Sunday, September 22, 2013

Transient Neonatal Pustular Melanosis

Transient Neonatal Pustular Melanosis  very good article. This is not uncommon and is NOT herpes. Usually leaves pigmented(melanosis) lesions where the vesicles were.

posted by joe @ 9/22/2013 06:04:00 PM   0 comments

Thursday, September 12, 2013

Newborn rash

Newborn nurses concerned that it has Herpes!

posted by joe @ 9/12/2013 04:06:00 PM   1 comments

Thursday, September 05, 2013

Black Widow Spider - Latrodectus mactans

I got tired of seeing that bloody eye looking back at me every time I open this site so here is a picture of a black widow spider, Latrodectus mactans that I took at my house a couple of years ago.

posted by Clay @ 9/05/2013 05:39:00 AM   1 comments

Friday, March 08, 2013

Don't rub your eyeball! The second most common cause of subconjunctival hemorrhage!

posted by joe @ 3/08/2013 08:36:00 AM   4 comments

Saturday, November 03, 2012

Loss of Nails Following Hand Foot and Mouth Disease Infection in 2 Children

I present an unusual case of 2 unrelated children who coincidentally presented to me on the same day with Hand, Foot, and Mouth Disease and then returned 7 and 8 weeks later with the same uncommon complication of this disease.

The first was an otherwise healthy 3 year old boy whose symptoms at presentation were a 2 day history of fever up to 102 degrees, and a vesicular rash on the hands, feet, buttocks and around the mouth.  A diagnosis of hand, foot and mouth disease was made, he and mom were sent home with reassurance.  No further contact was made until he presented 7 weeks later with his mother who was complaining that his nails were peeling off.  He had no other symptoms.  I had no specific explanation for this, so I inquired about any recent systemic illnesses.  She reminded me of the recent HFM infection so I did some quick research - Google Search:  "hand foot mouth disease onycholysis" and I found this article.  It describes 4 cases of onycholysis and/or onychomadesis following HFM infection.

 The second case involved a 20 month old girl who had initally presented with 2 day history of temp. up to 99.8 and vesicular rash on hands, feet and groin area.  The diagnosis of hand, foot and mouth disease was made and reassurance was given.  A few days later she returned with worsening of the rash but had no significant feeding problems.  There were no signs of dehydration or fever at that time, but the child now was extensively covered with the vesicular rash over all extremities, trunk and external lips.  No further treatment was recommended at that time and f/u by telephone a few days later revealed that she was finally improving and further follow up for this was planned on an as needed basis.  Our next encounter was just under 8 weeks later for an unrelated minor problem.  As we were finishing the visit, the mom said "All her fingernails and toenails fell off after she had that hand foot and mouth disease".  Indeed, on her exam, all of her fingernails had shed and were growing back with some small irregularities and indentations and the same was true for her toenails except the nail of each great toe which had not completely lost the older portions of the nails.

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posted by Clay @ 11/03/2012 03:57:00 PM   26 comments

Thursday, September 06, 2012

A Large Brown Recluse

Most of the times I am able to get a picture of a brown recluse (Loxosceles reclusa), the subject is already pretty smashed up.  I found this one on a bag in my garage and pulled it out on the driveway where I knew it could not escape so I could get pictures.  I have been seeing more of  these here recently.  This one was rather large for a brown recluse.  Of course the characteristic marking on the dorsum of its cephalothorax which resembles a violin is the best known identifying feature.

Here is a good article on the bite of a brown recluse spider from Wikipedia.  It mentions that an estimated 80% of reported brown recluse spider bites are misdiagnosed and it gives a nice list of infectious and noninfectious conditions that have previously been misdiagnosed as brown recluse bites.  I do find this portion lacking in that it does not mention specifically the classic case of an attack from 'The Methicorn'.

posted by Clay @ 9/06/2012 06:03:00 AM   1 comments

Thursday, July 26, 2012

Crazy Hunters!

posted by joe @ 7/26/2012 05:49:00 PM   1 comments

Saturday, July 21, 2012

More Sheep

posted by joe @ 7/21/2012 10:24:00 AM   0 comments

Murakami ????

posted by joe @ 7/21/2012 10:18:00 AM   2 comments

Tuesday, April 03, 2012

Hand, Foot and Mouth Disease

This is a 6 year old girl who presented with a 3-4 day history of sores on the hands feet and mouth.  The child was otherwise acting well.  She had no fever or really any other symptoms.  The mother stated that the child had been exposed to another child at the school with Hand, Foot and Mouth Disease.  This is probably the most demonstrative case I have seen.  The lower pic is of the lower lip and chin of the child; the upper lip looks the same.  There were no mucosal lesions identified in this case but they are very commonly present.  Treatment is usually supportive.  Here is an entry on HFM disease from Mayo Clinic.

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posted by Clay @ 4/03/2012 10:30:00 PM   2 comments

Monday, April 02, 2012


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posted by joe @ 4/02/2012 06:05:00 AM   1 comments

Friday, March 23, 2012

Forever Marilyn

posted by Clay @ 3/23/2012 10:05:00 PM   1 comments

Monday, March 12, 2012

Kahn Academy I saw this on 60 minutes last night. Very interesting for families with young learners. Also the free app 3-D brain is interesting.

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posted by joe @ 3/12/2012 07:30:00 PM   0 comments

Saturday, February 25, 2012

Morula or Raspberry ?


posted by joe @ 2/25/2012 10:41:00 AM   3 comments

Monday, December 12, 2011

The Sartorius Muscle

The other night I awakened with severe muscle pain(cramp) in my leg. As usual I got up to stretch by walking around. This time no improvement. It hurt so bad I thought I was going to vomit. The next morning I decided it was my sartorius. Located in the medial thigh, the Taylor's muscle responds to sitting cross legged or putting your foot on your opposite knee and pressing the knee toward the floor. This is the longest muscle of the body and crosses 2 joints(hip and knee). Hope you never have a sartorius spasm but if you do now you know how to treat it.

posted by joe @ 12/12/2011 08:26:00 PM   1 comments

Disclaimer: This blog is for entertainment purposes. If you need a doctor, call a nurse. If you are a doctor, practice at your own risk.