Tinea Pedis and OnychomycosisA 50-year-old man had a long-standing rash on both soles. The patient’s toenails were yellow and dystrophic. These physical findings strongly suggested moccasin- variety tinea pedis and onychomycosis (also called tinea unguium)—two often concurrent infections.
Keratosis Pilaris<div id="article-content-body"><p>For 2 months, an asymptomatic rash had been present on the upper arms of a 16-year-old boy of normal weight. The rash, as seen on the patient’s right arm, consisted of abundant fine papules. He had no other lesions. </p></div>
Port-Wine Stain<div id="article-content-body"><p>A 10-month-old infant was referred for evaluation of possible Sturge-Weber syndrome. According to his parents, the discoloration on the child’s face was present at birth.</p></div>
Acute pericarditis<div id="article-content-body"><p>A 35-year-old woman (gravida 3, para 2) presented at 25 weeks’ gestation with a 24-hour history of continuous, pressure-like, retrosternal chest pain, radiating only to the back. The pain worsened when she lay down, took deep inspirations, or coughed; it diminished when she leaned forward. </p></div>
Baghdad Boil<div id="article-content-body"><p>A 33-year-old active-duty soldier who had been in Iraq for 6 months presented with a depressed lesion on his left lateral elbow of several months’ duration. It was neither healing nor enlarging. (The yellowish tint to the skin in the photograph was from a topical <span class="DrugLink">iodine<span></span></span> solution.) In Iraq, he was a truck driver and often slept in the cab of his vehicle.</p></div>
Tinea Manuum<div id="article-content-body"><p>For years, a 39-year-old man had an eruption on his hand, which seemed to be controlled with topical corticosteroids. The patient was a rancher. The lesion’s well-defined annular, scaly border raised suspicion of tinea manuum, which was confirmed by a <span class="DrugLink">potassium hydroxide<span></span></span> evaluation.</p></div>
Rapid-Acting Insulin<div id="article-content-body"> <p>Apidra (insulin glulisine injection) from Aventis is approved by the FDA for use in adult patients with type 1 or type 2 diabetes mellitus for the control of hyperglycemia. Compared with human insulin, Apidra has a more rapid onset and a shorter duration of action.</p> </div>
Ruptured Aortic AneurysmSevere abdominal pain radiating to the back prompted a 72-year-old man to go to the emergency department (ED). The patient had experienced similar pain 2 days earlier and was treated at another hospital for renal colic on the basis of concomitant microscopic hematuria.
Sebaceous Cyst<div id="article-content-body"><p>A painless swelling on the dorsum of the scalp had been present for many years in a 36-year-old man. An increase in the size of the lesion prompted the man to seek medical evaluation. Les Trope, MD, Hillel Trope, MD, and Shlomo Trope, MD, of New York included a lipoma and a kerion (a condition associated with tinea infections) in the differential diagnosis.</p></div>
Steroid-Exacerbated Tinea Corporis<div id="article-content-body"><p>The continuous use of a corticosteroid cream briefly relieved the pruritus of an annular, papulosquamous eruption on the left anterior thigh of a 50-year-old woman. The lesion was present for 6 months and grew larger with application of the topical corticosteroid.</p></div>
Long-Standing Tinea Corporis<div id="article-content-body"><p>For more than 20 years, a 55-year-old man had a faintly erythematous, papulosquamous rash with arciform borders on his groin and waistline. The rash had been treated with a variety of medications. Topical and oral antifungals and antibiotics and topical corticosteroids had been used but to no avail. </p></div>
Tinea Corporis<div id="article-content-body"><p>For 1 year, a 30-year-old man had an intermittent rash that was confined to the area of his jockey shorts; no other part of the body was affected. The patient reported that the pruritic eruption arose and disappeared spontaneously and was more prominent during the heat of summer. </p></div>
Peroneal Ganglion<div id="article-content-body"><p>A 7-year-old boy presented with an asymptomatic cystic lesion on the lateral aspect of the left ankle of 4 months’ duration. There was no history of trauma. The mass fluctuated in size; it was smaller when the child was recumbent and larger when the child was upright.</p></div>
- Hypertensive crises encompass a spectrum of clinical situations that have in common elevated blood pressure (BP) and progressive or impending target organ damage.