A message from Renata Block, MMS, PA-C, President, SDPA
By Susan K. Smith, DMSc, PA-C
By Mandy Frith, DMSc, MPAS, PA-C
By Parth S. Patel, DMSc, MPAS, PA-C
By Sara M. Wilchowski, MS, PA-C
By Jennifer M. Orozco, DMSc, PA-C, DFAAPA Jennifer M. Orozco, DMSc, PA-C, DFAAPA, is Director of Advanced Practice Providers at Rush University Medical Center in
The purpose of this article is to review the diagnosis of atopic dermatitis along with various disease mimickers. Traditionally, atopic dermatitis is a clinical diagnosis with distinctive history, morphology, and distribution of pruritic eczematous lesions aiding in determining the condition and treatment. However, multiple other conditions may mimic atopic dermatitis, requiring further workup. We review diagnostic mimickers of atopic dermatitis and divide them into four major categories: immunodeficiencies, malignancies, nutritional deficiencies, and systemic disease. In addition, we organize a workup to be considered if there is a high suspicion for something other than atopic dermatitis. Although there are multiple other conditions that can mimic atopic dermatitis, there are gaps in not only considering them, but also in recognizing when to proceed with further workup and what to include.
Merkel cell carcinoma (also called primary neuroendocrine carcinoma of the skin) is a rare and aggressive skin cancer. Because of its variable clinical appearance, its diagnosis is often delayed. Here we present an atypical case of this tumor in an elderly Black man who experienced diagnostic delay, and eventually, fatal metastases. Primary neuroendocrine carcinoma is difficult to treat and often requires a multi-disciplinary approach. This case report highlights the importance of early diagnosis, and this tumor’s appearance in skin of color individuals, who are affected relatively infrequently.