DERMATOLOGYStories From the Field

Sarcoidosis Uncovered: How VisualDx Guided My Diagnosis

I had a female patient in her mid-50s who presented with multiple shiny, violaceous papules and nodules on and around her nose. These had been growing for over five years, and the patient was seeking cosmetic removal. Thanks to VisualDx’s differential diagnosis tool, sarcoidosis quickly emerged as a top consideration. The concise yet thorough synopsis guided me through the diagnostic process, which can be challenging as sarcoidosis is a diagnosis of exclusion. I was able to refer the patient for an x-ray and to the appropriate specialists for follow-up, feeling confident that I had covered all the bases.

—A.G., Direct Dermatology physician assistant

Newborn Rash Mystery Solved with VisualDx

As a brand-new attending, my first case of cutis marmorata telangiectatica congenita (CMTC) walked into my clinic. It was a 2-week-old newborn with a reticulated, non-blanching vascular pattern on the left leg, present at birth. The condition didn’t change with warmth or cold, and there were no other dermatologic findings. The newborn was full term and otherwise healthy. When I examined the leg, I blanked, realizing I had seen something similar during my residency but couldn’t recall the exact diagnosis.

I asked the standard questions and told the mother I would be right back. I quickly performed a VisualDx search with the details: “Rash or multiple lesions, Lower leg, No pruritus, Patient appears well, Present at birth, Reticular configuration, < 1 month old male.” Cutis marmorta was listed as the second option, and it clicked. I reviewed the page, noted it didn’t match perfectly with symmetric presentation or persistence with warming, and then saw CMTC in the differential. After reading that page, I was confident in the diagnosis.

I was able to explain the disease, potential risks, and other findings to the mother. I felt relieved to have VisualDx as a quick and easy resource while the patient was still in the clinic.

—A.W., Yokota Air Force Base physician

Nailed It: Lichen Nitidus Confirmed with VisualDx

I recently encountered a case labeled ‘rule out measles’ from a local health agency. While it clearly wasn’t measles, I noticed monomorphic Koebnerized papules scattered across the patient’s body. With some help from VisualDx, I arrived at a diagnosis of lichen nitidus. My attending was skeptical, so we decided to biopsy, and lo and behold, it was indeed lichen nitidus. I looked awesome!

—N.J., NYU physician

Eczema Diagnosis in Skin of Color Made Easy with VisualDx

—V.S., Dermatology clinic physician

Misdiagnosed Fungal Infection? VisualDx Sets the Record Straight

I had a patient who came for a consultation after being aggressively treated multiple times for a fungal infection that wasn’t improving. The previous diagnoses were incorrect, as the condition was actually pityriasis rosea. I used VisualDx to show the patient various photographs of the condition, which immediately reassured him and clarified the correct diagnosis.