The Clinical Picture

Methemoglobinemia in an HIV patient

He had restarted his home dapsone prophylaxis, but his dyspnea worsened and his urine became dark.

The Clinical Picture

Paraneoplastic acral vascular syndrome

The patient presented with a painful blue great toe, abdominal pain, and unintentional weight loss.

The Clinical Picture

Erythema ab igne

The patient had been using a heating pad daily, often for several hours at a time, to relieve his back pain.

The Clinical Picture

The Leser-Trélat sign

The patient presented with night sweats, dry cough, weight loss, and sudden onset of “itchy moles” on her back.

The Clinical Picture

Scapular rash and endocrine neoplasia

A woman in her 30s presents with an itchy skin-colored rash over her scapula of 8 years’ duration.

IM Board Review

Fever after recent travel

The patient had been taking a TNF-alpha inhibitor and had recently returned from Mexico.