Tag Archives: diagnosis
(A) Skin impairment. Papulonodular skin lesions on the tip of the nose, from 3 to 10 mm, characteristic of sarcoidosis: firm, nonedematous, noninflammatory, nonpainful, nonpruriginous, with predominant facial involvement. (B) Endoscopic view (right nasal fossa) showing a major mucosae thickening. (C) Numerous uniform circumscribed nests of non-caseating granulomata which are characterized by the paucicity of lymphocytes and absence of necrosis.

Skin and Nasal Involvement: Look for Sarcoidosis!

  Sarcoidosis is a systemic, noncaseating, granulomatous disease affecting young adults between the ages of 25 and 40 years, most often of Black origin (35.5/100,000 vs 10.9 in the White population). Although the lower respiratory tract is affected in 90% of cases, ear, nose, and throat locations are very uncommon, with a prevalence varying between […]

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Photograph of the patient's face shows bilateral periorbital ecchymosis (raccoon eye appearance).

Raccoon Eye Appearance: Amyloidosis

To the Editor: An 82-year-old woman presented to our outpatient clinic with a 6-month history of recurrent internal bleeding near the eyes. The patient had a history of type 2 diabetes mellitus, but had no significant medical history including traumatic injuries. Physical examination revealed bilateral periorbital ecchymosis and large tongue (Figure). Serum protein electrophoresis revealed […]

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A Depressing Diagnostic Error

To the Editor: A 52-year-old woman with diabetes presented to the hospital with acute onset of right flank pain, in the setting of profound lower extremity weakness and cachexia with a 30-lb unintentional weight loss over the past 6 months. She was diagnosed with ascending pyelonephritis and treated with empiric antibiotics. On hospital day 2, […]

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Magnetic resonance imaging brain lesions typical of multiple sclerosis.

Multiple Sclerosis Re-Examined: Essential and Emerging Clinical Concepts

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by exacerbations of neurological dysfunction due to inflammatory demyelination. Neurologic symptoms typically present in young adulthood and vary based on the site of inflammation, although weakness, sensory impairment, brainstem dysfunction, and vision loss are common. MS occurs more frequently in women […]

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Increased Vulnerability to Poorer Cancer-Specific Outcomes Following Recent Divorce

Prior studies have only considered the association between static marital status and cancer-specific outcomes. We aim to measure the effect of recent divorce on cancer-specific outcomes. Methods There were 83,804 patients with 2 malignancies, diagnosed 12 to 60 months apart, from 1973-2006 from the Surveillance, Epidemiology, and End Results database. Patients were identified as newly […]

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The patient had multiple telangiectasias. (A) These were evident on the fingertips. (B) The oral mucosa was also affected.

Site-Seeing: Hereditary Hemorrhagic Telangiectasia with Native-Valve Endocarditis

A 69-year-old Japanese man had 2 disparate illnesses with a comparable sign. The first, an undiagnosed genetic disease, made him more susceptible to the second. He was admitted to our hospital after reporting a 1-month history of chills, malaise, anorexia, pain in the left knee, and blurred vision in the right eye. He denied urinary […]

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