Mystery Diagnosis- Skin Diseases and Disorders
You are doctors. Each of you has a patient who has come in with some mysterious symptoms. Your job is to do the
following:
1.
2.
3.
4.
5.
Identify the disease/disorder your patient is suffering from.
Describe the disease – what is it?
What is the cause of the disease?
How will you treat your patient?
What is the prognosis of the disease (the likely outcome, will the individual improve? If yes, how much? Will they
ever completely heal?)
6. Could this be prevented? If yes, how?
7. You must cite your references, this should be done accurately. If you don’t know how to do this, go to
www.easybib.com (I can help with this if you ask BEFORE the due date.)
You will present your findings to your fellow doctors in a brief presentation. You must have at least 3 visuals on a PowerPoint
to show your colleagues. Your PowerPoint will have MINIMAL typed information. You may use notecards for your
presentation. You may NOT simply read the cards, they are simply your notes. The presentation must be in your own words.
How you will be graded:
Requirement
Points
Possible
Identification of disease (you must
summarize symptoms)
Description
4
Cause
6
Treatment
7
Prognosis
6
Prevention
6
3 visuals
3
References cited correctly
3
Quality of presentation
8
Total Points
50
7
Points
Received
1
 Pimple-like irritations, burrows or rash of the skin, especially the webbing between the fingers; the skin folds on
the wrist, elbow, or knee; shoulder blades.
 Intense itching, especially at night and over most of the body.
 Small children or babies may have involvement of the face, scalp, palms of the hands, or soles of the feet.
2
3
4
5
6
7
8
Rash, begins looking like a bad sunburn with tiny bumps and it may itch. The rash usually appears first on the neck
and face, often leaving a clear unaffected area around the mouth. It spreads to the chest and back, then to the rest
of the body.
Aside from the rash, there are usually other symptoms that help to confirm a diagnosis, including a reddened sore
throat, a fever above 101 degrees Fahrenheit (38.3 degrees Celsius), and swollen glands in the neck. The tonsils and
back of the throat may be covered with a whitish coating, or appear red, swollen, and dotted with whitish or
yellowish specks of pus.
 Benign growths
 Are located on the face, chest, shoulders, back, or other areas
 Are yellow, brown, black, or other colors
 May have a rough or wart-like texture
 Often may have waxy surface
 Have a round-to-oval shape
Single or multiple, discrete, dry, rough, adherent scaly lesions occur on the habitually sun-exposed skin of adults
 Rough and dry textured skin lesion
 A macule, patch, or growth on the skin
 Itch, burn, or sting
 Range in size from 1 to 3 mm or larger (about the size of a small pea)
 Be numerous, with several patches close together
 Be surrounded by red, irritated skin.
Erythema, widespread detachment of the superficial layers of the epidermis, resembling scalding, and occurring
mainly in newborns and infants younger than 2 years.
 crusted infection site, often around the nose or ears
 red, painful areas around infection site
 blistering, fever, chills, weakness, fluid loss
 top layer of skin begins peeling off in sheets
 Bruising: purplish areas on the skin or mucus membranes (such as in the mouth) due to bleeding. The
bruises may occur for no apparent reason.
 Petechiae: pinpoint red spots on the skin (typically the legs) that often occur in groups and may look like a
rash. The spots are due to bleeding under the skin.
 Bleeding that is hard to stop.
 Heavy menstrual bleeding in women.
 Blood in the stool
 red spot on the skin, enlarging to an ulcer
 enlarged lymph nodes of groin or armpits
 headache, muscle pains
 possible conjunctivitis
 shortness of breath
 fever, chills, sweating, weight loss, joint stiffness
Red, itchy rash on the skin that usually appears first on the abdomen or back and face, and then spreads to almost
everywhere else on the body, including the scalp, mouth, nose, ears, and genitals. The rash begins as multiple small,
red bumps that look like pimples or insect bites. They develop into thin-walled blisters filled with clear fluid, which
becomes cloudy. The blister wall breaks, leaving open sores, which finally crust over to become dry, brown scabs.
Some children have a fever, abdominal pain, sore throat, headache, or a vague sick feeling a day or 2 before the rash
appears. These symptoms may last for a few days, and fever stays in the range of 100°–102° Fahrenheit (37.7°–38.8°
Celsius), though in rare cases may be higher. Younger kids often have milder symptoms and fewer blisters than older
children or adults.
9
10
11
12
13
14
15
17
White patches (depigmentation) on the skin. These patches are more common in sun-exposed areas, including the
hands, feet, arms, face, and lips. Other common areas for white patches to appear are the armpits and groin and
around the mouth, eyes, nostrils, navel, and genitals.
Generally appears in one of three patterns. In one pattern (focal pattern), the depigmentation is limited to one or
only a few areas. Some people develop depigmented patches on only one side of their bodies (segmental pattern).
But for most people, depigmentation occurs on different parts of the body (generalized pattern). In addition to
white patches on the skin, people may have premature graying of the scalp hair, eyelashes, eyebrows, and beard.
People with dark skin may notice a loss of color inside their mouths.
 Red patches of skin covered with silvery scales
 Small scaling spots (commonly seen in children)
 Dry, cracked skin that may bleed
 Itching, burning or soreness
 Thickened, pitted or ridged nails
 Swollen and stiff joints
 Patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.
 Goes through cycles, flaring for a few weeks or months, then subsiding for a time or going into remission.
 Red to brownish-gray colored patches
 Itching, which may be severe, especially at night
 Small, raised bumps, which may leak fluid and crust over when scratched
 Thickened, cracked or scaly skin
 Raw, sensitive skin from scratching
 Though the patches can occur anywhere, they most often appear on the hands and feet, in the front of the
bend of the elbow, behind the knees, and on the ankles, wrists, face, neck and upper chest.
 Red areas on your face
 Small, red bumps or pustules on your nose, cheeks, forehead and chin (but not the same as whiteheads or
blackheads)
 Red, bulbous nose (rhinophyma)
 Visible small blood vessels on your nose and cheeks (telangiectasia)
 Burning or gritty sensation in your eyes (ocular rosacea)
 Tendency to flush or blush easily
The signs and symptoms usually affect only a small section of one side of your body. These signs and symptoms may
include:
 Pain, burning, numbness or tingling
 A red rash that begins a few days after the pain
 Fluid-filled blisters that break open and crust over
 Itching
 Some people also experience:
 Fever and chills
 General achiness
 Headache, Fatigue
 Small, painful, fluid-filled blisters on a raised, red area of your skin, typically around the mouth
 Pain or tingling, called the prodrome, which often precedes the blisters by one to two days
 Usual duration of 10 to 14 days
 A circular rash on your skin that's red and inflamed around the edge and healthy looking in the middle
 Slightly raised expanding rings of red, scaly skin on your trunk or face
 A round, flat patch of itchy skin
Usually begins as a small area of tenderness, swelling, and redness that spreads to adjacent skin. As this red area
begins to enlarge, the affected person may develop a fever -- sometimes with chills and sweats -- and swollen
lymph nodes ("swollen glands") near the area of infected skin.
16
18




