panniculitis<p><img src="/sites/default/files/images/Screen%20shot%202012-02-09%20at%2011.37.00%20AM_thumb.png" width="90" height="90" style="float: left; margin: 5px;">The parents of a 9-month-old boy were concerned about the enlarging areas of reddish discoloration on his cheeks.</p>
pyomyositis<p><img src="/sites/default/files/images/Screen%20shot%202012-02-09%20at%2011.36.03%20AM_thumb.png" width="90" height="90" style="float: left; margin: 5px;">Six days after a 28-year-old man had been thrown from an all-terrain vehicle, he presented to the emergency department with intractable pain in the left buttock and leg, along with difficulty in walking.</p>
dermatographism<p><img src="/sites/default/files/images/Screen%20shot%202012-02-09%20at%2011.35.03%20AM_thumb.png" width="90" height="90" style="float: left; margin: 5px;">When this patient’s skin is briskly stroked with a firm object (such as the edge of a tongue depressor or the edge of a fingernail), a linear wheal with a flare immediately develops and typically lasts about 30 minutes.</p>
cutaneous reaction<P class=p5><SPAN class=s2><EM><IMG style="MARGIN: 5px; FLOAT: left" src="/sites/default/files/images/Screen%20shot%202012-02-09%20at%2011.33.36%20AM_thumb.png" width=90 height=90></EM>Several sharply demarcated round discrete erythematous lesions were noted over a 67-year-old man's left gluteal region. </SPAN>It was subsequently revealed that the patient was applying the rivastigmine patch over this region.</P> <DIV><EM><BR></EM></DIV>
Vasculitis<p>Cocaine abuse can be dangerous, deforming, and fatal. Among the host of adverse effects are an association with hepatitis C followed by cirrhosis, as well as aortic dissection, seizures, interstitial lung disease, and vasospasm and thrombosis with lethal consequences, including ischemic bowel, digital, or limb necrosis, and myocardial infarction. Recently, a novel vasculitis has been added to this growing list of serious complications.</p>
eosinophilia<p><img alt="" height="90" src="/sites/default/files/images/1202Con_WDDRESS_FaceFg_thumb.jpg" style="float:left" width="90" /><br /> A 12-year-old girl had fever, headache, nausea, and a papular and bullous rash of 4 days’ duration. The rash initially appeared on the dorsal surfaces of the hands and feet and spread centrally to involve most of her body surface.</p>
MRSA, Thrombosis<p>2 cases of adults with MRSA infections complicated by left transverse, sagittal cerebral venous thromboses with septic emboli to the lungs and bilateral iliac vein thrombosis, respectively.</p>
radiology<p><img alt="" height="90" src="/sites/default/files/images/1202Con_PERadio1_Vent_thumb.jpg" style="float:left" width="90" />A 72-year-old woman who had fallen and injured the left side of her chest came to the emergency department complaining of pain in that area. She was physically stable and not short of breath. A soft systolic murmur was heard over the left precordium; the lungs were clear. A posteroanterior chest film showed no rib fracture but it did show an enlarged heart and a large, calcified ventricular aneurysm (arrow).</p>
Abuse<p>Although the prevalence of intimate partner violence in the United States is arousing increased alarm, its importance as a <em>medical</em> issue is less acknowledged. Recently, however, in a consensus report on women’s health, the Institute of Medicine recommended screening and counseling all women and adolescent girls for interpersonal and domestic violence as part of preventive health services.</p>
Eye PainWoman with eye swelling and pain diagnosed with periorbital cellulitis after CT scan showed proptosis of the eyeball with rectus muscle hypertrophy.
EdemaA 61-year-old man presents with swelling and discoloration of his face and neck of several weeks’ duration. He noted tightness of his shirt and tie, which has worsened.
dermatophyte infections, carcinoma, Folliculitis<p><em><img src="/sites/default/files/images/1202Con_DC_C2_0_thumb.jpg" width="90" height="90" style="float: left; margin: 5px;"></em>One month earlier, 3 hard, nontender nodules erupted on the scalp of a 74-year-old woman. She denies using any new hair treatments or shampoos. She has taken a diuretic for hypertension for several years and has not started any new medications.</p><div><em><br></em></div>
GastroenterologyMany gastrointestinal diseases are inherited or have a genetic predisposition involved in disease expression.
Polypharmacy<p>I have reached a select milestone: I receive <em>AARP</em> magazine. I guess I can confess that I am no longer a “spring chicken.” Also age-appropriate, I take 4 to 5 medications for chronic conditions (hypertension for one) and, as a result, have become empathetic to patients who are receiving 5 or more pharmaceuticals. Unfortunately, as the number of medicines increases, so do adverse drug events (ADEs). Elderly patients are particularly susceptible to ADEs.<sup>1</sup> How can we mitigate the dangerous epidemic of polypharmacy-induced adverse events?</p>