Abstract
A 68-year-old, disheveled gentleman presents with a report of itchiness over his upper body for several months. On examination, there are thick, erythematous plaques with overlying scale and excoriations along his arms and torso. He cannot recall if he has ever had similar lesions or been given a diagnosis of psoriasis. Because of concern for a malignant process, you recommend a biopsy. When explaining your reasoning, he repeats the same questions and appears confused. Because of your uneasiness, you ask him for his name, the date, and where he lives. He quickly responds with his correct name, but then pauses. Although he gives the correct month and day, he believes the year to be 1995. He is also unaware of his street address, despite knowing the state. He denies being accompanied by a family member, but informs you that his neighbor drove him here.
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