new medications<div id="article-content-body"> <p>Ezetimibe/simvastatin (Vytorin) recently became available for the treatment of high LDL cholesterol levels, as adjunctive therapy to dietary modification, in patients with primary hypercholesterolemia or mixed hyperlipidemia. This drug, from Merck/Schering-Plough Pharmaceuticals, inhibits the production of cholesterol in the liver and blocks the absorption of cholesterol in the GI tract, including cholesterol obtained from food.</p> </div>
Oral and Perioral Lesions<p><img src="/sites/default/files/old/img_4dbc2b842b78e.jpg" alt="Figure 3" style="float: left; margin-left: 8px; margin-right: 8px;" width="150" height="119"></p><p>For several months, a 26-year-old woman has had papules and erythema around her mouth that she self-treated with her husband’s topical <span class="DrugLink">clobetasol<span></span></span>. The initially minor eruption has persisted and worsened.<strong></strong></p><p><strong>What is responsible for this rash?</strong></p>
Sprained ankle<p><img alt="" src="/sites/default/files/images/acute-ankle-pain-runner.jpg" style="height:169px; margin-left:8px; margin-right:8px; width:150px; float:left" />A healthy 23-year-old woman, who is a longtime runner, calls your office the day after she tripped on a tree root while running in the woods and twisted her right ankle. She noted immediate pain on the lateral side of the ankle but did not hear or feel a pop. She was able to bear weight and walked out of the woods. However, as she walked, the ankle became more painful and began to swell. When she reached home, she applied a heating pad and rested the ankle. The next morning she noted increased swelling and moderate discomfort while walking.</p>
Gastric Obstruction<div id="article-content-body"><p><img src="/sites/default/files/images/Gastric%20Outlet%20Obstruction2.jpg" style="float: left; margin-left: 8px; margin-right: 8px;" width="150" height="192">For 2 weeks, a 60-year-old man had severe nausea and vomiting. Two years earlier, he had had a cholangiocarcinoma, which was treated with palliative cholecystectomy followed by a course of rebeccamycin, an investigational chemotherapeutic agent.</p></div>
Treatment of Protozoal Diarrhea in Children<div id="article-content-body"><p>Nitazoxanide (Alinia), from Romark Laboratories, has been approved by the FDA for the treatment of children who have diarrhea caused by protozoa.</p></div>
Abdominal Pain<p><img alt="Figure 2" height="114" src="/sites/default/files/old/img_4dbc2b7e270d8.jpg" style="float:left" width="150" />A 23-year-old woman presents with weight loss, epigastric pain, abdominal fullness, and mild nausea. She reports that she has had a slow-growing mass on her upper middle abdomen.</p>
Cleidocranial DysostosisThese findings are consistent with the midline fusion anomalies typically seen in cleidocranial dysostosis.
Vulvar Intraepithelial Neoplasia<div id="article-content-body"><p><img src="/sites/default/files/images/Vulvar%20Intraepithelial%20Neoplasia.jpg" style="margin-left: 8px; margin-right: 8px; float: left;" width="150" height="113">A 67-year-old woman presented with a painful genital ulcer. She denied new sex partners and previous genital lesions.</p></div>