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Norman Levine, M.D.
Norman Levine, M.D., is a private practitioner in Tucson, Ariz. He also is a member of the Dermatology Times Editorial Advisory board and a co-medical editor.
Case: Eruption on upper extremities
Consider lichenoid drug eruption in a patient on angiotensin-converting enzyme inhibitors with a pruritic eruption consisting of violaceous scaly papules. Other drugs also are associated with such eruptions.
Case: Blistering eruption of hands
Consider dyshidrosis in a patient with recurrent pruritic vesicles on the hands.
Commentary: 'Big tent' approach to dermatology
A few months ago, I wrote an editorial for Dermatology Times on the subject of Mohs micrographic surgery and its potential abuses. I noted that while the procedure is very beneficial, it is sometimes overused for questionable indications.
Case: Asymptomatic eruption
Consider allergic cutaneous vasculitis in a patient with the rapid onset of palpable purpura of the lower extremities.
Case: Blistering eruption on lower extremities
Consider bullous pemphigoid in a patient with non-inflammatory vesicles or bullae localized to the lower extremities.
Case: Intensely pruritic eruption of extremities and buttocks
Consider dermatitis herpetiformis in a patient with a pruritic vesicular eruption.
Case: Recurrent, pruritic blisters on lower extremities
Consider insect bite reaction in a patient with scattered, pruritic inflammatory vesicles.
Commentary: Mohs overkill: 'Aggressive' procedure often performed unnecessarily
My friend and colleague, Ted Miller, recently related a story about one of his patients, who was 92 years old and had consulted with another dermatologist about several growths on his face.
Case: Slowly enlarging, pigmented lesion on temple
Consider lentigo maligna in an elderly patient with an irregular pigmented patch in chronically sun exposed skin.
Case: Small bump at edge of scar where lesion removed
Consider recurrent basal cell carcinoma if a lesion recurs at the margin of the original scar.

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