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Flea Bites

This 26 year old health professional reported these extremely pruritic lesions after sleeping in a bed later found to be infested with fleas. Note the grouping; the elastic line for the patient's underwear and pants is at the level of the linear stripe of lesions on his side. The lesions are almost completely unilateral--there are only a couple of lesions on the left side and all covered areas were completely spared.

The pruritis resolved with loratadine and topical steroid therapy. Once the patient's bedding was changed and clothing washed he stopped getting new bites.

Long-Term Minocycline Use

Nail discoloration in a man on long-term minocycline for pemphigus vulgaris.

Amyopathic Dermatomyositis

Amyopathic dermatomyositis in a 24 year old female.

Squamous Cell Carcinoma

A squamous cell carcinoma found on the scalp of a 78 year old female with metastases to the submandibular lymph nodes.

Calcinosis

A significant calcium deposit evident on the back of a patient with advanced CREST syndrome.

Dermatographism

These lesions developed shortly after the patient scratched her back and faded soon thereafter.

Primary Lyme Disease (Erythema Migrans)

The targetoid rash of erythema migrans found in a 48 year old male after a weekend in the woods. The patient was treated for lyme disease; no tick was ever spotted.

Koebner Phenomenon in Psoriasis

A linear stripe of psoriasis in a patient with a diffuse psoriasis flare after stopping methotrexate. The patient reports that this lesion formed after she was scratched on her leg by her cat.

Pressure Alopecia Secondary to Drug Overdose

A patient presents with pressure alopecia after a drug overdose. The patient overdosed on drugs and was comatose for an unclear period of time.

An excellent review of the topic: Pressure Alopecia

Neurotic Excoriations

Neurotic excoriations in an elderly patient in a hospitalized patient. A consult was called for alopecia; the patient was found to be picking at his scalp and back. A history confirmed a long-standing disorder.