Untreated HPV with possible chemical burn and gangrene | Figure 1

Untreated HPV with possible chemical burn and gangrene

40/50M states it started out as HPV with genital warts. He was prescribed a cream (Salic acid) which burned and caused redness and pain. He didn’t get further treatment after that. This is after 10-12 years I believe he said. Plastic surgery said they will not touch. He has no insurance so university hospital he was referred to, denied him. He recently needed 2 units of blood due to the loss of blood from this. At times, it just pools. Continuous oozing and smell. Pieces have been falling off as well. No mention of difficulty urinating.

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69 y/o CM walked in to the fire house complaining of "mild" sub-sternal chest pressure. He said it began yesterday while doing yard work, but went away after he went and relaxed in his recliner. When he woke up next morning it had come back, but not as bad. So he went to go out and do more yard work when it intensified and then he came to us. Good thing too because he had a 100% occlusion of his circumflex artery. Guess he is one of the 15% whose circumflex supplies blood to the inferior portion. The cardiologist said if he'd waited another day he would've been found dead in the morning.

31 years old man presented for the first time with this rash which started on upper chest 2 weeks back and then progressed on the back down to gluteal area itchy and painful now of the side of the face. Nil in the mouth, nil past medical history. Back rash very painful said he can not sleep on it. He was in anabolic steroid injection and #Testosterone injection. He had the injections while he got the rash. He stopped 4 days after he had the rash. He is afebrile, Blood pressure 115/65, PR 78. Any ideas what this rash could be and what is the best treatment apart from antihistamine.

28 year old male, with history of anal pain of 1 year of evolution, also says that he feels a mass in the anus when he touched. After going to the bathroom he said it hurts. You can reduce the mass to the inside, not bleeding. Probable dx? Probable tx?

A 56-year-old patient comes to the ER complaining of swelling in his #Scrotum. He has cirrhosis and said that for the past month his belly swelling got smaller and his scrotum was getting bigger day-by-day. He has no local pain. No blood exams were available at the moment. Physical exam shows a transillumination positive test.

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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.

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.

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.

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 EKG that would warrant further work-up or is this just a pediatric EKG?