19
 Blistering of your skin — how widespread and severe depends on the type
 Deformity or loss of fingernails and toenails
 Internal blistering, including on the throat, esophagus, upper airway, stomach, intestines and urinary tract
 Skin thickening on palms and soles of the feet (hyperkeratosis)
 Scalp blistering, scarring and hair loss (scarring alopecia)
 Thin-appearing skin (atrophic scarring)
 Tiny white skin bumps or pimples (milia)
 Dental abnormalities, such as tooth decay from poorly formed tooth enamel
 Excessive sweating
 Difficulty swallowing (dysphagia)
Red sores that quickly rupture, ooze for a few days and then form a yellowish-brown crust
Itching
Painless, fluid-filled blisters
In the more serious form, painful fluid- or pus-filled sores that turn into deep ulcers
Following the incubation period, a sudden onset of flu-like signs and symptoms occurs. These include:
 Fever
 Overall discomfort
 Headache
 Severe fatigue
 Severe back pain
 Sometimes vomiting, diarrhea or both

20
21
22
23
26
A few days later, flat, red spots appear first on your face, hands and forearms, and later on your trunk. Within a day
or two, many of these lesions turn into small blisters filled with clear fluid, which then turns into pus. Scabs begin to
form eight to nine days later and eventually fall off, leaving deep, pitted scars.
The rash is usually most noticeable on the palms of your hands and the soles of your feet. Lesions also develop in
the mucous membranes of your nose and mouth and quickly turn into sores that break open, spreading the virus
into your saliva.
 Itching, stinging and burning between your toes
 Itching, stinging and burning on the soles of your feet
 Itchy blisters
 Cracking and peeling skin, especially between your toes and on the soles of your feet
 Excessive dryness of the skin on the bottoms or sides of the feet
 Toenails that are thick, crumbly, ragged, discolored or pulling away from the nail bed
 Clusters of small red bumps that develop around hair follicles
 Pus-filled blisters that break open and crust over
 Red and inflamed skin
 Itchiness or tenderness
 Small, fleshy, grainy lesions, or growths, on the soles of your feet
 Hard, thickened skin (callus) over a well-defined "spot" on the skin, where a wart has grown inwards
 Black pinpoints, which are commonly called "wart seeds" but are actually small, clotted blood vessels
 Lesions that interrupt the normal lines and ridges in the skin of your feet
 Pain or tenderness when walking or standing
White, oily looking flakes of dead skin that dot your hair and shoulders, and an itchy, scaling scalp. The
condition may worsen during the fall and winter, when indoor heating can contribute to dry skin, and
improve during the summer.



