Book contents
- Frontmatter
- Contents
- Preface
- Acknowledgments
- Prologue
- Introduction
- 1 The Case of Black Sweat
- 2 A Case of Hives That Wouldn't Go Away
- 3 The Painful Bath
- 4 A Shower of Hives
- 5 A Premenstrual Rash
- 6 Uncombable Hair
- 7 The Man Who Couldn't Sweat
- 8 Scratch Blisters
- 9 Skin Deep Photography
- 10 The Bug That Never Was
- 11 Blue Spots
- 12 White Spots
- 13 Same Place, Next Time Rash
- 14 The Brown Spots That Wouldn't Go Away
- 15 The Case of the Painful Fingertips
- 16 A Strange Sunburn
- 17 A Multiple Personality Dermatitis
- 18 Accidental Hives
- 19 Rotten Fish Odor
- 20 Hormone Blisters
- 21 Flower Shop Itch
- 22 “Stress and a Penny” Hives
- 23 The Case of Unilateral Wrinkles
- 24 Fiery Red Legs
- 25 Painful Feet
- 26 Hot Flashes and Cold Cream
- 27 The Blisters and the Skin Test
- 28 A Chilling Pain
- 29 Rough Skin and Sore Throats
- 30 The Premenstrual Purple Chin
- 31 Nine Year Hives
- 32 Golf Course Dermatitis
- 33 The Secret Message
- 34 Herpes Gladiatorum
- 35 Sunshine Allergy
- 36 L'homme Rouge
- 37 Rings of Rash
- 38 The Breasts That Never Stopped Growing
- 39 The Minister's Hives
- 40 Hardened Skin
- 41 Battery Blisters
- 42 Swollen Lips
- 43 The Worm from Outer Space
- 44 A New Light on Psoriasis
- 45 Black and Blue Spots
- 46 The Emergency Room Itch
- 47 The Sleeper
- 48 A Crazy Rash
- 49 Bald Spots
- 50 The Dog Died
- 51 The Abacus Tumor
- 52 No Spit
- 53 The Smell of Burnt Toast
- 54 The Twenty-Three Year Itch
- 55 The Mysterious Treatment
- 56 The Creeping Acne Cyst
- 57 Our First Case
- 58 A Strange Case of Acne
- 59 The Case of the Glass Eye
- 60 The Hand Eczema Caper
- 61 The Sore That Would Never Heal
- 62 Black Blisters
- References
- Index
61 - The Sore That Would Never Heal
Published online by Cambridge University Press: 23 November 2009
- Frontmatter
- Contents
- Preface
- Acknowledgments
- Prologue
- Introduction
- 1 The Case of Black Sweat
- 2 A Case of Hives That Wouldn't Go Away
- 3 The Painful Bath
- 4 A Shower of Hives
- 5 A Premenstrual Rash
- 6 Uncombable Hair
- 7 The Man Who Couldn't Sweat
- 8 Scratch Blisters
- 9 Skin Deep Photography
- 10 The Bug That Never Was
- 11 Blue Spots
- 12 White Spots
- 13 Same Place, Next Time Rash
- 14 The Brown Spots That Wouldn't Go Away
- 15 The Case of the Painful Fingertips
- 16 A Strange Sunburn
- 17 A Multiple Personality Dermatitis
- 18 Accidental Hives
- 19 Rotten Fish Odor
- 20 Hormone Blisters
- 21 Flower Shop Itch
- 22 “Stress and a Penny” Hives
- 23 The Case of Unilateral Wrinkles
- 24 Fiery Red Legs
- 25 Painful Feet
- 26 Hot Flashes and Cold Cream
- 27 The Blisters and the Skin Test
- 28 A Chilling Pain
- 29 Rough Skin and Sore Throats
- 30 The Premenstrual Purple Chin
- 31 Nine Year Hives
- 32 Golf Course Dermatitis
- 33 The Secret Message
- 34 Herpes Gladiatorum
- 35 Sunshine Allergy
- 36 L'homme Rouge
- 37 Rings of Rash
- 38 The Breasts That Never Stopped Growing
- 39 The Minister's Hives
- 40 Hardened Skin
- 41 Battery Blisters
- 42 Swollen Lips
- 43 The Worm from Outer Space
- 44 A New Light on Psoriasis
- 45 Black and Blue Spots
- 46 The Emergency Room Itch
- 47 The Sleeper
- 48 A Crazy Rash
- 49 Bald Spots
- 50 The Dog Died
- 51 The Abacus Tumor
- 52 No Spit
- 53 The Smell of Burnt Toast
- 54 The Twenty-Three Year Itch
- 55 The Mysterious Treatment
- 56 The Creeping Acne Cyst
- 57 Our First Case
- 58 A Strange Case of Acne
- 59 The Case of the Glass Eye
- 60 The Hand Eczema Caper
- 61 The Sore That Would Never Heal
- 62 Black Blisters
- References
- Index
Summary
“I've had this sore on my chin for twelve years. It never heals. Can you help?” asked a fifty-four-year-old man. Ordinarily, a sore that does not heal is a skin cancer. But, three skin biopsies taken of the sore never showed any evidence of cancer. Nor was there any evidence of a draining sinus from an infected tooth. In fact, he had had excellent dental care with annual x-rays of his teeth, all totally normal.
Here was a man in excellent health with a sore that waxed and waned, but never completely healed. We secured a fourth skin biopsy and did bacterial and fungal cultures. Again, there was no cancer or other definable skin disease, such as scarring lupus erythematosus. There were also no pathogenic bacteria present or any evidence of the actinomycetes which cause the chronic ulceration of actinomycosis. X-ray of the jaw showed no osteomyelitis or other bone change. Again, the biopsy showed only nonspecific inflammatory changes.
The sore was never itchy, but our patient readily admitted to picking at the spot, trying to remove the crusts and debris. Sometimes, he felt that underlying ingrown hairs were responsible. We wondered if his constant picking of the chin could be a compulsive tic. This proved not to be the case, as psychotropic drugs had no effect.
At the time of his first visit, the sore was an open ulcer about a quarter of an inch in diameter.
- Type
- Chapter
- Information
- Consultations in DermatologyStudies of Orphan and Unique Patients, pp. 188 - 190Publisher: Cambridge University PressPrint publication year: 2006