Managing Tough Real Life Dermatology Cases

In this presentation by Christine Warren, a dermatologist at the Cleveland Clinic, various challenging dermatology cases are discussed. The first case features a 63-year-old woman with persistent blistering lesions on her lower extremities, misdiagnosed initially as cellulitis. Through multiple evaluations and biopsies, she was ultimately diagnosed with bullous lichen planus, leading to a tailored treatment regimen. The second case addresses a 65-year-old female post-mastectomy who developed reticular telangiectatic erythema (RTE) after tissue expanders were placed, showcasing a timely diagnosis that allowed her to proceed with permanent implants. The third case involved a 76-year-old woman exhibiting irritation in the eyelid creases, culminating in the diagnosis of actinic keratosis after a thorough examination and biopsy, tied to her chronic use of hot eye compresses. Warren emphasized the importance of detailed patient history, physical examination, appropriate diagnostic tests, and the potential for misdiagnosis in dermatological practice. Additionally, she discussed treatment strategies and highlighted the necessity of awareness regarding both clinical manifestations and necessary interventions, including possible malignancies due to excessive heat exposure.