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Chest computed tomography (CT) and skin and kidney biopsies.

Overlapping Syndrome of Systemic Scleroderma and Cryoglobulinemic Vasculitis

A 58-year-old woman with a 10-year history of Raynaud phenomenon presented with moist cough, and a 2-month progression of general edema and relapsing digital ulcer of the toes. Physical examination revealed fine crepitations in the lungs, sclerodactyly with digital ulceration, pretibial edema, and extremities with eczema-like eruptions (Figure 1B ). Her C-reactive protein and serum […]

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Multiple vesicular lesions on an erythematous base.

Fever and Rash in an Adult: Varicella Re-infection in Conjunction with Newly Diagnosed Chronic Lymphocytic Leukemia

A 36-year-old otherwise healthy white man presented to our hospital with fever and generalized rash. Symptoms initially started with a few painless, nonpruritic “pimples” at the back of his scalp that he had noted after a haircut. Within 24 hours, the lesions spread to his face, neck, and trunk. They continued to evolve despite empiric […]

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The patient's daughter provided us with these cell phone pictures (we obtained her written permission for publication); this first figure shows initial white plaques suggesting possible thrush.

Giant Cell Arteritis Presenting with a Tongue Lesion

An 83-year-old woman presented to our hospital with a 2-month history of progressive weight loss, weakness, and recent odynophagia. Her daughter first noticed her tongue with white plaques about 2 weeks prior to our admission (Figure 1). She was admitted to another hospital, treated for thrush, and discharged. Her tongue surface then developed a whitish […]

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Swelling on the upper lip (black arrow).

Strawberry Marks on Lip

A 32-year-old male patient presented with enlargement of his upper lip since childhood, which was compromising his facial aesthetics, as well as causing inability to close the mouth completely. History revealed the presence of a red spot on his lower lip when he was 2 months old, and it had increased considerably ever since. The […]

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Raised nodular lesions on patient's shins at presentation.

Nodular Thyroid Dermopathy: Not a Hallmark of Graves Disease

  A 40-year-old man presented to the outpatient department with complaints of multiple, nontender, raised nodular lesions on his shins bilaterally for the past year (Figure 1). The lesions had an insidious onset and were progressively increasing in size. He was evaluated at an outside clinic. Biopsy was performed multiple times, and possibility of spindle […]

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The patient also had hemorrhagic necrosis of the skin and soft tissue of the right thigh.

A Genetic Origin? Purpura Fulminans

Over days, a patient’s relatively small lesion evolved into widespread tissue damage. A previously healthy 49-year-old Arab woman was admitted for a 2-cm painful red lesion on her left breast. She had been well until a few days earlier, when she developed left flank pain and was treated with ofloxacin for a presumed urinary tract […]

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