A 60 year old male with history of CABG 3 weeks back presented with complaints of itchy lesions of 1 week duration over the chest and trunk. On examination there were hyperpigmented discrete papules of siz ranging from 2-4 mm over the chest and trunk. Close examination revealed that the lesions were motile. Microscopic examination revealed the characteristic Pediculus humanus corporis or body louse and the patient was diagnosed to have Pediculosis corporis.
44yrs old male visited OPD with c/o deformities of both thumb nails since few yrs.. Detailed history revealed that patient has habitual nail picking and nail biting which leads to severe damage of the nail plate. He is on treatment for anxiety disorder.
A 27 year-old woman with acne came with painful swallowing of ten days duration, not responding to Ranitidine prescribed by her GP. The pain was located in the mid chest. She denied medication intake. Upper GI endoscopy revealed a tiny 3 mm ulcer in the mid Esophagus. It was difficult to detect, and required careful examination. On later questioning the patient recalled taking Doxycycline recently for acne after consulting a dermatologist.
A 35yr old female came with c/o linear multiple hyper pigmented itchy papules over the left forearm and hyper pigmented ill defined plaques over the scalp since 3 months. Detailed history revealed that patient is on methotrexate since 3yrs for rheumatoid arthritis and was started on colchicine for the same 4 months back.The lesions developed 3 months back after starting the new drug.
A 55-year-old female was referred from the rheumatology clinic, with a/c onset inflammatory polyarthritis and neuritic symptoms. Inflammatory markers were elevated. Vasculitis was suspected and was referred to dermatology to look for skin involvement. Careful examination revealed ill-defined hypopigmented skin lesions which the patient had not noticed; with moderate sensory loss and nerve thickening. AFB smears and histopathologic examination was done which revealed lepra bacilli in clumps and the case was diagnosed as Borderline lepromatous leprosy with type 1 downgrading reaction
A 60 year old man presented with a painful brownish raised skin lesion near the right eye of 5 days duration. On examination there was a tender shiny brownish papule near the medial canthus of right eye(Image 1). On closer examination a 'movement ' of the lesion was appreciated and it was found to be an insect(tick) that was holding on to the skin. It was removed using a fine curved forceps( Image 2). Ticks are blood sucking ectoparasites which may transmit various diseases. It may remain unnoticed on human skin until it becomes painful. This case is being presented to hightlight the importance of careful examination which may point towards the diagnosis.