Spot Diagnosis

A 58-year-old healthy man was evaluated for a toothache of 2 days' duration. He was treated with oral penicillin and an opiate analgesic and advised to have the affected teeth pulled.

What is the diagnosis based on this image ?

A 62-year-old man reported acute left retro-orbital pain of one week's duration. Physical examination revealed no abnormalities. Three days later, double vision developed, and the next day a rash appeared on the forehead.

His medications were apixaban, ramipril, bisoprolol, amlodipine, and amiodarone. Physical examination showed discoloration of his nose, cheeks, and forehead.

A 7-year-old girl presented to the emergency department with a 2-week history of fever and with several days of painful blisters on her arms, legs, and face. Two weeks earlier, she had completed a course of penicillin for tonsillitis.

A 27-year-old primigravid woman was admitted with new-onset diabetes and hypertension at 32 weeks of gestation. She had worsening proximal muscle weakness, striae, and facial plethora for several months.

A 64-year-old man presented to the oral medicine clinic with a painful, smooth, red tongue and a burning sensation around his lips that had developed 6 months earlier. No deficits were found on neurologic examination.

A 42-year-old man who was undergoing treatment for non-Hodgkin’s lymphoma presented to the oncology clinic with changes in his fingernails. What is the most likely underlying cause of this presentation?

A 70-year-old woman presented with a 1-week history of dizziness and generalized rash following the onset of a viral respiratory tract infection. On physical examination, she had a generalized, macular, nonblanching, purplish rash.

A 30-year-old man presented with a rash on his face, hands, and feet. He had a history of HIV with a CD4+ T-cell count of 374 per cubic millimeter. Physical examination showed circinate lesions on the palms, soles, and face and patchy alopecia.