Bullous Impetigo: A Mimicker of Immune-mediated Dermatoses.

The differential diagnosis of vesiculobullous lesions can be intimidating to the primary care provider. While some entities such as bullous impetigo may easily be diagnosed clinically if the patient's demographics as well as the lesion morphology and distribution present classically, atypical presentations may require additional laboratory studies for confirmation. We describe a case of bullous impetigo with characteristics that clinically mimicked two rare immunobullous dermatoses.

Doctor in a bottle: examining the increase in essential oil use.

In recent years there has been a push for more natural medicine, attributed to the rise of the Internet and easy accessibility to information and misinformation. Unfounded claims leading to the antivaccination and anti-Big Pharma movements have caused patients to seek control over their own health care. Simple ingredient names and lack of larger "scary-sounding" chemicals also have attributed to this shift.

A fluorescing spot on the temple: a helpful reminder for a detailed history and physical exam.

We discuss a woman with a history of non-melanoma skin cancer who presented with a new erythematous macule on her right temple. On examination with Wood lamp the well-demarcated macule fluoresced pink making neoplasm unlikely. Further history and physical examination suggested an inadvertent ink stain and the patient was spared a biopsy highlighting the importance of eliciting a good history and performing a detailed physical examination with additional tools such as a Wood lamp when necessary.

Segmental distribution of nodules on trunk.

A 70-year-old Caucasian man presented with a longstanding history of numerous nontender, fleshy, skin-colored papules on his trunk, ranging from 3 to 8 mm in size. They were noted incidentally during an examination of unrelated nonhealing lesions on the patient's left cheek. He said the lesions on his trunk first appeared when he was 28 years old and had continued to grow in size and number.

Linear atrophy and vascular fragility following ultrasoundguided triamcinolone injection for DeQuervain tendonitis.

A 64 year-old woman presented with a one-yearhistory of purpuric, atrophic, linear patches alongthe left lateral forearm. The patient had receivedtwo ultrasound-guided triamcinolone injectionsone year earlier into her left extensor pollicis brevisand abductor pollicis longus tendon sheathsfor DeQuervain tendonitis. In the seven monthsfollowing the second injection, the patient developedatrophy, purpura, and telangiectasias starting at thesite of injection and extending proximally, followingthe course of her left cephalic vein.