A 60-year-old man who is HIV positive presents with fever, dyspnea, and inflammatory lesions on the skin. A biopsy reveals a diagnosis of histoplasmosis. At what threshold should antiretroviral therapy (ART) be initiated in adults with HIV?
Figure 1
Do you recognize this adverse drug reaction?
A 58-year-old male with a history of rosacea presents with blue-black discoloration on his neck and face that worsens after sun exposure. What drug is the most likely cause of this reaction?
Quiz: How would you treat this tumor?
A 21-year-old female presents with a six-month history of irregular menses, decreased libido, impaired vision, and galactorrhea. An MRI is completed.Based on this imaging and the patient’s clinical findings, which of the following should be recommended as a first-line treatment?
Do You Recognize This Blistering Pruritic Rash? Â
A 4-year-old boy with known G6PD deficiency is brought to the pediatrician by his mother with a blistering pruritic rash. On examination, numerous tense vesicles and bullae are seen on his neck, lower abdomen, and extremities. Ulcerative lesions on his buccal mucosa are also noted. Direct immunofluorescence of a skin biopsy later reveals linear deposits of immunoglobulin A (IgA) at the dermoepidermal junction. Which of the following treatments is recommended for this patient?
Quiz: A Case of Broken-Heart Syndrome
A 67-year-old woman presents to the emergency room with acute chest pain and dyspnea after the death of her husband. She is hypotensive, tachycardic, and diaphoretic. A diagnosis of takotsubo cardiomyopathy is suspected. Which of the following findings best confirms this diagnosis?
What infection preceded this rash?
An 8-year-old boy is brought to the pediatrician by his mother over concerns of a new-onset rash. He is otherwise healthy, though his mother mentions that he was unwell two weeks prior to the rash appearing. On examination, numerous small salmon-pink scaly papules are seen on his trunk and extremities. Which of the following infections most likely preceded this cutaneous eruption?
What’s causing this patient’s diminished femoral pulses?
A 56-year-old man presents with a three-month history of erectile dysfunction and bilateral buttock pain on exertion, but not at rest. His past medical history is significant for type 2 diabetes, dyslipidemia, and hypertension. Examination reveals bilaterally diminished femoral pulses. What is the most likely diagnosis?
A Creeping Eruption
A 40-year-old male presents to his family physician with a pruritic, erythematous lesion on his foot after returning from vacation in coastal Brazil a week earlier. On examination, a serpiginous, slightly elevated tunnel can be seen on the lateral aspect of his left foot. He is otherwise well, but mentions that the intense pruritus is disturbing his sleep. Which of the following treatments is the next best step?
Is this patient high-risk?
A 55-year-old female presents with a low-grade fever, a new heart murmur, and Janeway lesions one week following a dental cleaning, and a preliminary diagnosis of infective endocarditis is made. Prophylactic antibiotics are administered prior to dental cleanings to prevent endocarditis in patients considered to be high-risk. Which of the following valvular conditions requires prophylactic antibiotics prior to dental cleanings?
Quiz of the Week: Painful urination, a swollen knee, and eye pain—what’s the cause?
A 31-year-old female presents to the emergency department with a two-day history of pain on urination and discomfort in her left knee and heel. She also complains of right eye pain, which is exacerbated by reading and bright lights. She recently recovered from a gastrointestinal illness two weeks earlier, but is otherwise healthy. Examination reveals a swollen left knee that is warm to the touch, and tenderness at the insertion point of the left Achilles tendon. Her right eye is red, and she has direct and consensual photophobia. Cells and flare are noted in the right anterior chamber on slit lamp examination. Based on this patient’s probable diagnosis, which of the following cutaneous manifestations is most likely?