Rheumatology
- Allopurinol hypersensitivity is rare, bad, and partially avoidable, but allopurinol can still be used effectively
The shadow of the 1984 Hande et al guidelines still hangs over clinical decision-making when managing allopurinol dosing in patients with gout and chronic kidney disease.
- Severe cutaneous reaction induced by allopurinol
Three weeks after starting allopurinol for gout, an 86-year-old woman presented with a maculopapular rash and painful blistering and erosions of the oral mucosa.
- What diagnostic tests should be done after discovering clubbing in a patient without cardiopulmonary symptoms?
Computed tomography of the patient’s chest is indicated based on the robust association between clubbing and intrathoracic malignancy.
- All sulfa drugs are not created equal
Misinformation about “sulfa allergy” can result in unnecessary avoidance of useful medications and the prescription of less effective alternatives.
- Sarcoidosis with diffuse purplish erythematous plaques on the hands
A 70-year-old woman presented in winter with a 1-month history of asymptomatic redness of the hands.
- Can my patient with a ‘sulfa allergy’ receive celecoxib or other nonantimicrobial sulfonamides?
There is no cross-reactivity between antimicrobial and nonantimicrobial sulfonamides, and patients with a history of immunoglobulin E–mediated reaction to a sulfonamide antibiotic can receive nonantimicrobial sulfonamides.
- The causes of vascular insufficiency and Hickam vs Ockham
Is our reflexive search for a single explanatory diagnosis always reasonable and warranted—or is it truly “just” an academic intellectual exercise?
- A 74-year-old woman with purple toes
While the patient was undergoing treatment for livedoid vasculopathy, her toes started to become purple and she experienced persistent “stinging” pain in her feet.
- Salt-and-pepper skin pigmentation
Dermoscopy of the skin lesions revealed homogeneous depigmented areas with perifollicular pigmentation.
Incidentally detected noninfectious thoracic aortitis: A clinical approachThe author reviews how aortitis is detected, its many possible causes, and the workup and treatment of patients who are found to have it.