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

Drug reaction or metastatic lung cancer?

Imaging shows nodules randomly distributed throughout both lungs, a paradoxical reaction to drug therapy.

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.

IM Board Review

Big heart, small ring

A 58-year-old man has stopped wearing his wedding ring, and his wife suspects him of having an affair.