A 69-year-old man with stage II chronic kidney disease due to hypertension fell from his bicycle and presented to the emergency department (ED) with abrasions, ecchymoses, and a 3-cm laceration on his right leg. The patient was an avid cyclist. His wounds were cleaned and the laceration sutured. There were no fractures, and the patient was discharged home.
This 40-year-old man presented with fever and a generalized, painful, nonpruritic rash of 2 days’ duration. The rash first appeared on his face then spread to his hands, buttocks, and lower extremities. Two weeks earlier, he had an episode of severe rhinitis followed by high fevers, chills, muscle aches, and ankle pain.
A 38-year-old man found lying on the floor in his home was hospitalized because of alcohol intoxication. A chest radiograph showed a large calcified lesion in the left upper abdomen. A CT scan with intravenous contrast revealed a large, well-defined, cystic mass with mural calcification in the spleen. The CT findings were not consistent with a vascular malformation or echinococcal cyst—specifically, the mass was sharply demarcated, unilocular without septations, and round with a thin wall and attenuation similar to water. Urine Histoplasma antigen test results were negative.
During a skin cancer screening, a 45-year-old male soldier was noted to have bilateral subcutaneous nodules on the dorsa of his feet. The patient reported that the nodules had remained unchanged since they first appeared in his early 20s and were asymptomatic. He had no other lesions.
For several months, a 43-yearold woman had erythematous plaques on the cheeks that were more prominent on the right side. The patient had no pruritus but reported occasional facial burning. She had tried overthe- counter lotions but no medicated or corticosteroid topical preparations. She was otherwise healthy and was currently taking no medications.
A 61–year–old man presented to the emergency department with diffuse lower abdominal pain, nausea, and severe diarrhea (20 episodes within the past 12 hours). His symptoms began the night before and had gradually worsened. He denied fever. His medical history was significant for hypertension.
During a new-patient evaluation, a 49-year-old Hispanic man was found to have several nontender, hard nodules protruding from the lingual area. The nodules had evolved slowly over several years. The patient reported no trauma to the area. He was a long-time smoker and took no medications. His medical and family histories were unremarkable.
Six days ago, a 36-year-old man had noticed a dark spot in the field of vision of his left eye. Now the spot more closely resembled a line. He denied other changes in his vision and had not seen any floaters or flashing lights.
Six months after testing positive for HIV in 10 bands, a 24-year-old homosexual man presented with a macular rash on his palms and soles. He first noticed the lesions 2 weeks earlier; they were not pruritic or painful. He also had a brighter, more inflamed rash in the groin and antecubital fossae that was presumed to be a yeast infection and was treated with fluconazole. He had no other symptoms.
Hidradenitis suppurativa is a chronic acneiform infection of the cutaneous apocrine glands.