NYC Health + Hospitals Resident Uses VisualDx for Diversity in Images

Andy D., a resident at NYC Health + Hospitals, describes how he uses VisualDx to see images and descriptions of conditions on varying skin types:

VisualDx is a great teaching tool. When students rotate through our clinic, we can show them common and uncommon presentations of different skin conditions. For example, a 3-year-old Caribbean-American boy presents with violaceous to hyperpigmented patches in antecubital fossa, which is consistent with a flare of his atopic dermatitis. Using VisualDx, students can see how this common condition may appear in different skin types.

What is atopic dermatitis?

Atopic dermatitis (eczema) is a chronic, relapsing, pruritic condition that is often associated with allergic rhinitis and/or asthma. Infants and children are most often affected, with 85% of cases appearing in the first year of life, and 95% of cases appearing by 5 years. Uncommonly, the condition may persist into, or even arise in, adulthood. Less than 1% of adults are affected by atopic dermatitis.

What should we be aware of when making a diagnosis?

In darker skin colors, erythema may be subtle and overlooked, including in patients with erythroderma. Gentle pressure to blanch areas of involvement may help reveal subtle erythema upon removal of pressure on skin. Look for the presence of vesicles in acute eczema; scaling, desquamation, hyperpigmentation, erosions, and crusts in subacute eczema; and hyperpigmentation, lichenification, scaling, and desquamation in chronic eczema.

How can we treat this?

Intermittent topical corticosteroids are used to treat disease flares. Class 6-7 topical steroids can be used on the face, and mid- to high-potency preparations can be used on the trunk and extremities.

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