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Images in Clinical Medicine
Nevus Sebaceous
Figure 1.
- May 17, 2012
- Cifuentes L. and Ziai M.
- N Engl J Med 2012; 366:1923
- Free Full Text
A 6-year-old girl who was born with a plaque on her forehead presented to the clinic. The plaque was smooth, elevated, and arranged in a linear pattern on the forehead.
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Images in Clinical Medicine
“Half-Half” Blisters
Figure 1.
- May 17, 2012
- O'Connell M. and Goulden V.
- N Engl J Med 2012; 366:e31
- Free Full Text
A 66-year-old man presented with an acute pustular eruption. On examination, an annular rash with multiple blisters was seen on the patient's trunk; the blisters contained both clear and yellow fluid. He had no associated cutaneous or systemic symptoms, ...
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Case Records of the Massachusetts General Hospital
Case 14-2012 — A 43-Year-Old Woman with Fever and a Generalized Rash
Presentation of Case. Dr. Sarah Gee (Dermatology): A 43-year-old woman was admitted to the hospital because of fever and a generalized rash. The patient had a history of atopic dermatitis and had been in her usual health until approximately 1 week before admission, when a painful, pruritic rash…
- May 10, 2012
- Mackool B.T., Goverman J., Nazarian R.M.
- N Engl J Med 2012; 366:1825-1834
- CME
A 43-year-old woman with a history of atopic dermatitis was admitted to the hospital because of fever and a generalized painful, pruritic rash involving the entire body. Examination revealed vesicles, pustules, and erosions with scalloped borders. A diagnostic test result was received.
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Correspondence
Bortezomib to Treat the TEMPI Syndrome
To the Editor: Recently, on the basis of a case series involving six patients, Sykes et al. described the TEMPI syndrome, a novel multisystem disease defined by telangiectasias, erythrocytosis with elevated erythropoietin levels, monoclonal gammopathy, perinephric-fluid collections, and…
- May 10, 2012
- N Engl J Med 2012; 366:1843-1845
- Free Full Text
Telangiectasias, erythrocytosis, monoclonal gammopathy, perinephric-fluid collection, and intrapulmonary shunting are characteristic of the TEMPI syndrome. A case report documents improvement with bortezomib, a drug used in the treatment of myeloma.
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Images in Clinical Medicine
Lymphangioma Circumscriptum
Figure 1.
- May 3, 2012
- Tan S.-K. and Tay Y.-K.
- N Engl J Med 2012; 366:1724
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A 52-year-old man presented with a 1-year history of a vesicular rash on his scrotum. The lesions were painless, but they occasionally ruptured and drained clear fluid.
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Images in Clinical Medicine
Eschar Formation from Testosterone Patch
Figure 1.
- May 3, 2012
- Orme C. and Imaeda S.
- N Engl J Med 2012; 366:e28
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A 78-year-old man presented for his yearly skin exam and was noted to have an oval-shaped, green-black eschar on his midback. A pink, atrophic scar was located nearby, in addition to a medicated patch of similar size.
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Original Article
Brief Report: Integrin α₃ Mutations with Kidney, Lung, and Skin Disease
Epithelial–mesenchymal interactions are important in the development and tissue homeostasis of many multicompartment organs, such as the kidneys, lungs, and skin. Adhesion of epithelial cells to basement membranes provides the structural and functional integrity of the organs. Cues from the…
- April 19, 2012
- Has C., Spartà G., Kiritsi D., et al.
- N Engl J Med 2012; 366:1508-1514
Three patients with homozygous mutations in the integrin α3 gene, a transmembrane integrin receptor subunit, were found to have disrupted basement-membrane structures causing congenital nephrotic syndrome, interstitial lung disease, and epidermolysis bullosa.
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Review Article
Medical Progress: Alopecia Areata
The impact of certain skin diseases on the lives of those affected tends to be underestimated or even dismissed as simply a "cosmetic problem." Alopecia areata exemplifies such a condition, owing to its substantial disease burden and its often devastating effects on the patient's quality of life…
- April 19, 2012
- Gilhar A., Etzioni A., Paus R.
