Functional Medicine

08/21/2025

A 46-year-old male presented to the emergency department with severe discoloration and hardening of the right hand, progressing over several days.

The patient reported initial swelling and pain following a minor puncture wound, but delayed seeking medical attention.

On examination, the hand appeared blackened and necrotic with visible tissue breakdown, suggesting advanced ischemic or infectious complications.

08/19/2025

Diagnosis?
A 12-year-old immigrant girl was admitted to the dermatology department with multiple brown skin lesions on her trunk and face, along with a large cerebriform mass on the right side of her scalp.

According to her parents, she was born with several brown papules and nodules scattered across her trunk and face and a flat, brown patch on the scalp. Over the years, the skin lesions gradually enlarged, though they remained non-painful and non-pruritic. The scalp lesion, originally flat and brown at birth, slowly grew in size and thickness over the past 8 years and developed a nodular, cerebriform surface in the last 5 years. Recently, the child began experiencing severe itching and foul-smelling discharge from the scalp mass.

The patient’s birth and developmental milestones were normal despite these skin findings. On examination, her nutritional and developmental status were within normal limits. Head circumference and systemic examinations—including neurologic, cardiovascular, musculoskeletal, and ophthalmologic—were unremarkable.

The cerebriform mass on her scalp measured approximately 22 cm × 18 cm × 2.5 cm and had a nodular surface, covering a significant portion of the right side of the scalp.

08/19/2025

After the honeymoon, the patient noticed this rash.

What is your diagnosis?

08/18/2025

A 25-year-old woman presents with multiple dome-shaped, flesh-colored, umbilicated papules clustered on thighs and buttocks, slowly progressive over months, mildly pruritic, with no systemic symptoms or prior significant dermatological history.

08/17/2025

A 49-year-old woman presents with progressive swelling in her left leg that has been worsening over the past year.

She reports heaviness, tightness, and occasional discomfort in the affected limb, which interferes with daily activities such as walking and standing for long periods.

On examination, the left leg shows significant enlargement with thickened skin and non-pitting edema, while the right leg appears normal.

08/15/2025

Which antihypertensive drug can cause this?

08/14/2025

What is the Diagnosis?

A man in his 30s presented to the dermatology with widespread lesions.

He was inconsistently housed, worked on farms, and had a history of alcohol misuse. On examination, foul-smelling verrucous plaques and whitish papules with central black dots were observed on the feet, legs, knees, buttocks, elbows, and hands, with nail dystrophy.

Several lesions were manually extracted using sterile forceps, and histopathological analysis confirmed the presence of sand flea eggs.

08/13/2025

Diagnosis?
A 38-year-old Woman presented with a painful rash that started on her abdomen and was spreading rapidly to her extremities, trunk, and face over a period of 3 weeks.

Previous biopsy report showed necrotic keratinocytes, lymphohistiocytic infiltrate and edema in papillary dermis.

On admission, her haemoglobin was 7.5 gm/dl, total white cell count was 6300/cu mm. Liver enzymes were deranged. Viral markers negative.

New lesions kept occurring in crops, prominently over the lower extremities. They started as purpuric macules evolving to form coalescing ulcers with black crusts and necrotic center.

Some lesions evolved into hemorrhagic bullae.
The ulcers healed with hypopigmented, atrophic or varioliform scars Over the period of next 3 weeks, the lesions on lower extremity worsened.

There was desquamation from the scaly plaques. The ulcers became deep and foul smelling due to secondary infection. There was black eschar-like formation on a few lesions, Skin biopsy showed parakeratosis, necrotic keratinocytes, basal cell vacuolation, pigment incontinence and lymphocytic vaculitis.

08/13/2025

08/13/2025

What’s the diagnosis?

08/12/2025

Patient presents with this skin finding all over the body.

What is the diagnosis??