The Clinical Picture

Paraneoplastic acral vascular syndrome

The patient presented with a painful blue great toe, abdominal pain, and unintentional weight loss.

The Clinical Picture

Erythema ab igne

The patient had been using a heating pad daily, often for several hours at a time, to relieve his back pain.


The Clinical Picture

The Leser-Trélat sign

The patient presented with night sweats, dry cough, weight loss, and sudden onset of “itchy moles” on her back.

The Clinical Picture

Scapular rash and endocrine neoplasia

A woman in her 30s presents with an itchy skin-colored rash over her scapula of 8 years’ duration.

IM Board Review

Fever after recent travel

The patient had been taking a TNF-alpha inhibitor and had recently returned from Mexico.

The Clinical Picture

A 68-year-old man with a blue toe

The patient had undergone coronary artery bypass grafting, which caused cholesterol crystal embolism.