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Ebola virus and Marburg virus are responsible for Ebola hemorrhagic fever (EHF) and Marburg hemorrhagic fever (MHF), respectively.

Ebola Hemorrhagic Fever and Marburg Hemorrhagic Fever

A 67-year-old woman noted the appearance of several non-tender, rock-hard, purple-colored nodules on her legs. Her medical history was significant for distant non-Hodgkin lymphoma.

A 67-year-old woman noted the appearance of several non-tender, rock-hard, purple-colored nodules on her legs. Her medical history was significant for distant non-Hodgkin lymphoma. The violaceous color and configuration of the skin lesions suggests which of the following? 

Clinical Topics

Hard Purple Nodules: Your Dx?

During a routine skin examination, a papule of several years' duration is noted on the upper lip of a 71-year-old man. The patient states that the lesion has been slowly enlarging; it does not bleed even during shaving.

This long-standing papule has been slowly enlarging. Its pearly translucence suggests a skin cancer. What's your impression?

Slowly Progressive Pearly Papule

A 9-year-old boy presented with a 1-week history of pruritus and rash on his elbows, knees, back, and legs. Several areas of excoriation were noted. He had recently run through a field of tall grass but denied any other exposure history.

A 9-year-old boy presented with a 1-week history of pruritus and rash on his elbows, knees, back, and legs. He had recently run through a field of tall grass but denied any other exposure history. Your Dx?

What Cause of This Itchy Rash?

A 76-year-old woman seeks your attention for an asymptomatic “red spot” on her neck. She has a history of multiple non-melanoma skin cancers.

Squamous cell carcinoma in situ (Bowen  disease)

Lichenoid keratosis (an inflammatory variant of seborrheic keratosis)

A 76-year-old woman seeks your attention for an asymptomatic “red spot” on her neck. What does this look like to you?

What's This "Red Spot"?

Acromegaly was diagnosed in a 36-year-old woman who presented with loss of vision in the right eye that had initially involved the peripheral field. MRI scans of the brain revealed a 6 × 6 × 4-cm sellar mass with suprasellar and parasellar extension encasing the right cavernous sinus and carotid artery.

A. Excess growth hormone production from the pituitary gland as a result of a functional adenoma is the most common cause.

B. It remains undiagnosed for up to 10 years on average.

C. The diagnostic test of choice is an oral glucose tolerance test.

D. End-organ manifestations (eg, arthropathy, cranial nerve palsies, diabetes) contribute to overall mortality increase.

Acromegaly was diagnosed in a 36-year-old woman who presented with loss of vision in the right eye that had initially involved the peripheral field. Which statement about acromegaly is NOT true?

Acromegaly: A Pop Quiz

Five days after a 41-year-old man started taking a new medication, this superficial but painful lesion appeared on his neck. It slowly resolved after the drug was stopped and a topical corticosteroid was applied twice daily.

Five days after starting a new medication, this lesion appeared on a man’s neck. It slowly resolved after the drug was stopped. Which of these drugs do you suspect might have caused the lesion?

Round Red Patch on a Man's Neck

Alan M. Spira, MD

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