William F. Keenan, MD




Dark lesion

April 01, 2010

This lesion looks suspiciously like a malignant melanoma.

Inflammatory Seronegative Arthritis

September 14, 2005

The 83-year-old woman whose hands are shown in photograph A had a severe flare of arthritis in the metacarpophalangeal and proximal interphalangeal (PIP) joints after corticosteroid therapy for her asthma was stopped. The clue to the diagnosis of psoriatic arthritis is in her fingernails, which show both pitting and onycholysis.

Chigger Bites in a Young Boy

September 14, 2005

This young boy complained of itchy lesions after he spent a day in a semiwooded area. The lesions appear urticarial, but note that the pattern of eruption is over areas of constrictive clothing: the arm of a shirt and the belt.

Chigger Bites at Waist

September 14, 2005

Several hours after returning from a walk in tall grass, a 9-year-old boy began to complain about intense itching around his waist, lower back, and upper arms. Wheals developed on these areas.

Remitting Seronegative Symmetric Synovitis With Pitting Edema

September 14, 2005

Abrupt onset of symmetric inflammatory arthritis and edema, as seen on the dorsum of this 72-year-old man's hand, is characteristic of remitting seronegative symmetric synovitis with pitting edema-or RS3PE. The work-up of this patient was essentially negative for other types of inflammatory arthritides.