no longer supports your web browser (Internet Explorer version 9 or lower). See what browsers we support.

Harvard Medical Student Sees New-To-Him Rash, Uses VisualDx to Learn

dsap.jpgJonathan F., a 4th year medical student at Harvard, writes about how VisualDx helped him understand his patient's condition and write up a detailed consult note for his attending.

"A patient recently diagnosed with AML (acute myeloid leukemia), after initiating decitabine chemotherapy, presented with scattered erythematous, scaly lesions on his bilateral arms and legs. He was seen by dermatology with concern for a drug eruption. Sharing my exam and initial impressions over the phone with my attending, he immediately thought of disseminated superficial actinic porokeratosis, which I had never seen before. Using VisualDx, I was quickly able to pull up photos of the condition and confirm the similarity to the appearance of our patient. I also was able to quickly educate myself about DSAP through the well-written article on VisualDx, which was a huge help in writing my consult note!"

*Disseminated superficial actinic porokeratosis pictured here is not patient in this case study. See more pictures of DSAP in VisualDx.

So, what exactly is DSAP?

DSAP is a common form of porokeratosis. The lesions are slightly elevated keratotic papules distributed symmetrically on sun-exposed skin. During the summer, DSAP patients can experience increased symptoms (pruritus, burning sensation, etc.)

What should we be aware of when making a diagnosis?

Look for:

Small, annular, minimally elevated papules (2-5 mm), which

  • Can number in the hundreds
  • Color: can be flesh-colored, brownish-red, or brown
  • A distinct scaly ridge

*Dermoscopy is helpful in differentiating porokeratosis from other lesions.

How can we treat this?

  • Advise patients to avoid strong sunlight.
  • Advise patients to use a broad-spectrum sunscreen (against UVA and UVB) with SPF of 35 or greater.

VisualDx has more content about topical therapies for DSAP. Launch VisualDx now to learn more or start your free 30-day trial of VisualDx today.

It's easy to share your VisualDx story. Fill out this quick form with as much clinical presentation detail as possible, but do not include identifiable information (including patient names or recognizable patient details). 

About VisualDx

VisualDx is an award-winning diagnostic clinical decision support system that has become the standard electronic resource at more than half of U.S. medical schools and more than 1,500 hospitals and institutions nationwide.  VisualDx combines clinical search with the world's best medical image library, plus medical knowledge from experts to help with diagnosis, treatment, self-education, and patient communication. Expanding to provide diagnostic decision support across General Medicine, the new VisualDx brings increased speed and accuracy to the art of diagnosis. Learn more at