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Dermatology Case 2:
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2. EG 43 y/o F Chief Complaint:
Plaques and Nodules on the face, trunk, and extremities

3. HISTORY OF PRESENT ILLNESS
8 months PTC
Few erythematous ill-defined asymptomatic patches over both upper extremities
associated tingling sensation and numbness of the hands and forearms
No consult was done nor medications taken
6 month PTC
Plaques and nodules involving the forehead, malar area, left ear, trunk and extremities
CONSULT

4. FAMILY HISTORY
(+) HPN, DM
(-) similar lesion

5. PHYSICAL EXAMINATION Skin: (+) leonine facies (-) madarosis
multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm over the malar area, helix of ears, upper extremities, thighs
(+) leonine facies
(-) madarosis

6. CLINICAL IMPRESSION Lepromatous type of Leprosy (Hansen’s Disease)
Salient Features
erythematous ill-defined asymptomatic patches (upper extremities) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)
(+) leonine facies
(-) madarosis

7. DIFFERENTIAL DIAGNOSIS
Hansen’s Disease (other types)
Erythema multiforme
Fixed drug reaction
Seborrheic dermatitis
Cellulitis
Urticaria
Exfoliative dermatitis

8. (Differential Dignosis)
(brief description of pathology)
(epidemiology, incidence, etc.)

9. (Differential…) Patient’s Data (pertinent data per differential)
erythematous ill-defined asymptomatic patches (upper extremities) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)
(+) leonine facies
(-) madarosis

10. (Differential Dignosis)
(diagnostic evaluation)
(therapeutic plans)

11. (Differential Dignosis)
(brief description of pathology)
(epidemiology, incidence, etc.)

12. (Differential…) Patient’s Data (pertinent data per differential)
erythematous ill-defined asymptomatic patches (upper extremities) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)
(+) leonine facies
(-) madarosis

13. (Differential Dignosis)
(diagnostic evaluation)
(therapeutic plans)

14. (Differential Dignosis)
(brief description of pathology)
(epidemiology, incidence, etc.)

15. (Differential…) Patient’s Data (pertinent data per differential)
erythematous ill-defined asymptomatic patches (upper extremities) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)
(+) leonine facies
(-) madarosis

16. (Differential Dignosis)
(diagnostic evaluation)
(therapeutic plans)

17. (Differential Dignosis)
(brief description of pathology)
(epidemiology, incidence, etc.)

18. (Differential…) Patient’s Data (pertinent data per differential)
erythematous ill-defined asymptomatic patches (upper extremities) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)
(+) leonine facies
(-) madarosis

19. (Differential Dignosis)
(diagnostic evaluation)
(therapeutic plans)

20. (Differential Dignosis)
(brief description of pathology)
(epidemiology, incidence, etc.)

21. (Differential…) Patient’s Data (pertinent data per differential)
erythematous ill-defined asymptomatic patches (upper extremities) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)
(+) leonine facies
(-) madarosis

22. (Differential Dignosis)
(diagnostic evaluation)
(therapeutic plans)