Lady with a lid lesion

48y, white woman, comes in concerned about a lesion on her Rt eyelid. She has had the lesion for several years and denies any associated ocular or systemic symptoms associated with it. Her PMH is significant for anxiety and occasional muscle spasms for which she receives alprazolam and carisiprodol.
Exam shows a 1.2 cm, slightly raised, greasy, brown-grayish, plaque with some fine superficial desquamation.
What is the most likely diagnosis?

CORRECT ANSWER: Seborrheic Keratosis

19 year old man with penile rash

19-year-old AAM, comes to the clinic for a physical. He denies any symptoms except for some lumps on his penis for the past 7-8 years. He denies any systemic symptoms, local discomfort, dysuria or penile discharge. He denies being ever sexually active.
On examination, he has rows of small, flesh-colored, smooth, dome-topped to filiform papules situated circumferentially around the corona and sulcus of the glans penis.

What is the best approach of management?

1. Refer to dermatologist for biopsy
2. Start topical Lotrisone cream, f/u in 2-3 weeks.
3. Start topical Imiquimod, f/u in 2-3 weeks
4. Reassure and counsel about safe sexual practices- CORRECT ANSWER
5. Topical podophyllin bid for 3 days, followed by 4-day rest period. Repeat cycle up to 4 times.
6. This appears to be molluscum contagiosum, check his HIV status.

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