Heart Failure

Cardiovascular Clinical Consult

Adult Immunization

Hepatic Disease 

Behcet’s Disease

Rare Disorders

Pediatric Immunization

Implementing The Topcon Ocular Telehealth Platform

Weight Management

Screening

Monkeypox

Guidelines

Men's Health

Panic Disorder  

Anxiety

Eating Disorders

Depression

Substance-related Disorders

ADHD

Psychiatry 

Seasonal Allergies

Allergy

Nutrition 

Pregnancy and Birth

Women's Health

Atrial Fibrillation

Cholesterol Disorders

Cardiovascular Disease

Hypertension

Cardiology

Substance Use

Child/Adolescent

Pediatrics

Kidney Disease

Genetics

Medical Cannabis

Complimentary & Alternative Medicine

Skin Diseases

Dermatology

Thyroid Disorders 

Diabetes

Diabetes Type 2

Insulin

Endocrinology 

Oral Medicine 

Otorhinolaryngologic Diseases

Fibromyalgia

Pain

Irritable Bowel Syndrome 

Inflammatory Bowel Disease

Gastrointestinal Disorders

Geriatrics

Coronavirus

Hepatitis C

Cold, Cough, and Flu

Bacterial Conjunctivitis

Immunization

Influenza

HIV AIDS

Sexually Transmitted Diseases

Infection

Osteoporosis

Imaging 

Musculoskeletal Disorders  

Obesity

Rheumatoid Arthritis

Arthritis

Gout

Rheumatology

Technology

Colorectal Cancer

Kidney Cancer

Lung Cancer

Melanoma

Skin cancer

Prostate Cancer

Breast Cancer

Cervical Cancer

Cancer

Nephrology

Anemia

Dementia

Epilepsy

Cerebrovascular Diseases

Headache and Migraine

Parkinson Disease

Alzheimer disease

Stroke

Mental Health

Headache

Migraine

Nervous System Diseases

Sleep Disorders

Neurology

Asthma

Cystic Fibrosis

COPD

Pneumonia

Respiratory Diseases

Pulmonology

News

All News

Office Procedures

Practice Management

Media

Around the Practice

Between the Lines

ConsultantLive

Expert Interviews

Institutional Insights

Medical World News

Podcasts

Primary View

Provider Toolkits

Readout360

Conferences

Conference Coverage

Conference Listing

Resources

Image IQ

Interactive Posters

Polls

Publications

Quizzes

Subscribe

CE/CME

Advertise

Contact Us

Terms and Conditions

Privacy

Do Not Sell My Information

Patient Care Online

Facebook

LinkedIn

Clinical Focus

Allergy & Immunology

Endocrinology

Gastroenterology

Infectious Disease

Men’s Health

Pain Management

Psychiatry

Women’s Health

Business Focus

Billing and Collections

Career Planning

Coding and Documentation

Concierge Medicine

Cybersecurity

EHRs

Investing

Patient Relations

Personal Finance

Remote Patient Monitoring

Staffing

Telehealth

Value-based Care

Spotlight

Unmet Needs in Managing MDD

Interpreting Thyroid Function Tests

Using Thyroid Lab Tests

Testing & Screening to Optimize Men's Health

1rem

Authors

A 39-year-old woman presented with dry cough, which she had had for 3 months. She had mild intermittent asthma and a 5 pack-year smoking history. Her symptoms started after an upper respiratory tract infection and persisted despite multiple courses of antibiotics, decongestants, and corticosteroids.

What is causing this woman’s dry cough?

Acromegaly was diagnosed in a 36-year-old woman who presented with loss of vision in the right eye that had initially involved the peripheral field. MRI scans of the brain revealed a 6 × 6 × 4-cm sellar mass with suprasellar and parasellar extension encasing the right cavernous sinus and carotid artery.

A. Excess growth hormone production from the pituitary gland as a result of a functional adenoma is the most common cause.

B. It remains undiagnosed for up to 10 years on average.

C. The diagnostic test of choice is an oral glucose tolerance test.

D. End-organ manifestations (eg, arthropathy, cranial nerve palsies, diabetes) contribute to overall mortality increase.

Acromegaly was diagnosed in a 36-year-old woman who presented with loss of vision in the right eye that had initially involved the peripheral field. Which statement about acromegaly is NOT true?

Clinical Topics

Acromegaly: A Pop Quiz

A 5-year-old boy with a history of atopic dermatitis since 6 weeks of age, presents with a rash around his mouth that has been present for approximately 1 year. The patient’s mother reports that desonide topical cream was applied to the affected area for about 5 days, which initially resulted in improvement, however the rash returned after this medication was discontinued. The rash also recently improved after the patient took amoxicillin for an infection. She also notes that the patient has been licking his lips more frequently.

On examination there is an erythematous papulopustular eruption restricted to the perioral region, with sparing of the vermillion border. Mild hyperpigmentation is noted on the patient’s neck. There is no active involvement of other areas of the body.

The eruption has been present for 1 year and is restricted to the perioral region. What is included in your differential? 

Rash Around the Mouth of a 5-year-old Child

Five days after a 41-year-old man started taking a new medication, this superficial but painful lesion appeared on his neck. It slowly resolved after the drug was stopped and a topical corticosteroid was applied twice daily.

Five days after starting a new medication, this lesion appeared on a man’s neck. It slowly resolved after the drug was stopped. Which of these drugs do you suspect might have caused the lesion?

Round Red Patch on a Man's Neck

An 89-year-old woman with a history of biopsy-proven actinic keratosis on her scalp is seen for a new erosion on the right frontal area. Two weeks of twice-daily mupirocin has brought no improvement and now crusting and purulent exudate are seen. Skin cultures taken show normal flora.

C. Erosive pustular dermatosis of the scalp

E. Chronic actinic damage with secondary infection

An 89-year-old woman is seen for an erosion on the frontal area of the scalp. History is positive for actinic keratosis. What's your Dx?

Crusty Scalp Lesion 

A 76-year-old woman seeks your attention for an asymptomatic “red spot” on her neck. She has a history of multiple non-melanoma skin cancers.

Squamous cell carcinoma in situ (Bowen  disease)

Lichenoid keratosis (an inflammatory variant of seborrheic keratosis)

A 76-year-old woman seeks your attention for an asymptomatic “red spot” on her neck. What does this look like to you?

What's This "Red Spot"?

A 67-year-old woman noted the appearance of several non-tender, rock-hard, purple-colored nodules on her legs. Her medical history was significant for distant non-Hodgkin lymphoma.

A 67-year-old woman noted the appearance of several non-tender, rock-hard, purple-colored nodules on her legs. Her medical history was significant for distant non-Hodgkin lymphoma. The violaceous color and configuration of the skin lesions suggests which of the following? 

Hard Purple Nodules: Your Dx?

Toshita Kumar, MD

Articles

Latest Updated Articles