Spot Diagnosis

What is the diagnosis in this 3-year-old girl with recent upper respiratory infection and new pruritic blanching rash?

A 41-year-old woman received a diagnosis in of an overlap syndrome, with limited systemic sclerosis and dermatomyositis. Subcutaneous hard lumps developed over her buttocks and elbows a year after and progressed clinically.

An 18-year-old Fijian woman presented with a 3-year history of a concentric, scaly rash on her shoulders; the rash was also present on her trunk, arms, and legs (not shown). The rash was pruritic and progressively spread to involve approximately 70% of the body-surface area. Her brother had similar skin findings.

A 34-year-old woman with a nine-month history of postprandial dyspnea and substernal fullness had severe pain in her epigastrium, without emesis, shortly after the ingestion of an evening meal.

Five weeks after uneventful coronary-artery bypass grafting, an 81-year-old woman presented to the hospital with extensive livedo reticularis and cyanosis of the toes.

A 46-year-old man presented to the emergency department with the sudden onset of dyspnea, pleuritic chest pain, and hypoxemia.

A 50-year-old woman with dermatomyositis presented with progressive, diffuse subcutaneous nodules on the arms and legs.

A 60-year-old man with advanced diabetic nephropathy and secondary hyperparathyroidism underwent radiographic imaging of the abdomen and pelvis as part of an evaluation for nephrolithiasis.

A 64-year-old man presented with a two-year history of this asymptomatic skin condition, which was symmetrically distributed over his trunk, arms and legs. Laboratory tests demonstrated a raised fasting blood glucose level.

A 1-year-old boy presented with a 3-day history of intermittent fever, barking cough, and hoarseness. The physical examination revealed neck lymphadenopathy and audible stridor, but the patient was not in respiratory distress and was not drooling.