Stanford Medicine 25 Blog

  • Signs of Scleroderma

    Scleroderma is an autoimmune disease with sclerotic (thickened) skin and many other clinical findings such as hyper and hypo pigmentation of skin, telangiecstasias and many other possible findings reviewed here.

  • Miliaria Crystallina: What is it?

    Miliaria (heat rash/sweat bumps/prickly heat) is a dermatologic manifestation of eccrine sweat gland occlusion and a stimulus for sweat production.

  • What is amyopathic dermatomyositis?

    37 yr old male with a history of these lesions on his the back of his hands for the past two years. Notes no other medical issues. No weakness, fatigue, fevers or rashes anywhere else on his body. He works as a chiropractor and is concerned about his patients seeing his hands. Use of various over the counter treatments such as topical steroids and moisturizers did not improve the lesions.

  • What is skin coining (Gua sha)?

    A 46-year-old Vietnamese female with history of Churg-Strauss syndrome was seen for a flare-up and had the above skin changes. Based on the characteristics pattern can you diagnose the cause of this skin rash?…

  • What is the Sister Mary Joseph nodule?

    A 78 year woman presents with weight loss, lethargy and abdominal pain. Clinical examination showed abdominal distention and a firm, non-tender, irregular 1 cm nodule within the umbilicus...

  • What is rhinophyma?

    This 42 year old male give a history of a chronic “skin rash” of his face. He notes he’s had it for many years and never sought treatment. While it comes and goes on its own, it seems to get worse with alcohol consumption...

  • What is the ugly duckling sign?

    The ugly duckling sign refers to one mole among many that sticks out and looks different (“the ugly duck”) and should raise suspicion for melanoma...

  • Diagnose this skin lesion with newest Stanford 25 video and topic.

    Presenting the first of our dermatology series. Every skin exam starts with a description. Can you accurately describe the below lesion and make the diagnosis? If you need help, visit our newest Stanford 25 page: “The Dermatology Exam: Learning the Language”...

  • What is the exam of calciphylaxis?

    A 49 year-old obese man with non-alcoholic steatohepatitis and cirrhosis, complicated by hepatorenal syndrome not on dialysis, was admitted for expedited liver transplant workup. On admission, he was found to have the lower extremity skin lesions shown below. He noted that these slowly-enlarging lesions had developed over the past 2 months and were extremely tender, requiring opiates to control the pain...

  • Medical Errors and Adverse Events from a Missed or Inadequate Physical Exam

    In the last 20 years the knowledge base for a physician has grown exponentially. Meanwhile technological advances, combined with a growing healthcare system and greater demands on the physician have left the need to find more ways to overcome these challenges. The physical exam, once regarded in the medical profession and the litmus test to...

  • Guttate psoriasis Exam and Overview

    Guttate psoriasis is a common dermatologic finding in children and young adults (usually up to the age of 30). The physical exam showing multiple small (usually less than 1 cm) scaly lesions such as with this patient is usually enough to make the diagnosis...

  • Patient has this new skin finding, what should you worry about?

    This patient has livedo reticularis. This can be a sign of severe bacteremia and possible sepsis. This patient was later diagnosed with bacterial pneumonia, bacterial meningitis and later grew streptococcal pneumonia in his blood. He was treated in the ICU and recovered fully a week later.

  • Happy Halloween! So this is the scariest picture we’ve got! What is it?

    It’s just a solitary keratoacanthoma (KA). A keratoacanthoma represents a proliferation of the squamous layer of the skin. Some doctors believe this to represent a spectrum of squamous carcinoma of the skin.

  • Your patient gets this rash, what’s the diagnosis?

    DRESS is an immune response seen most commonly with certain drugs including anticonvulsants (lamotrigine, carbamazepine and phenytoin) and allopurinol. The diagnosis is usually made with a rash (such as in the picture) combined with eosinophilia and end-organ dysfunction (renal failure, transaminitis or lung involvement). Many other organs can be less commonly affected.

  • A patient asks you… what is this?

    The Stanford Medicine 25 website recently passed 500,000 total visits and 375,000 unique visits since our initial launch in February, 2012. We just wanted to thank everyone for all the support!…

  • Can you diagnose the cause of the patient’s lymphedema?

    Neurofibromatosis Type-1 (NF-1) can have a number of clinical exam findings. A hallmark of NF-1 are the tumors that can be anywhere (most commonly cutaneous). However, if deeper, they can lead to lymphatic obstruction as seen in our patient.

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