A 35 year old half Filipino- half Pakistan presented to the outpatient department of dermatology at CVMC, with chief complaints of numerous hyperpigmented lesions on the proximal arms and on the upper back of approximately 5 months’ duration. The lesions become so itchy with the change of weather or when the affected parts got sweating. There was no other cutaneous or systemic complaints. His past health was unremarkable. The physical examination revealed numerous sharply demarcated brownish macules and patches on the arms and back. The size of the lesions ranged 3- 6 mm in diameter. Under the wood lamp examination, some of the lesions fluoresced into yellowish gold.   Questions: Based on the clinical appearance of the lesions, what diagnosis can you infer? This is caused by what organism? If the scrapings from lesions will be tested for 10% KOH, what pattern or appearance can be seen under the microscope? What causes the hyperpigmentation of the lesions?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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A 35 year old half Filipino- half Pakistan presented to the outpatient department of dermatology at CVMC, with chief complaints of numerous hyperpigmented lesions on the proximal arms and on the upper back of approximately 5 months’ duration. The lesions become so itchy with the change of weather or when the affected parts got sweating. There was no other cutaneous or systemic complaints. His past health was unremarkable. The physical examination revealed numerous sharply demarcated brownish macules and patches on the arms and back. The size of the lesions ranged 3- 6 mm in diameter. Under the wood lamp examination, some of the lesions fluoresced into yellowish gold.

 

Questions:

  1. Based on the clinical appearance of the lesions, what diagnosis can you infer? This is caused by what organism?
  2. If the scrapings from lesions will be tested for 10% KOH, what pattern or appearance can be seen under the microscope?
  3. What causes the hyperpigmentation of the lesions?
  4. What can be done to treat and avoid the recurrence of the disease?
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