Case Questions
Chief Complaint: I have bumps around eyes
Demographic
Age: 50
Biological sex: Female
Race: White
Ethnicity: Not Hispanic or Latino
Medications
Atorvastatin
Before you continue, what questions do you want to ask this patient?
ROS
Constitutional: Denies
Genitourinary: Denies
ENT: Denies
Musculoskeletal: Denies
Cardiovascular: HLD
Neurologic: Denies
Pulmonary: Denies
Psychiatric: Denies
Endocrine: Denies
Immunologic: Denies
Dermatological: Denies
Hematologic: Denies
Gastrointestinal: Denies
Obstetrical: Denies
Naji FS, Hajmiri MS, Mazari Z, et al. Erdheim-Chester disease with long-standing diabetes insipidus and generalized edema. Clin Case Rep. 2021;9(10):e04898. Published 2021 Oct 4. doi:10.1002/ccr3.4898 (image cropped)
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None required for this patient
Format: [Testing] [Reason]
Example: Fundus photos to rule out retinal disease
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Xanthelasma
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Educated patient on findings. Referred patient to PCP and cardiologist for systemic evaluation of cholesterol levels and cardiovascular risk management. Discussed that treatment for xanthelasma is cosmetic and does not address underlying systemic issues. Offered referral to oculoplastic surgery for consideration of removal with surgical excision, laser therapy, or chemical cauterization if desired for cosmetic reasons. Emphasized that recurrence is possible even after removal. RTC in 6 months to monitor ocular health or sooner if any changes are noted.
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Educated the patient on the diagnosis of xanthelasma palpebrum. Explained that xanthelasma are cholesterol-rich plaques that typically form on the eyelids and, while benign, can be a marker for elevated lipid levels and increased cardiovascular risk.