More articles from The Clinical Picture

  • Blue sclera: An overlooked finding of iron deficiency
    Yasuhiro Kano, MD
    Cleveland Clinic Journal of Medicine October 2022, 89 (10) 549-550; DOI: https://doi.org/10.3949/ccjm.89a.22045

    The pathogenesis is thought to involve thinning of collagen fibers of the sclera due to iron deficiency, allowing the bluish color of the underlying uvea to become visible.

  • Widespread skin-thickening and hyperpigmentation
    India K. Poetzscher, Nikolai Klebanov, MD and Shinjita Das, MD, MPH
    Cleveland Clinic Journal of Medicine September 2022, 89 (9) 485-487; DOI: https://doi.org/10.3949/ccjm.89a.21099

    A 37-year-old military veteran presented with extensive velvety hyperpigmented plaques over nearly 15% of the total body surface.

  • Hyperpigmentation as a clue to Addison disease
    Yusuke Hirota, MD, PhD and Takaya Matsushita, MD, PhD
    Cleveland Clinic Journal of Medicine September 2022, 89 (9) 498-499; DOI: https://doi.org/10.3949/ccjm.89a.21082

    The 66-year-old woman presented with fatigue, loss of appetite, and hyperpigmentation of the tongue, soft palate, buccal mucosa, lower lip, fingers, and nail beds.

  • Phenytoin-induced gingival overgrowth
    Mitesh Karn, Ranjan Sah and Shabal Sapkota, MD
    Cleveland Clinic Journal of Medicine September 2022, 89 (9) 488-489; DOI: https://doi.org/10.3949/ccjm.89a.21107

    A young man presented with lower-extremity weakness and slurred speech. He has been on seizure prophylaxis after experiencing a seizure following hemicraniectomy for subdural hematoma.

  • Mucinous ascites: Pseudomyxoma peritonei
    Sansrita Nepal, MD, Adam Schwertner, MD and John M. Cunningham, MD
    Cleveland Clinic Journal of Medicine September 2022, 89 (9) 491-493; DOI: https://doi.org/10.3949/ccjm.89a.21086

    A 59-year-old man presented with progressive abdominal distention that limited daily activities and oral intake. The ascitic fluid was markedly viscous and jelly-like.

  • Nasal herpes simplex virus infection
    Nina L. Tamashunas, MD, Robert Simonds, MD and Sarah Young, MD
    Cleveland Clinic Journal of Medicine September 2022, 89 (9) 495-496; DOI: https://doi.org/10.3949/ccjm.89a.21096

    Skin changes on the nose in a 37-year-old patient that began after a scratch were concerning for extensive nasal skin necrosis.

  • Xanthomas: Differentiating atherogenic from nonatherogenic
    Vy Mai, MD and Hossein Akhondi, MD
    Cleveland Clinic Journal of Medicine August 2022, 89 (8) 429-431; DOI: https://doi.org/10.3949/ccjm.89a.21088

    The patient had tendinous xanthomas on the dorsal joints of the hand and eruptive xanthomas on the buttock, as well as xanthoma striatum palmare on the volar aspect of the hand.

  • The double-tongue sign
    Nami Yoshimura, MD, Takashi Watari, MD, MHQS, MCTM, PhD, Keisuke Misao, MD, Toshihiro Imada, MD and Junji Mashino, MD
    Cleveland Clinic Journal of Medicine August 2022, 89 (8) 435-436; DOI: https://doi.org/10.3949/ccjm.89a.21080

    Computed tomography showed enlarged mylohyoid and geniohyoid muscles, surrounding inflammatory findings, and small gas retentions.

  • Unraveling a challenging diagnosis: Role of a TNF inhibitor
    Soumya Chatterjee, MD, MS, FRCP, FACP, FACR
    Cleveland Clinic Journal of Medicine July 2022, 89 (7) 368-370; DOI: https://doi.org/10.3949/ccjm.89a.21128

    Painful swelling of the dorsum of the right hand had been diagnosed as chronic cutaneous sarcoidosis with tenosynovitis, treated unsuccessfully with prednisone and methotrexate.

  • Mondor disease of the breast
    Toshiyuki Yamaguchi, MD
    Cleveland Clinic Journal of Medicine July 2022, 89 (7) 371-372; DOI: https://doi.org/10.3949/ccjm.89a.21097

    A 43-year-old woman had 2 weeks of pain and skin tightness over the right breast. Ultrasonography revealed a noncompressible, dilated, subcutaneous vein without flow.

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