Dermatology Practice Today : Disease Management

Facial Skin Presentations

Kelly Wolfgang — Thu, 06 Jun 2013 14:39:00 GMT

Editori's note: The information and photos in this post were provided by Amy Gouley. A p atient presented today for a patch on left temple that "stings." Diagnosis: Proven by biopsy, Basal Cell Carcinoma A 12-year-old male presents with a new lesion on...(read more)

Examining the Scalp

Amy Gouley — Mon, 13 May 2013 19:00:00 GMT

(Pictured above and below) A 54-year-old male presents with two bald patches on the scalp. He complains that the bald patches itch. Diagnosis: Alopecia Areata (Pictured below) A one-year-old presents with a lesion on her scalp since birth. Diagnosis:...(read more)

I’ve Got Bugs

Raymond Shulstad — Mon, 15 Apr 2013 16:50:00 GMT

There are several presentations for patients who have or believe they have "bugs" in or on their skin. There are the haves, have nots and the "I know I have it and I brought proof but have nots." The haves are easy to diagnose. The most common of these...(read more)

Neurodermatitis

Amy Gouley — Thu, 04 Apr 2013 20:25:00 GMT

This was a 71-year-old female who reported a rash for 7 months. Her primary physician thought she needed a dermatologist evaluation. At the beginning of taking her history, she was pointing to lentigines scattered on her face, arms and legs that she "disliked."...(read more)

The Use of Dermatoscopes

Raymond Shulstad — Thu, 28 Mar 2013 13:04:00 GMT

I had a student ask me recently if I had a dermatoscope and if I could show her how to use it. The answer was simple enough. No, I don't need one. This of course led to the logical question...Why? This blog post was inspired by this exchange. The simplest...(read more)

Spring Breakers Beware

Raymond Shulstad — Mon, 11 Mar 2013 19:36:00 GMT

As the universities and secondary schools are preparing for spring break, it is important that we are educated and educate our young patients on the dangers of ultraviolet exposure. I am going to focus this blog more specifically towards the use of tanning...(read more)

A Rapid Case of Metastatic Melanoma

Amy Gouley — Fri, 01 Mar 2013 19:47:00 GMT

Above, a 75-year-old patient with stage 4 metastatic melanoma. He came to us after a staged excision and graft. The black dots are new satellite nodal mets. Above, metastatic satellite lesions on the scalp of the same patient. He had the original scalp...(read more)

A Case of the Creeping Crud

Raymond Shulstad — Thu, 21 Feb 2013 18:30:00 GMT

If you have been around medicine long enough and seen enough patients with rashes then you have probably heard the term "creeping crud." It is often used by older patients to describe a rash that appears to be spreading or moving to other areas of the...(read more)

For the Love of Derm

Amy Gouley — Thu, 14 Feb 2013 18:40:00 GMT

(Above) Heart-shaped pigmented Basal Cell Carcinoma on the back of a 71-year-old male. (Above) Heart-shaped Actintic Keratosis on the left forearm of an 88-year-old male. (Above) Heart-shaped squamous cell carcinoma on the lower leg of a 73-year-old male...(read more)

Cellulitis, Melanoma and Acne Granulomatous

Amy Gouley — Thu, 07 Feb 2013 15:10:00 GMT

Malignant Melanoma on a 69-year-old female Breslow Thickness: 0.9mm Clark Level 3/Early 4 Mitotic Index: 2 dermal mitosis Referred for Lymph node mapping and treatment Cellulitis on the lower leg. Cellulitis on the lower leg 2 days later, following Predinsone...(read more)

Treating Stasis Dermatitis

Raymond Shulstad — Thu, 31 Jan 2013 20:06:00 GMT

As this is my first attempt at blogging I will start by introducing myself. My name is Raymond Shulstad, DNP, ARNP-C, BC, DCNP. I have been practicing dermatology for the past 11 years in the Tampa Bay area. I completed my DNP in December of 2009 at the...(read more)

Diagnosing Carcinoma and Melanoma

Amy Gouley — Fri, 25 Jan 2013 18:04:00 GMT

This patient had perfectly symmetrical basal cell carcinomas on both forearms. The patient even remembers getting horribly sun burned on both arms twenty years ago! This 72 year old patient presented for a total body exam. The patient reported a pencil...(read more)

Rashes, Bumps and Burns, Oh My!

Amy Gouley — Thu, 13 Dec 2012 14:41:00 GMT

1. 61 y/o M new patient presents for rapidly growing bump on right cheek. Shave biopsy proven Invasive Squamous Cell Carcinoma and scheduled for MOHS. 2. 56 y/o F spilled hot water on her ankles on Thanksgiving. Patient is complaining of soreness and...(read more)

Three Derm Diagnoses

Amy Gouley — Fri, 30 Nov 2012 14:27:00 GMT

1. A patient presented to my clinic for a rash on his hands. After a plan was developed, he stood up and I said, "How about I take a quick look at your back since it's difficult to see our own backs." He raised his shirt and here this was, a large 3cm...(read more)

My Four Favorite Derm Cases

Amy Gouley — Thu, 15 Nov 2012 14:26:00 GMT

1. A patient presents with a new spot on the nose for 3 months. No history of skin cancer. I believe it's a BCC and path proves it's a SCC, WOW! 2. Ceruloderma, a drug-induced pigmentation secondary to Lupus medication. 3. "Show and Tell:" I love a zip...(read more)