Mubashir Shah, MD

A 62-year-old woman presented with a rash and intermittent pain of the right upper quadrant. The reticular, brown hyperpigmentation was also seen on her right flank and around the umbilicus. The patient reported that she often applied heating pads to these areas for pain relief.

A 74-year-old man had vague abdominal pain, jaundice, pruritus, gray stools, and dark urine. A painless, palpable mass in his right upper quadrant was found at examination.

A 78-year-old man presented to theemergency department with a 3-weekhistory of progressive shortness of breathand cough with blood-streaked, yellowishsputum. The patient had dyspnea onexertion limited to 2 blocks, 2-pilloworthopnea, paroxysmal nocturnal dyspnea,and nocturia. Neither fever norchills were present. He had lost 7.2 kg(16 lb) during the last year.

A 62-year-old woman presented with a rash and intermittent pain of the right upper quadrant. The reticular, brown hyperpigmentation was also seen on her right flank and around the umbilicus. The patient reported that she often applied heating pads to these areas for pain relief.