Inpatient Dermatology from Horses to Zebras: Lessons Learned at an Academic Hospital

The seminar on inpatient dermatology highlighted two complex cases treated at an academic hospital during the COVID era. The first case involved a 47-year-old woman with severe thigh pain and swelling, which led to a diagnosis of calciphylaxis—an exceedingly painful condition characterized by tissue necrosis due to intravascular calcifications. Following an extensive examination and imaging, the team performed a biopsy that confirmed the diagnosis, detailing the various risk factors and implications of non-uremic calciphylaxis. Treatment approaches emphasized collaborative care and the urgency of management due to the serious nature of the disease. The second case centered on a 54-year-old man presenting with a severe rash and systemic symptoms, which ultimately led to a diagnosis of secondary syphilis complicated by acute HIV infection. The presentation included typical and atypical skin findings, showcasing the dermatological implications of syphilis in HIV patients. The discussion revealed the rising incidence of syphilis and the essential role of dermatologists in early diagnosis and management in the context of public health, especially as syphilis cases continue to spike across different demographics.