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Worsening painful ulcers on both legs prompted a 62-year-old woman to seek medical attention. She had a history of rheumatoid arthritis (RA), demonstrated by the markedly deformed interphalangeal joints in her thumbs (A), and scleroderma-polymyositis overlap syndrome.

A 74-year-old woman presented with a refractory pruritic eruption. Four months earlier, she had sought evaluation of a thickened, slightly crusted 6 3 8-cm patch on her right ankle of 2 months' duration. Contact dermatitis with secondary impetigo from scratching was suspected, and a topical corticosteroid and an oral antibiotic were prescribed.

I often drive home key points I make to patients by drawing on the paper cover on the examining table. A graph, a key lab value, an anatomical aid--indeed, any kind of visual aid--is likely to help patients "get" the concept I am trying to explain.

The sharply demarcated, smooth red plaques on this 3-year-old's tongue had been present for several months.

Over the past 20 years, the treatment armamentarium for diabetes has greatly expanded: 8 different classes of non-insulin drugs and 8 different types of insulin are now available. The newer classes of agents include disaccharidase inhibitors, thiazolidinediones, meglitinides, glucagonlike peptide analogs, and dipeptidyl peptidase IV inhibitors.

CHICAGO -- Physicians will be able to report smoking-cessation counseling efforts soon using two new Current Procedural Terminology (CPT) codes that address tobacco use specifically.

SYDNEY, Australia -- Stretching before or after exercise won't spare either elite athletes or weekend warriors from muscle soreness one to three days later, investigators here have found.

PHILADELPHIA -- Ulcerative colitis patients had up to a 50% reduction in colectomy risk at one year when treated with infliximab (Remicade), found pooled results of trials at two doses.

SYDNEY, Australia -- Traditional Chinese remedies may ease painful menstrual cramps better than nonsteroidal anti-inflammatories (NSAIDs) and other drugs, according to a Cochrane systematic review.

NEWCASTLE, Australia --Three antifibrinolytic agents each reduced blood loss and red-cell transfusions associated with elective surgery, without an increased risk of thrombosis, according to a literature review.

LIVERPOOL, England -- Amniotomy during a spontaneous birth did not reduce the time of labor or improve the condition of the newborn, according to a systematic review of the literature.

PHILADELPHIA -- The benefits of screening colonoscopy extend to patients 80 and older, according to two studies reported here.

STANFORD, Calif. -- In mid-level coronary artery disease, outcomes are about the same for either angioplasty or bypass graft surgery, found researchers here.

PHILADELPHIA -- Most patients with gastroesophageal reflux disease continue to have reflux, despite twice-daily dosing with a proton pump inhibitor, according to results of a study reported here.

PHILADELPHIA -- The FDA has approved topotecan (Hycamtin) capsules for treatment of relapsed small-cell lung cancer, GlaxoSmithKline has announced.

SAN FRANCISCO -- Acupuncture immediately before surgery may reduce postoperative pain, allowing for lower opioid analgesic doses, researchers said here.

ATLANTA -- Invasive infections of methicillin-resistant Staphylococcus aureus (MRSA) may be more common than suspected, according to the first nationwide surveillance estimates.

ROCKVILLE, Md. -- The FDA said today it has received 30 reports of acute pancreatitis in patients taking exenatide (Byetta) for treatment of type 2 diabetes.