Reference no: EM133805847

Question

The patient is a 49-year-old female who comes in with the complaint of having bumps on her arms. She states some of the bumps have been there a long time. Recently the bumps have been increasing in number and size. She was last seen about two years ago for eczema and was prescribed cyclosporine, at that time. However, she did not have these bumps. The bumps are not itchy or painful. Objective: Very pleasant, alert, and oriented x3 female in no apparent distress. A full integumentary exam of the upper arms was performed today. The left radial aspect demonstrated erythematous macules. The right ulnar aspect demonstrated actinic keratosis. Bilateral hands appeared dry with linear excoriation and fissuring of her fingertips. Bilateral upper arms demonstrated superficial and deep masses. Deep subcutaneous masses are mobile and may represent lipomas. Superficial masses appear to be sebaceous cysts. Assessment and Plan: Actinic keratosis of the right ulnar aspect was treated with liquid nitrogen. Possible lipomas: Schedule surgical biopsy of larger masses. Sebaceous cysts: Punch biopsy performed today; await pathology report. Apply Neosporin to biopsy site. Start Hydrocortisone intensive cream. Start Prednisone as directed.