Infectious Disease

The patient knew that he had psoriasis, but failed to connect onychodystrophy to his underlying skin disease.

Pitted keratolysis is caused by pedal hyperhidrosis and subsequent overgrowth of bacteria that produce proteinases that dissolve keratin and lead to pit formation.

Spontaneous pneumomediastinum with subcutaneous emphysema is rare. Alveolar rupture allows air to enter the pulmonary interstitium and penetrate the mediastinum.

For many patients with diabetic peripheral neuropathy, severe pain can be controlled to a degree sufficient to improve their quality of life. Here: effective management strategies, including topical agents, oral medications, and nonpharmacological therapies (eg, acupuncture and transcutaneous nerve stimulation).

Common MS exacerbation triggers: infection, vaccination, stress, smoking, vitamin deficiency, or environmental changes.

This was presumed to be an ectoparasite bite when the patient reported that she had a new pet kitten. A myriad of diagnostic possibilities exist, including the start of a drug eruption or viral infection, early allergic contact dermatitis, or first manifestation of an autoimmune bullous disease.

Epidermoid cysts may be treated with intralesional injections of phosphatidylcholine to avoid potential recurrence, eliminate scarring, and reduce cost.

Autosomal dominant polycystic kidney disease (ADPKD) is common. Presenting symtpoms include hypertension, hematuria, proteinuria, and renal insufficiency.

For most patients who have had low back pain for less than 6 weeks, there is little need for imaging studies.

Is the increased risk of IBD due to pollution, a too-clean home, or antibiotics? Or none of the above?

Leishmaniasis remains an important infection which can be “imported” from endemic foci, such as the Middle East.

Benign mucous membrane pemphigoid is an autoimmune disease; that involves the oral mucosa and eyes. Clinical signs: edematous bright red gingiva and bullae formation.

This itchy, scaly rash extending from the underarm onto the upper arm was tinea corporis.

A 58-year-old man with a past medical history of chronic sinus disease and hypothyroidism presented with left periorbital pain and erythema that worsened despite outpatient treatment with topical antibiotics. An outpatient CT scan showed pansinusitis and orbital stranding. The diagnosis was orbital cellulitis and sinusitis.

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

A boil, painful and nasty: Is it a cyst? Is it a bug bite? Should you culture? Is it MRSA? How should you treat it? What if it recurs? Listen and learn.

A 32-year-old woman presents with a swollen, painful fourth digit on the right hand. While housecleaning, a traumatic erosion developed on the ipsilateral hyponychium.

Would you treat the elevated A1C aggressively-and what would your target level be? Would you consider statins? Dr Shahady invites your insights.

Here: a review of the potential health effects of bed bugs, diagnosis and treatment, and comments about future directions in bed bug control and public health efforts to manage the pest.

What is causing this clubbing of the fingernails, and what is it called?

A 45-year-old woman noted painless, red, crusted papules on the hand. This was followed by the appearance of deep, slightly tender red nodules on the arm and ipsilateral axillary adenopathy.

A 92-year-old woman presented with a 6-month history of progressively worsening fatigue, weight loss, generalized bone pain, and dyspnea on exertion. A skeletal survey found lytic lesions in the pelvis, sacrum, and calvarium (shown here).

With no history of papulosquamous skin disease (eg, psoriasis), a solitary, well-demarcated, bright red scaly patch should suggest either superficial basal cell or in situ squamous cell carcinoma.

Did you know: The hepatitis B virus is the only human virus that is routinely tested for by measuring a marker, or “footprint,” of the virus in the blood? Here, an explanation for this and 4 more things you need to know about HBV.

Obtain an accurate food/water ingestion history; be suspicious of bacteria, protozoa, and environmental toxins; educate patients on good kitchen hygiene. Here, a few more essentials to keep in mind when you suspect a foodborne illness.

An 82-year-old woman presents with a persistent “face sore,” which she ascribed to repeatedly and frequently blowing her nose during a recent upper respiratory infection.

A 58-year-old man presents with myalgias of approximately 1 week’s duration. He had been recently treated for sinusitis and symptoms resolved. His only medications were hydrochlorothiazide for hypertension and simvastatin for hyperlipidemia. He and his wife had gone camping 1 month before this visit.

A woman in her 20’s presents for care after 9 days of sore throat and subjective fevers followed by neck stiffness that developed over the last 2 to 3 days. The pain is exacerbated by swallowing and any neck motion. She has had sore throats before, but never this bad or this long and never that made her neck stiff.