Bleomycin induced flagellate Dermatitis

Why you should join Figure 1

• Share your knowledge with our global community of healthcare professionals
• Get help from experts in your field
• Learn from our library of real-world cases and quizzes

Case Descriptions

Case 1:

36 year old female came into clinic with complaints of intermittent left ear pressure, occipital tension headaches, neck pain (muscular but only on left side), pain in right knee joint (bilateral knee crepitus, but no swelling), Lumbar spinal narrowing and pain, bilateral pressure under ribcage with strange muscle contractions in ribcage while twisting or bending forward, fatigue that causes her to sleep for 14 hours daily, and small petechiae around her left ribcage area. Patient also has developed what appears to be a red, itchy hive-like rash on her knees and elbows which lasted a few days. Labs are all within normal limits other than positive C1q antibodies, C1q binding complex, Antiphosphatidylserine Antibodies, and EBV nuclear antibodies which are elevated and low vitamin D. At this time Anticardiolipin antibodies, Anti-SSA and Anti-SSB antibodies are normal but pt has had elevations of Anticardiolipin Antibodies IgM and IgG as well as positive Anti-SSA Antibodies within low positive range. Lupus anticoagulant antibodies and cryoglobulin are normal as well. Pt vitals are all within normal limits with a lower blood pressure of 95/62 which she states is her baseline. Pt sent to rheumatologist. Would Lupus be out of the question here since her most recent labs came back negative for SSA antibodies and Lupus Coag? She was ANA positive but there was no pattern reported.

Case 2:

10 years female living in camp refugee endemic in infectious mononeoclosis presented with these lesions started one year ago no investigation available as in rural area itching with fever occasionally healed with skin discoloration bilateral with family history of atopy what do you think dx?

Case 3:

USCG Doc here, 24 y/o male presented with nonpruritic rash onset this am, no known exposure to chemicals or any other agents. I treated with 25mg Benadryl thinking urticaria this morning and he reported this afternoon spreading rash to chest and buttocks. Thoughts?

Case 4:

66 yo male with C/O pain in both knees along with swelling and discomfort while walking. Limping gait. Exfoliation of skin of the foot. Probable diagnosis?

Case 5:

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

Case 6:

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

Case 7:

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Case 8:

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family. Are there any features in this ECG that would warrant further work-up or is this just a pediatric ECG?