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01/2009
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Clinical vignette: A 25
year old woman from South America was referred to
the internal medicine service because of itching and
the development of an eruption consisting of dark
lesions in her extremities and her body. She was 32
weeks pregnant. Obstetrically, she was gravida 5 and
para 2, 0, 2,2.
DIAGNOSIS AND MANAGEMENT
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04/2007
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Clinical vignette: A 66
year old woman presented with odynophagia of 5 days
duration. She specifically complained of pain in the
left side of the face and jaw radiating all the way
to the angle of the jaw.
DIAGNOSIS AND MANAGEMENT
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02/2007
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Clinical vignette: A 31 year old
vegetarian healthy woman presented with a history of a
bothersome rash of 3 days duration. It began in the back
and it was associated with mild pruritus. There was no
history of travel, sexually transmitted disease, viral
infections or contact with pets.
Dr. Ingrid Solomon
The Gordon Clinic.
Florida, USA
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01/2007
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Clinical vignette: A
49 year old man with history of diabetes mellitus, type
1, presented with history of scalp lesions associated
with mild pruritus of several weeks duration.
DIAGNOSIS AND MANAGEMENT
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13/2006
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Clinical vignette: 41 year old man
presents for evaluation because of chest pain. He has a
strong family history of coronary artery disease.
DIAGNOSIS AND MANAGEMENT
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12/2006
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Clinical vignette: A 29 year old man
born in South Florida of Nicaraguan parents presented
for an employment physical examination.
DIAGNOSIS AND MANAGEMENT
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11/2006
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Clinical vignette: 89 year old woman
with a long history of arthritis presented with redness
and tenderness in the left foot.
DIAGNOSIS AND MANAGEMENT
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10/2006
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Clinical vignette: A
43-year-old man with history of IV drug use and HIV
infection previously presented with a history of itching
and a skin eruption of several days duration. He denied
any changes in medications or habits. He claimed that he
was “clean: of illicit drugs. Several weeks prior the
patient had been released from a correctional
institution.
DIAGNOSIS AND MANAGEMENT
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09/2006
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Clinical vignette:A
76-year-old woman was seen for primary care. She
complained of dizziness and was found to be
hypertensive. This a
photograph of her face.
DIAGNOSIS AND MANAGEMENT
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08/2006
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Clinical vignette:A
64 year old woman with history of diabetes mellitus,
type 2, presented with 2 week history of left lower back
pain radiating to the buttocks. She has a history of
osteoarthritis. On review of systems, the patient
reported a skin lesion in the left buttocks appearing in
the past month. On physical examination she appeared to
be in moderate pain, 7/10 as described above. She had
exquisite tenderness over the left femoral trochanter, a
skin lesion in the mid-buttocks photographed here, and
signs of osteoarthritis and mild spondylolisthesis in
the lumbar spine.
DIAGNOSIS AND MANAGEMENT
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07/2006
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Clinical vignette:42
year old man with history of intravenous drug use and
recurrent incarcerations diagnosed 2 months prior to
this visit with non-Hodgkin’s lymphoma. The patient had
a very irregular antiretroviral regimen due to denial,
poor compliance and incarcerations.
At this time, he complained of severe sore throat and
odynophagia. His last laboratory studies revealed the
following:CD 4 19
cells/cubic ml, CD4 6.4%, CD4/CD8 0.15
HIV RAN PCR 84,320 viral
particles/microliter
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06/2006
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Clinical vignette: A
66 year old man employed in the Brinks Security
trucos presented with
history of breaking a glass accidentally in his home and
sustaining a laceration in the right knee.
He was examined, the wound cleansed and treated with a
tetanus booster. He missed the “wound check” visit 24
hours paster sutures were
applied because he could not get out of work.
DIAGNOSIS AND MANAGEMENT
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05/2006
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Clinical vignette:
A 52 year old man presents with history
of a lump in the volar side of his right thumb.
He is a carpenter by profession but has not done any
carpentry in many years. The lump appeared about two
years ago. He has an otherwise negative medical history
except for hypercholesterolemia.
DIAGNOSIS AND MANAGEMENT
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04/2006
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Clinical vignette:
64
year old who became a widow after his wife died of
ovarian cancer several years ago went down to Panama and
returns now with itching in his right elbow.
The patient denies fever, malaise, or systemic
complaints.
DIAGNOSIS AND MANAGEMENT
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03/2006
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Clinical vignette: 76 year
old man with history of left hand lesion.
According to both the patient and his wife this was the
result from a bite from some unidentified insect.
DIAGNOSIS AND MANAGEMENT
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02/2006
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Clinical vignette:
66 year old woman presented with history of lesions in
the skin since 5 days prior.
She denied any significant past medical history before
this event.
DIAGNOSIS AND MANAGEMENT
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01/2006
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Clinical vignette: This is a 17
year old girls who presented to an outpatient center complaining
of swelling and pain in the right axilla. She has no history of
diabetes or other illnesses in the past.
DIAGNOSIS AND MANAGEMENT
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