Frequent, noticeable, excessive sweating that can soak through clothing
Abnormally excessive and bothersome perspiration on your feet, underarms, head or face
Clamminess or dripping of sweat droplets on the palms of the hands or the soles of your feet



24





25






27




28
29








Dry, scaly skin
Tile-like, small scales, in polygon shapes
Scales colored white, dirty gray or brown — with people with darker skin tending to have darker colored
scales
Flaky scalp
Deep, painful cracks in your palms and soles in severe cases
The scales usually appear on your elbows and lower legs and may be especially thick and dark over your
shins
Symptoms usually worsen or are more pronounced in cold, dry environments and tend to improve or even
resolve in warm, humid environments
Purplish, flat-topped bumps may appear anywhere on the body, but they are most often located on the
inner forearm and near the wrists or ankles. Other common locations include the lower back, neck and legs.
Bumps may appear in lines along creases in the skin, in clusters, or along the site of a scratch or other injury.
Bumps may appear to be covered with fine, lacy white lines.
The affected skin is often itchy.
Rarely, the bumps become crusty, scabby or blistery.
The lesions rarely scar unless they are scratched deeply.
When the lesions eventually disappear, the skin may have a dark brownish discoloration that may eventually
fade away.
Painful, red, swollen area around the nail, often at the cuticle or at the site of a hangnail or other injury.
There may be pus-filled blisters, especially with a bacterial infection.
Itchy skin in a single, limited area
Leathery or scaly texture to the skin
Raised, rough patch that is red or darker than the rest of your skin
The primary symptom is itchy skin — often a single patch on the neck, wrist, forearm, thigh or ankle.
The primary feature is the appearance of blisters. Characteristics of the blisters include the following:
Blisters are large, filled with fluid and don't easily rupture when touched.
Fluid inside the blisters is usually clear but may contain some blood.
Skin around the blisters may appear normal, reddish in people with light skin color or darker than normal in people
with dark skin color.
Blisters can appear anywhere on the body, but they are most often on the abdomen, groin, inner thighs and arms.
Blisters are often located along creases or folds in the skin, such as the skin on the inner side of a joint.
The site of a ruptured blister may be painful or sensitive.
Others symptoms include:
Hives. Raised, red or dark patches of swollen skin (hives) may appear before the development of blisters. In some
cases, hives may be the only skin lesion to develop.
Itching. The affected areas of skin are usually very itchy.
Mouth sores. You may develop blisters or sores in the mouth and, rarely, on other mucous membranes.
30





Draining sores in the skin, especially on the chest wall from lung infection with Actinomyces
Fever
Minimal or no pain
Swelling or a hard, red to reddish-purple lump on the face or upper neck
Weight loss
31



An itchy sore develops that is similar to an insect bite. This sore may blister and form a black ulcer (sore).
The sore is usually painless, but it is often surrounded by swelling.
A scab often forms, and then dries and falls off within 2 weeks. Complete healing can take longer.
32
Attacks most often last 4 - 8 weeks. Symptoms may disappear by 3 weeks or last as long as 12 weeks.
The rash starts with a single large patch called a herald patch. After several days, more skin rashes will appear on the
chest, back, arms, and legs.
The skin rashes:





33
34
Are often pink or pale red
Are oval in shape
May be scaly
May follow lines in the skin or appear in a "Christmas tree" pattern
May itch

The outer layer of skin (epidermis) and part of the underlying layer of skin (dermis) is damaged or lost.

The ulcer may appear as a shallow, pinkish-red, basin-like wound.

It may also appear as an intact or ruptured fluid-filled blister.

Blackheads. Small pitted areas of skin containing blackheads, often appearing in pairs or a "double-barreled"
pattern.

Red, tender bumps. These bumps, or lesions, often enlarge, break open and drain pus. The drainage may have an
unpleasant odor. Itching, burning and excessive sweating may accompany the bumps.

Painful, pea-sized lumps. These hard lumps, which develop under the skin, may persist for years, enlarge and
become inflamed.

Leaking bumps or sores. These open wounds heal very slowly, if at all, often leading to scarring and the
development of tunnels under the skin.