Dr. Vlahovic's blog

As summer officially begins this week, patients may need reminders about the importance of protecting their skin from sunburn, particularly oft-neglected areas such as the feet. I feel compelled to discuss the myths of tanning and sunscreen as outlined by Sandra Fryhofer, MD, on Medscape’s Medicine Matters.1 Two years ago, I discussed sunscreens more in depth (http://goo.gl/ufVhB ), but I would like to take this time to go through the most common misconceptions about sun exposure. Chances are, you probably hear these lines from your patients from time to time.

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Can you identify the type of lesion shown in the photo at the left?

These atypical moles differ from common nevi as they are usually larger in size and lack pigment uniformity. Color ranges from reddish hues to brown to blue-black. The clinical appearance of a popular, pigmented central portion surrounded by a less pigmented macular border gives rise to the “fried egg” nomenclature.

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Lately at the Foot and Ankle Institute, we have had a “rash” (pun intended) of patients presenting with erythrasma and/or pitted keratolysis. Let’s focus on pitted keratolysis.

Pitted keratolysis is a condition characterized by superficial erosions and 1 to 3 mm discrete crateriform pits along the sole of the foot due primarily to prolonged bromhidrosis.1 Although typically asymptomatic and non-inflammatory, patients with this condition often seek treatment because of the associated psychosocial factors such as odor and embarrassment.

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Can you identify the type of dermatitis shown in the photo at the left?

The condition depicted is a chronic pruritic skin disorder often associated with a personal or family history of asthma, hay fever, allergic rhinitis and eczema. Most cases first become apparent in early childhood. An onset of the disorder after the age of 14 is uncommon.

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