The Hazards of Winter: A Photo Quiz on Seasonal Conditions

January 17, 2014

Many medical disorders occur more frequently in the cold, dry weather of the winter season. Take this week’s photo quiz to test your knowledge of these hazardous conditions.

Question 1:

A 17-year-old Caribbean-American female presented with a 1-month history of violaceous papules, petechiae, and healing ulcerations on the distal digits of both hands and feet. Her fingers had become cold and white intermittently during the winter months. She did not have fever, chills, or cough. Dermatoscopic evaluation revealed dilated capillaries of the proximal nail folds.

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Question 2:

Pneumonia is more likely to occur during the winter months than in other seasons. Chest radiographs help reveal areas of consolidation or interstitial disease in young patients-the pattern of abnormal findings provides a clue to the causative agent.

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Question 3:

The patient’s condition, known as “winter itch,” occurs primarily in the very cold weather. This red plaque developed after she had habitually scratched the xerotic skin on her legs. The dermatosis usually occurs on the anterolateral aspect of the lower legs. Initially, the skin becomes dry and scaly, then red plaques develop from scratching. The erythematous skin can resemble cracked porcelain or “crazy paving.”

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Question 4:

A 56-year-old man sought medical attention because of the sudden appearance of a rash on the trunk and extremities. Immediately before presentation, he had a severe upper respiratory tract infection, which included pharyngitis. He has psoriasis.

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Question 5:

This 5-year-old boy’s condition typically occurs in late winter and early spring and at an early school age. He presented with an asymptomatic lacy, reticular rash. It began with the appearance of a solid red rash on his cheeks, then the lacy rash covered his entire body and the solid rash on his cheeks became lacy. He has fifth disease.

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Question 6:

A 20-year-old woman presented in mid-winter with a mildly painful, swollen, and discolored left toe and several small pruritic lesions on the toes of both feet. Similar lesions had intermittently appeared and resolved over the winter months. There was no history of trauma to her feet or excessive cold exposure.

The red-purple papules, patches, and plaques develop on the extremities in nonfreezing cold or damp conditions

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Question 7:

A 62-year-old woman was evaluated in preparation for cholecystectomy. She had a purplish red lace-like pattern on the skin, with mottling most prominent on the thighs and forearms. She said that the rash became more pronounced when she was exposed to cold.

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ANSWER KEY:

Question 1. D

Question 2. C

Question 3. C

Question 4. D

Question 5. D

Question 6. A

Question 7. B