Decision Support in Medicine

Decision Support in Medicine

Toxic Shock Syndrome

Are You Confident of the Diagnosis? Characteristic findings on physical examination Toxic shock syndrome (TSS) is an acute, potentially life-threatening, condition characterized by fever, rash, hypotension, and multiorgan damage. It is caused by toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes (group A streptococcus), and each type of TSS is defined as follows: Staphylococcal toxic…

Tinea Versicolor (pityriasis versicolor)

Are You Confident of the Diagnosis? What you should be alert for in the history History is suggestive when an individual reports an asymptomatic or minimally pruritic eruption that appears and/or recurs on the upper trunk and proximal arms, areas rich in sebaceous glands, in warm weather months. Characteristic findings on physical examination The rash…

Tinea capitis (Ringworm, Tinea Tonsurans)

Are You Confident of the Diagnosis? Characteristic findings on physical examination The clinical presentation of tinea capitis varies. There are three main clinical forms: Noninflammatory (tinea capitis superficialis) Inflammatory (tinea capitis profunda) Favus (tinea capitis favosa)Continue Reading The noninflammatory form has a number of patterns, ranging from diffuse scaling to black dot alopecia (Figure 1).…

Thyroglossal Duct Cysts

Are You Confident of the Diagnosis? What you should be alert for in the history The diagnosis of thyroglossal duct cyst (TDC) is based on the presence of an asymptomatic midline neck mass, usually in a child. It may also present as an infected neck mass in the setting of an upper respiratory infection. Characteristic…

Telogen Effluvium (Stress-Induced Alopecia)

Are You Confident of the Diagnosis? What you should be alert for in the history History will include a sudden onset of diffuse shedding. Patients often carry a bag of hair (see Figure 1). Women may report a fear of going bald. Figure 1. Telogen effluvium. Not uncommonly patients will bring in bags of hair…

Telangiectasia (generalized essential telangiectasia)

Are You Confident of the Diagnosis? What you should be alert for in the history Widespread symmetrical cutaneous telangiectasias can be seen in plaque-like, macular, retiform, annular, sheet-like, or net-like patterns. They are usually asymptomatic; however, some individual lesions can cause tingling, burning, or numbness. Characteristic findings on physical examination Characteristic findings include widespread cutaneous…

Talon noire (Black heel, calcaneal petechiae, runner’s heel, basketball heel, tennis heel, hyperkeratosis hemorrhagica, pseudochromhidrosis plantaris, chromidrose plantaire, eccrine intracornee, post-traumatic punctuate hemorrhage of the skin, post-traumatic cutaneous intracorneal blood, disseminated punctuate intraepidermal hemorrhage, black palm, playstation thumb, tennis toe)

Are You Confident of the Diagnosis? What you should be alert for in the history Talon noire is an asymptomatic condition of post-traumatic intraepidermal hemorrhage, arising predominantly in the young athlete. It is observed almost exclusively in sports associated with repetitive jumping or abrupt turning of the feet, including basketball, tennis, lacrosse, and football. An…

Syringoma (benign neoplasm of skin)

Are You Confident of the Diagnosis? What you should be alert for in the history Syringomas are benign adnexal neoplasms derived from the intraepidermal ductal portion of the eccrine gland. They are more common in women than men, and typically arise during puberty or early adulthood, although they may develop in prepubescent children or later…

Next post in Dermatology