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Four Cancers and a Rash: Henoch–Schönlein Purpura

A patient who had a history of 4 primary malignancies developed a rash that is usually seen among children. The 65-year-old man presented with a 2-day history of anasarca, painless skin lesions, and new arthralgias in both hands. He had a previous diagnosis of amyotrophic dermatomyositis, and although he had none of the typical skin […]

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Doubly Dangerous: Extranodal NK/T-Cell Lymphoma

The patient’s disease was already very advanced when the diagnosis was determined, and a hazardous complication was developing as well. A 63-year-old woman presented with a 2-month history of symmetrical violaceous swelling of the face (Figure 1A). Faint violaceous patches also marked her neck, upper chest, upper back, and both arms (Figure 1B). In addition, she had been […]

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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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Rare but Revealing

A Rare but Revealing Sign: Necrolytic Migratory Erythema Rash can signal any number of disorders, from the relatively minor to the life-threatening. For a 62-year-old woman, an unrelenting skin complaint proved to be evidence of an unusual disease. She presented with a 2.5-year history of an intermittent pruritic rash in her underarms and gluteal cleft […]

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Web of Confusion

The occurrence of a late-stage complication in a patient with early disease, reminds us that any illness can take an unpredictable course. A 63-year-old man presented with complaints of fatigue and rash. He had been in his usual state of health until approximately 2 months prior, when he developed decreased visual acuity in his right […]

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