Table of Contents
From the Editor
- A clinical trial and another clinical practice bites the dust, or should there not be an appendix?
Studies over the past 2 decades have assessed an alternative approach to acute appendicitis: treatment with systemic antibiotics and observation.
The Clinical Picture
- Atypical erythema as a clinical presentation of tinea incognito
The lesions were originally diagnosed as contact allergic dermatitis and treated with topical corticosteroids, but culture revealed Trichophyton rubrum.
- Skin-colored papules on the cheeks, acrochordons on the axillae
Biopsy revealed dermal follicular structures surrounded by a perifollicular fibrous sheath and a densely fibrous stroma, consistent with a fibrofolliculoma.
- Spider nevi secondary to alcoholic chronic liver disease
The lesions blanched when pressure was applied centrally and refilled from the center outward when pressure was released.
- Pigmented lesion on nail bed: Pseudo-Hutchinson sign
The discoloration had been present since the patient was 14, and it had not changed in appearance.
- Spotty skin pigmentation in Carney complex
Characteristic skin findings and their locations can indicate underlying hereditary lentiginosis syndromes.
1-Minute Consult
- Does incidentally detected common bile duct dilation need evaluation?
A patient-centered approach and knowledge of the diagnostic yield of further testing helps determine appropriate management.
Symptoms to Diagnosis
- Dyspnea and cough in a lung transplant recipient
The patient developed sudden shortness of breath at rest, a decline in home spirometry values, and dry cough and fatigue.
Review
Anticoagulation management of post-cardiac surgery new-onset atrial fibrillationA review of studies and recommendations for this condition.
- Chronic anal pain: A review of causes, diagnosis, and treatment
The authors identify and review 3 main diagnostic categories: local causes, functional anorectal pain, and neuropathic pain syndromes.
Commentary
Antibiotic therapy has been a successful alternative to surgery for more than 60 years, but surgery is still the primary treatment.