For about 10 years, a 26-year-old man had recurring cystic lesions on his scalp that would periodically enlarge, shrink, and occasionally drain. More>>

During the evaluation of a 61-year-old man who had sustained mild head and upper trunk injuries in a car accident, a right lower lobe consolidation was noted on the chest radiograph. More>>

For 25 years, a 74-year-old man had an intermittent, painful, and pruritic rash that caused cracking and erosions in the axillae and groin. It worsened with sweating and in the summer and also when clothing or skin rubbed against the eruption. More>>

For 2 days, a 17-year-old boy had a widespread pruritic eruption that involved the trunk and extremities but spared most of the face. Many of the lesions were annular, and they would appear and resolve within 1 day. The patient denied shortness of breath, difficulty in swallowing, and periorbital swelling. More>>

A 74-year-old man who had Parkinson disease dementia presented with constipation and bloating associated with abdominal pain. More>>

This finely papular, slightly raised lesion below the vermilion border of a 53-year-old man’s lip had been present for several months; it was asymptomatic. Six years earlier, the patient had a squamous cell carcinoma of the left lower leg excised. He worked outdoors on an offshore oil rig. More>>

For a week, a 36-year-old Marine had clusters of localized papular lesions on the right forearm; he had no systemic symptoms. The patient had been inoculated 20 days earlier in the United States with the vaccinia virus (smallpox vaccine) to the ipsilateral shoulder just before deployment. He had no history of eczema, psoriasis, or drug allergies. More>>

During a routine physical examination, flesh-colored papules were noted on a 36-year-old man’s elbows, knees, and interphalangeal joints. The patient reported that they had been present for a long time, were nonpruritic, and had remained the same color and size. More>>

A 21-year-old man presented for evaluation after he sprained his right ankle while hiking. Radiographs of the ankle showed no fractures but revealed diffuse sclerotic lesions in most of the visualized bones. More>>

Baylor College of Medicine, Houston This asymptomatic lesion had developed insidiously on the foreleg of an 82-year-old woman. She had a history of multiple non-melanoma skin cancers, most likely related to extensive sun exposure throughout life. More>>

A56-year-old man presented with pruritic, raised plaques with crusting and occasional weeping in tattoos he had acquired a few months earlier. The lesions were confined to the red (A) and blue (B) pigmented areas only, which suggested a contact dermatitis to the metal in the tattoo ink. More>>

For 5 weeks, a 27-year-old man had a rash with painful fissures on his hands (A). For the past 2 weeks, he also had mildly pruritic red, scaly lesions on his trunk (B and C). He was otherwise healthy, had no allergies, and did not take any medications. The patient denied the use of tobacco, alcohol, and illicit drugs. More>>

A 65-year-old man was concerned about a skin-colored papillary lesion on the right lateral lower eyelid along the eyelash line. It had been present for 1 week and was asymptomatic. More>>

An 18-year-old woman with a history of allergic rhinitis and moderate persistent asthma presented with right-sided nasal congestion of 6 months’ duration. Her symptoms persisted despite her usual allergy medications, allergen immunotherapy, and 2 courses of antibiotics. A sinus CT scan showed complete opacification of the right maxillary sinus with increased attenuation of the mucin (A). Allergic fungal rhinosinusitis was suspected, and an otolaryngologist was contacted. More>>

For 3 days, a 45-year-old woman with HIV infection who was noncompliant with her antiretroviral medications had cough, yellowish sputum, fever, and dyspnea. She denied hemoptysis, weight loss, or recent hospitalization. She had a long history of heavy smoking and alcohol and intravenous drug abuse. More>>

Increasingly severe dysphagia had bothered a 77-year-old woman for several months. By the time she sought medical attention, both food and liquids were sticking in the lower esophagus, leading to vomiting and weight loss. More>>

Twelve days after coronary artery bypass graft surgery, a 56-year-old man presented with worsening fatigue and difficulty in reading. Before surgery, he had a long-standing history of hot flashes and decreasing stamina. More>>

A previously healthy 26-year-old woman was hospitalized for melena. She denied prior episodes of GI bleeding, fatigue, or dyspnea. More>>

Swelling of the wrists (A) and ankles of 3 months' duration prompted a 33-year-old man to seek medical attention. The swelling was highly migratory, with periods of regression that lasted several days at a time. More>>

For 6 weeks, a 68-year-old woman had had sharp pain in the left breast that radiated to the left arm and back. The pain was worse on palpation; ibuprofen provided only mild relief. More>>