Practice Management
Download the article PDF: A 59-Year-Old with a Painful Finger Skin Lesion A 59-year-old woman presents with a painful skin lesion near her fingernail which has developed over the past week. She reports a history of advanced non-small cell lung cancer, for which she was recently started on erlotinib. On examination you observe a glistening, hemorrhagic papule at the lateral nail fold with surrounding erythema and edema. The patient denies trauma or exposure to skin …
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A 41-year-old male presents with knee pain after playing basketball in his driveway with his teenage son. He reports that he had sudden pain and heard a “pop” as he landed after jumping. He is unable to fully extend his leg. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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A 62-year-old woman presents with a rash that appeared simultaneously with the onset of ipsilateral facial palsy. She reports severe ear pain in the affected ear, along with hearing loss. Physical examination reveals grouped bullae and vesicles on an erythematous base ipsilaterally involving the auricle, external ear canal, and tympanic membrane, as well as the mouth and anterior two-thirds of the tongue. View the image taken and consider what your diagnosis would be.
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Figure 1: Initial ECG (Case presented by Benjamin Cooper, MD, MEd, FACEP, Department of Emergency Medicine, McGovern Medical School at UTHealth Houston.)
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A 46-year-old female presents with an evolving eruption that developed on her right hand and spread to her forearm over the past several weeks. She is an immunocompetent commercial landscaper who lives in Brazil, and she does not recall any specific injury. She is regularly exposed to toxic plants and sustains minor scratches and cuts at work. She also suspects that she could have experienced bug bites. She appears well and is without systemic symptoms. …
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A 40-year-old male presents with pain and swelling in his right eye after being struck by a foul ball while coaching his daughter’s softball game. View the images 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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A 61-year-old female with a past medical history of hypertension presents to urgent care with palpitations and shortness of breath for 3 days. She also reports cough and fever, and denies nausea or vomiting. View the initial ECG 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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A mother brings her 7-year-old son to your urgent care center because she’s concerned about asymptomatic lesions that have developed on his knees over the past couple of weeks. On examination, you observe smooth, crusted and scaly, erythematous and whitish papules and nodules on both knees. There was no history of recent trauma. The patient had a history of dermatomyositis. View the image and consider what your diagnosis and next steps would be. Resolution of …
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The patient is a 12-year-old boy who presents with pain after his foot became wedged in an escalator at the mall. The image on the left was taken upon presentation; the one on the right is from a 2-week follow-up. Review each 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 38-year-old female who presents with persistent pain in her left thumb. She explains that she was bitten approximately 2 months prior. There is redness and swelling to the proximal phalanx area. The patient is febrile. View the x-ray and consider what your diagnosis and next steps would be. Resolution of the case is described on the next screen.
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