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Medical Maladies Quiz #2

11 Apr
A patient having his blood pressure taken by a...

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Here is this week’s Medical Maladies Quiz! It’s a little more specific I hope.

The Case:

You are a newly minted resident working at a county hospital in Miami. A patient comes in to see you about their condition. The patient is a 56-year-old male of African-American dissent. He explains that he has been having problems with, what he describes as, dandruff in his pubic region lately, though he had never had problems like this in the past. Upon inspection, you find loose, white sheaths on the patient’s hair shafts. You do not see any signs of a rash or  irritation on the skin of the affected area.

What is your differential diagnosis of the patient’s problem?

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4 Comments

Posted by on April 11, 2011 in Medical Maladies

 

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4 responses to “Medical Maladies Quiz #2

  1. Pranab

    April 11, 2011 at 2:36 pm

    I would go with pubic lice, Pthirus pubis, but since the skin around is intact, this would be contrary to my diagnosis, as the intense scratching and itching would produce dermal excoriation, and possibly, secondary infections, most commonly with pyogenic commensals, Staph.

    That said, the white flaky stuff sounds eerily like eggs attached to the hair shaft, a very common mode of presentation.

    Would like to follow this and see where it goes with the next DDxes! 🙂

     
  2. Axl

    April 11, 2011 at 2:53 pm

    Hey man – thanks again for the well wishes. MCAT is done- so glad to have that behind me. Now for the longest month of my life 🙂

     
  3. mymedschooladventure

    April 13, 2011 at 3:17 pm

    Im with Pranab on this one. Other than lice, maybe tinea cruris (odd presentation) or dry skin.

     

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