Spot Diagnosis

Black Cutaneous Lesions A healthy 65-year-old man presented with a 4-month history of left flank pain and nocturia. These lesions developed over 1 to 2 years. What is the most…

Unilateral Leg Swelling and Bluish Discoloration An 85-year-old woman with newly diagnosed metastatic non–small-cell lung cancer was admitted for pain control. Two days after admission, unilateral leg swelling and bluish…

A 52-year-old man with diabetes reported a 3-month history of a pretibial rash during a routine visit. The lesions had begun to ulcerate and bleed but were not pruritic or painful.

This 9-year-old boy presented with a two-day history of right shoulder pain after an upper respiratory tract infection. What is the cause of the abnormality demonstrated?

37-year-old man with Dyspnea 37-year-old man with known end-stage renal disease and chronic uraemic pericardial effusion presented with gradually worsening dyspnoea and orthopnoea, 4 days after a nephrectomy to control…

Pleural aspiration from a 56-year-old man, who presented with a massive right pleural effusion, yielded purely black coloured fluid. This fluid was determined to be an exudate with very high…

A 70-year-old woman presented with asymptomatic blue-black discoloration of her legs and sclerae. She had a history of oxacillin-resistant coagulase-negative staphylococcal endocarditis complicated by aortic root abscess, needing surgery and…

A 19-year-old man presented with pedal oedema and facial puffiness of 3 months' duration. He denied history of orthopnoea, paroxysmal nocturnal dyspnoea, oliguria, haematuria, fever, sore throat, joint pains, rashes, exposure to heavy metals, or any drug abuse.

Painful Skin Lesions A 61-year-old who was receiving long-term treatment with prednisone for refractory idiopathic thrombocytopenic purpura required a dose increase after a large decrease in platelet count (6×109/L). He…