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.

Photo Quiz: A Human Parasite

Here is an easy one for you. This is a picture of a small part of a human parasite I took with a Celestron LCD Digital Microscope.
What is it?

Derm Photo Quiz: An Interesting Rash

This case involves a 67 year old, diabetic man who has taken no medications for the last 4 years except for a daily aspirin. He presented to my clinic for the first time in over four years with a 2 week history of a rash that started on his right arm as seen below. His left arm had a similar appearance.
The rash then spread to the rest of the right arm and all extremities. The rash was initially pruritic but by the time of the visit the itching had resolved. He denied any recent OTC medication use except for the daily aspirin. He denied any new or unusual foods or contacts. He was feeling well. He denied fever, nausea, vomiting, diarrhea, abdominal pain or headache. He denied any recent tick bites or possible exposure to ticks. His trunk showed no lesions but his legs were affected as seen below.



Lab work revealed: glucose 281, creatinine 0.9, sodium 134, total bilirubin 1.50, direct bilirubin 0.30 (both slightly elevated), AST 42, ALT 72, CRP 0.2, WBC 4,800 a with normal differential, platlets 92,000. He was seen by a dermatologist that day, and given a provisional diagnosis. A biopsy was done which confirmed the diagnosis. What was the diagnosis?