Today's Lesson

To change it up from my previous post, which was about my initial impressions of medical education research, this post will be about a clinical experience I had today. I saw several interesting cases, including dermatomyositis. Although I had read and seen photographs of clinical signs of dermatomyositis, it was a great learning experience to see the findings in an actual patient. The characteristic heliotrope rash was very obvious, as were the Gottron’s papules, and both her cheeks were erythematous. However, the patient insisted that it had taken a long time for her to be diagnosed, despite repeated visits to her family doctor. We also had an insightful discussion on the pros and cons of awaiting an official diagnosis before initiating therapy. In the end, it was decided that she should have a muscle punch biopsy to seal the diagnosis prior to initiating treatment. As the patient was getting ready to leave, we returned to her room to give her a bloodwork requisition and I was surprised to see that her face was completely clear and rash-free. How had her rash miraculously disappeared? She replied that she had just applied camouflage make-up to conceal the redness. Even upon closer inspection, I could not see any traces of make-up, which leads me to believe that make-up really can do wonders. It also turns out the patient had been wearing make-up at each of her family doctor visits, thus camouflaging her rash. The moral of the story? Don’t conceal a rash with make-up before visiting a doctor.

-Laura