Ted Rosen, MD

A 49-year-old woman insidiously developed spotty depigmentation of the chest along with thickened and bound-down skin of the upper torso. In addition, all of her fingers were swollen and her facial skin became so tight that she had difficulty smiling. What is her diagnosis?

A 74-year-old, previously healthy, nonsmoking Caucasian male presented with a 4-month history of an asymptomatic “lump” in the navel. Biopsy of the umbilical nodule revealed adenocarcinoma. The most likely primary site of this patient’s malignancy is . . . ?

A 34-year-old, ostensibly healthy Caucasian male presented with a 3 cm × 3 cm solitary skin lesion located on the distal portion of the dorsal aspect of the right arm. The lesion first appeared during the patient’s last year in high school, approximately 17 years earlier.

A 46-year-old woman presented for medical evaluation due to a 2-month history of increasing difficulty in ambulation, especially getting up out of a chair or climbing stairs. She had also noticed swelling and discoloration of both upper eyelids (as depicted) and some small erythematous papules on the dorsum of several fingers on both hands.

A 60-year-old woman developed metastatic renal cell carcinoma and was given oral sorafenib (400 mg twice daily). However, 3 weeks after commencing treatment, the patient became febrile without signs of localized infection and rapidly developed a nonpruritic, slightly tender cutaneous eruption. What is your diagnosis?

Toward the end of his second cycle of therapy, a 56-year-old man with RCC developed minimally pruritic, bright red erythema and fine scale involving both sides of the scrotum. What is your diagnosis?