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Curious Crosses: Injection-Induced Lesions

Skin biopsy provided an elusive diagnosis and evidence that the patient had likely omitted important information during medical interviews. A 43-year-old man with a history of alcohol and opioid use was admitted to the inpatient ward from the infectious disease clinic. For 2 weeks, he had experienced recurrent, painful skin nodules that expressed bloody, purulent […]

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Skin Lesion with Splenic Microabscesses in a Patient with Acute Myeloid Leukemia

  A 42-year-old male patient with acute myeloid leukemia was admitted to the hospital to start induction chemotherapy with idarubicin, cytarabine, and cytarabine. He was started on levofloxacin and fluconazole as prophylaxis. On day 14 post chemotherapy, he developed fevers along with a skin rash on his torso and extremities. Assessment Physical examination was notable for […]

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woman scratching her inflamed neck

Scabies Outbreak in the 14th Century: Clues from Correspondence Between Poets

  The deleterious effects of scabies, an infestation of the skin by the human itch mite Sarcoptes scabiei var. hominis, were well known in the Middle Ages. Here we report descriptions of medieval “itch” by Francesco Petrarca (1304-1374), called the “Father of Humanism,” and Giovanni Boccaccio (1313-1375), 2 eminent Italian poets who influenced further famous artists such as Shakespeare and Chaucer. […]

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Ongoing Pleuritic Chest Pain and a Guinea Pig: Missed Pulmonary Embolism and Majocchi’s Granuloma

A 27-year-old woman presented for a second opinion with chest pain, dyspnea, and a worsening rash with new pustules. Three weeks before presentation she developed a small rash on her anterior right lower abdomen. After treatment with topical hydrocortisone and mupirocin, oral valganciclovir and clindamycin, the rash increased in size, developed central clearance, and became warm […]

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Painful Violaceous Purpura on a 44-Year-Old Woman

Returning to the fundamentals of our medical training, eliciting a full social history, including the use of illicit drugs, can be the key to making a correct diagnosis. This point is illustrated in the following case. A 44-year-old woman with a past medical history notable for asthma and heroin abuse, presented to the Emergency Department […]

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