Holocaust Survivor: An Incidental Finding
An 87-year-old woman who recently moved to an assisted living facility from her home is seen for evaluation of facial edema and erythema after a bee or wasp sting sustained 2 days earlier. Patient denies pain, pruritus, or visual changes.
HISTORY
An 87-year-old woman who recently moved to an assisted living facility from her home is seen for evaluation of facial edema and erythema after a bee or wasp sting sustained 2 days earlier. Patient denies pain, pruritus, or visual changes. She took one dose of diphenhydramine shortly after the event and has noticed that the edema, which affected primarily the right side of the face, near the sting, has improved.
PHYSICAL EXAMINATION
Ambulatory, well-dressed woman in no acute distress. She is alert and pleasant, with clear but rambling speech consistent with her known mild dementia. Vital signs are stable. Skin is slightly warm; erythematous flat area periorbitally and extending down the right cheek. Erythema faintly crosses the bridge of the nose and is minimal on the left side of the face. Left forearm with the tattoo illustrated.
"WHAT'S YOUR DIAGNOSIS?"
ANSWER: HOLOCAUST CAMP SURVIVOR
Figure – Patient shows very little facial wrinkling. Expression is normal and friendly. Remnants of bee sting–related changes are minor, and the cellulitis that followed has cleared with antibiotics.
The crude tattoo on this woman's forearm constitutes a "human label" that includes a unique identification number used in a concentration camp. The same kind of mark was made, often even less neatly, on all other inmates of her camp. The "A" represents Auschwitz, the infamous work and death camp. The Nazis' "final solution" was designed to kill all Jews worldwide.1 This woman was at Auschwitz for part of the Holocaust, and then was moved to another camp, Maidanek.
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