily life and mental well-being.   During the consultation, the dermatologist notes the characteristic central scale-crust on the nodules and suspects prurigo nodularis. Treatment options discussed include superpotent topical corticosteroids, phototherapy, and possibly thalidomide.

Examination There are multiple, discrete, purplish, shiny flat-topped papules over the dorsum of her feet; some of the lesions have a lacy white pattern over their surface. Further similar lesions are seen scattered on her lower legs; some of the papules are clustered in a linear fashion demonstrating Koebner’s phenomenon. A number of her fingernails have longitudinal ridges on them with ‘V-shaped’ nicks. Her mouth, genital region and scalp are all normal.

Case scenario💡: History A 47-year-old woman is seen in the dermatology clinic with a 5-month history of itchy eruption consisting of lesions mainly on her feet but also scattered on her legs. The rest of her skin is unaffected. She does not complain of any symptoms in her mouth or involving the genital area. On direct questioning she had noticed that some of her nails have become slightly brittle and are liable to splitting. No one else in the family is currently affected, although she thinks her mother had suffered with a similar skin eruption some years previously. She is otherwise well and not taking any regular medication.

Case scenario 💡: Chief Complaint: A 16-year-old female, medically & surgically free presented complaining of excessive sweating in her palms and feet. Scenario: This patient presents with a 2-year history of excessive sweating that occurs without physical exertion or emotional triggers. She reports that the sweating is most prominent in her palms and feet and occurs regularly, even in cooler environments. The patient states that it interferes with her school activities, especially during exams, as she finds it difficult to hold a pen or touch paper without smudging her work.