Clinical Image Challenges

The patient is a 71-year-old female with type 2 diabetes who calls attention to a rash on her shins during an annual physical. The rash appears to be pink, atrophic scars surrounded by hyperpigmented patches. They have developed since her last physical. She denies discomfort but is concerned as to what could have caused them. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (!–nextpage–> Differential Diagnosis Diabetic dermopathyLichen planusNecrobiosis lipoidicaStasis dermatitis Diagnosis This patient …
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The patient is a 31-year-old woman who presents with new-onset cough and decreased breath sounds to the lower lobes. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page …
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The patient is a 57-year-old female with a history of coronary artery disease, congestive heart failure, and left ventricular thrombus on warfarin who presents with shortness of breath. She denies any bleeding, bruising, dark-colored stools, chest pain, fever, cough, or leg pain. On evaluation, the patient’s vital signs are normal. She is breathing comfortably and speaking in complete sentences. View the ECG and consider what your next steps and diagnosis would be. Resolution of the case is described on the next page. (Case presented by Tom Fadial, MD, The University …
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A 70-year-old female with history of coronary artery disease presents to urgent care with nonradiating chest pain of 2 days’ duration. She has a known history of left bundle branch block. Figure 1 Baseline ECG: Figure 2: Baseline ECG View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Benjamin Cooper, MD, McGovern Medical School, Department of Emergency Medicine, The University of Texas Health Science Center at Houston.) …
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During a regular check-up, a mother remarks that her 8-year-old son had developed clusters of follicular, scaly papules bilaterally on his knees and elbows “over the past few weeks.” They didn’t seem to bother him, but because her son is prone to allergies the mother wondered if changes in household substances like soap or laundry detergent could be responsible. View the photo and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page …
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