Oral cavity lesion

50y old man, with h/o tobacco abuse presents to the office complaining of a lesion in his oral cavity that he has had for a very long time. He is asymptomatic. The lesion is pedunculated, exophytic and papillary in appearance.
What is the diagnosis?

1. Squamous papilloma- CORRECT ANSWER
2. Verruciform xanthoma
3. Papillary hyperplasia
4. Condyloma acuminatum
5. Squamous cell cancer

• Discussion by Sun

Pruritic skin rash

37 y, woman, with h/o mild mental retardation, comes in with progressively spreading, intensely pruritic skin rash. Her mom was told that the patient had inadvertently shared a bed with her cousin (with h/o Down’s syndrome) who was found to have Scabies. Rash is shown in the picture.

Which of the following statement is false?

1. If the patient was African-American, she would be unlikely to develop scabies.
2. The skin rash most likely represents a hypersensitivity reaction, rather than a foreign body reaction.
3. It is a sexually transmitted disease
4. Absence of burrows in the inter-digital space makes the diagnosis unlikely- CORRECT ANSWER
5. Permethrin 5% topical, single application, is sufficient.

Nodular Lesion on the palm

69y brick-layer with history of DM, HTN, DJD and tobacco-induced COPD presents with painful hands, thickening in the palm and limitation of 4th and 5th finger movements.
Exam shows nodular lesion on the volar surface of the hand at the metacarpophalangeal joints of primarily the fourth and partially fifth finger.

What is the diagnosis?

1. Volkmann’s contractures
2. Trauma
3. Intrinsic joint disease
4. Dupuytren’s contracture- CORRECT ANSWER
5. Diabetic Cheiroarthropathy