Skin lesions and the role of the internist: a series of clinical cases

The skin often acts as an indicator of underlying internal diseases and skin lesions that are difficult to diagnose are one of the reasons for hospitalization in internal medicine departments where patients frequently arrive after a long journey between different dermatology specialists and after ineffective or sometimes responsible for diagnostic delays. In this article, we will illustrate three clinical cases observed in our General Medicine Unit of the Ospedale del Mare in Naples in the last year that are characterized by diagnostic errors that misled our attention, the notable difficulty in the diagnostic classification, and the duration of hospitalization necessary to reach the correct diagnosis. The first case is that of a patient diagnosed with violin spider lesions who, after a 2-week hospitalization, was discharged with the diagnosis of non-Hodgkin’s lymphoma. In the second case, the patient was hospitalized for suspected lesions caused by Burger’s disease and was instead discharged with a lesion caused by mycosis fungoides. The third case is that of a patient hospitalized for suspected vasculitis and discharged with the diagnosis of drug-induced toxic epidermal necrolysis.