
Osteosarcoma
Osteosarcoma with cartilage cap
| Subjective |
| 34 year old white male presents with dry patches on his scalp, back of his elbows, and the front of his knees. They have been present for several months. No itching. |
| Objective |
| Vital signs stable. Skin - dry, scaling plaques, well-circumscribed, silver present on scalp, extensor surfaces of elbow and knee |
| Assessment and Plan |
| A- Psoriasis P- topical corticosteroids, other options include ultraviolet light (sunlight), lubricants, and keratolytics |
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| Subjective |
| 75 year old male presents with ulcers in his mouth. Started five months ago. Ulcers have progressed to around his mouth and on his forearms. |
| Objective |
| Vitals signs stable. Oral- multiple bullae in mucosa Skin - multiple bullae Labs - biopsy shows antibody pattern in fish-net immunofluorescence pattern |
| Assessment and Plan |
| A- Pemphigus P- corticosteroids |
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| Subjective |
| 45 year old female presents with painful, red nodules on her shins. Started 1 month ago. Patient was recently diagnosed with ulcerative colitis. |
| Objective |
| Vital signs stable Extremities - pretibial, tender, erythematous nodules |
| Assessment and Plan |
| DDX - sarcoidosis, coccidiomycosis, ulcerative colitis, streptococcal infection, idiopathic A - erythema nodosum due to ulcerative colitis P - treat ulcerative colitis |
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| Subjective |
| 25 year old patient notes a growth on her forehead which is the color of her skin. It started about 2 months ago and has stopped growing. |
| Objective |
| Vital signs stable. Skin - flesh colored lesion on forehead with central crater, crater contains keratinous material |
| Assessment and Plan |
| A - Keratocanthoma P - Lesion will likely resolve in a few months, observation for few months, biopsy if needed. |
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