August 2007
Fg.1
History:
A 71 year old white male presented with a non-healing
wound on the dorsum of his left hand. Approximately 2 months ago
he caught his hand in an elevator door resulting in an avulsion
injury to his skin. He used butterfly bandages to tape the skin
in place. The area failed to heal over the course of 1 month and
he was prescribed cephalexin for cellulitis by his primary care
physician. This resulted in no improvement and he was referred
to the dermatology department.
Past Medical History, medications, family history: non-contributory
Social history: Avid fisherman. He admits to fishing a couple
days after the initial injury and immersing his hand in lake water,
bait containers, and handling his catch. Denies travel outside
the Midwest.
Physical Exam: significant only for an erythematous
verrucous plaque on the dorsum of the left hand (Figure 1)
Click here for the Diagnosis.
Click here for CME Credit
