Woman with red itchy bumps after staying in Hotel – Case of the Month

woman red splotches

A 48 year old woman reports multiple, red, pruritic bumps on her trunk. She just returned from New York 3 days ago.  The bumps appeared after the first night she stayed in the hotel. She reports that she kept her suitcase open on the other bed during her 4 day visit. After inspecting her suitcase she found little tiny black “specks” I her suitcase and in her bed sheets.  She brought them in for me to examine.  I took a macro photo of one of the specks and here is what one of the specks looked like:

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An infant with papules and pustules on feet. What is your diagnosis? Dr. Crutchfield’s Case of the Month

Foot sores

11-month-old infant presents with pruritic crusted papules and pustules on feet, as seen in the picture. Also hand and axilla involvement. A teen cousin visiting for the summer has a similar rash, and both are very pruritic.

Here is a picture of a mineral oil scraping I took through the microscope ocular with my cell phone.

Microscopic photo

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Woman with cream colored papules all over her chest – Crutchfield Dermatology Case of the Month.

Chest bumps skin24 year old woman presents to clinic with multiple cream colored papules on her chest.  She said she first noticed them at around age 13.  She reports that her mother has similar bumps. We performed a biopsy and a yellow oily substance came out of the papule when punctured.

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Inflammatory papular rash on man’s leg not responding to steroids, what’s your diagnosis? Crutchfield Dermatology Case of the Month

A 59 year old man developed a red itchy rash on his lower leg after traveling to Arizona and staying with a friend who had adopted a new cat from the local shelter. He went to an urgent care center and was prescribed triamcinolone 0.1% ointment to be applied twice daily. He said there was initial improvement for approximately the first 3 days then the rash started getting worse, more red, more papular and pruritic. The more triamcinolone he used, the worse it got. On examination he had a red scaling plaque/patch with follicular papules and pustules on the lateral side of his left lower leg.

A KOH scraping and microscopic evaluation was performed and this was the finding:

Dermatology case of the month microscope finding

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