Author: April Walnofer, BA
Co Author #1: Cara Conrad, BA
Co Author #2: John D. Bailey, DO
Co Author #3: Michelle Boyd, ATC
Senior Editor: Marc Hilgers, MD, PhD, FAMSSM
Editor: Leigh Romero, MD, ATC, LAT
Patient Presentation:
A 23-year-old male collegiate quarterback presented to the university's athletic training staff with blistering skin lesions on his hands. He was returning to football practice after working in construction over the summer. The athlete's symptoms progressed to include lesions on both arms and face. The lesions became larger, more tender, and fragile. Dark colored scarring on his hands also appeared. The lesions on his hands were so tender he could not touch the football. Use of synthetic gloves did not help. The athlete had no systemic symptoms.
History:
He had no significant medical history. His family history was significant for cancer and hypertension. He was drinking 7-8 alcoholic drinks twice a week and had previously used tobacco products.
Physical Exam:
Vital Signs: blood pressure 128/81 mmHg, heart rate 80 beats per minute, temperature 98.8 degrees Fahrenheit, respiratory rate 18 breaths per minute, body mass index 26.7
His physical examination was benign except for his skin exam which showed multiple lesions on both hands, arms, and face. These lesions were in various stages of healing along with areas of hyperpigmentation. The lesions were tender to palpation without warmth, fluctuance, or surrounding edema. Case Photo #1 Case Photo #2
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