Race for the Case

Race for the Case is a clinical quiz feature published quarterly in DermWorld Directions in Residency — and right here!

Answer the questions below to enter. Looking for the Winter 2024 answers? Review them now. To submit cases and questions, email Victoria Houghton at vhoughton@aad.org.

Diagnose this new case by Bryan Daines, DO

A 60-year-old male with a history of coronary artery disease, hypertension, hyperlipidemia, and gastroesophageal reflux disease presented to the emergency department due to multiple painful skin lesions that arose after the patient went camping locally two weeks prior. The patient reported subjective fevers and chills prior to hospital admission. The patient also reported blood in his stool for the past few months. The patient was started on broad spectrum antibiotics by primary care prior to dermatology consultation.

1. Initial biopsy results favored histiocytoid Sweet’s syndrome. What is the initial treatment for histiocytoid Sweet’s syndrome?

2. Lesions resolved after treatment, but subsequently recurred. Repeat biopsy showed CD-30+ lymphocyte aggregates. What is the most likely diagnosis?

3. Which other lymphoproliferative disorder should also be considered that is CD-30+?

4. If symptomatic, what is the best treatment for the patient's condition?

5. 25% of patients with this condition have an antecedent, concurrent, or subsequent malignant lymphoma. Which lymphoma is most common for these patients to have?

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