- N Engl J Med 2012; 366:1515-1525
- CME
This review article synthesizes relevant information about hair-follicle biology and pathobiology and summarizes the clinical presentation and management of this common condition.
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Images in Clinical Medicine
Metastatic Inguinal Lymphadenopathy
Figure 1.
- April 19, 2012
- Hajdarbegovic E. and Balak D.
- N Engl J Med 2012; 366:1526
- Free Full Text
A 59-year-old man presented with a weeping mole on his back that had been growing for 8 years. On examination, a 10-cm ulcerated lesion was found on his lower back, and multiple subcutaneous areas of swelling were found in both inguinal regions.
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Images in Clinical Medicine
Unilateral Dermatoheliosis
Figure 1.
- April 19, 2012
- Gordon J.R.S. and Brieva J.C.
- N Engl J Med 2012; 366:e25
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A 69-year-old man presented with a history of gradual thickening and wrinkling of the skin on the left side of his face. The physical examination showed hyperkeratosis with accentuated ridging, multiple open comedones, and areas of nodular elastosis.
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Case Records of the Massachusetts General Hospital
Case 11-2012 — A 60-Year-Old Man with Weakness, Rash, and Renal Failure
Presentation of Case. Dr. Pritha Sen (Medicine): A 60-year-old man with a history of schizophrenia was admitted to this hospital in late spring because of weakness, rash, and renal failure. The patient was in his usual state of health until several days before admission, when fatigue and myalgias…
- April 12, 2012
- Channick R.N., Lorenzo M.E., Wu C.C., Hoang M.P.
- N Engl J Med 2012; 366:1434-1443
- CME
A 60-year-old man from coastal New England was admitted to this hospital because of fever, weakness, rash, and renal failure. An initial measurement of creatine kinase was 20,437 U per liter. A diagnostic test was performed.
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Images in Clinical Medicine
Leonine Facies: Lepromatous Leprosy
Figure 1.
- April 12, 2012
- Salgado C.G. and Barreto J.G.
- N Engl J Med 2012; 366:1433
- Free Full Text
A 57-year-old man presented with a 7-year history of diffuse skin infiltration associated with sensory loss in his left hand. His face had multiple nodular lesions that coalesced into plaques, especially on the forehead, ears, nose, and lips.
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Images in Clinical Medicine
Digital Mucous Cyst
Figure 1.
- April 5, 2012
- Salerni G. and Alonso C.
- N Engl J Med 2012; 366:1335
- Free Full Text
A 37-year-old man presented with a history of a solitary, round, asymptomatic nodule on his second toe. The nodule measured 6 mm in diameter and was located off the midline on the dorsal side of the second toe, between the interphalangeal joint and the proximal nail fold.
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Clinical Problem-Solving
Skin Deep
Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows. Stage. A 56-year-old woman with symptoms…
- April 5, 2012
- Safdar N., Abad C.L., Kaul D.R., Saint S.
- N Engl J Med 2012; 366:1336-1340
- CME
A 56-year-old woman with symptoms of carpal tunnel syndrome for 6 months presented to a referral clinic with nodular lesions on her right forearm and hand and an increase in numbness and tingling in her right hand.
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Editorial
To Be 17 Again — Anti–Interleukin-17 Treatment for Psoriasis
Interleukin-17 is a cytokine that belongs to a family of six members (interleukins 17A through 17F), which bind a total of five receptors (interleukins 17RA through 17RE).– Of these six interleukin-17 cytokines, interleukins 17A and 17F are very homologous and bind the same receptor complex…
- March 29, 2012
- Waisman A.
- N Engl J Med 2012; 366:1251-1252
Interleukin-17 is a cytokine that belongs to a family of six members (interleukins 17A through 17F), which bind a total of five receptors (interleukins 17RA through 17RE).¹–³ Of these six interleukin-17 cytokines, interleukins 17A and 17F are very ...
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Images in Clinical Medicine
Fordyce's Angiokeratomas
Figure 1.
- March 29, 2012
- Machan M. and Tonkovic-Capin V.
- N Engl J Med 2012; 366:1240
- Free Full Text
During a routine full-body skin examination, a 60-year-old man was incidentally found to have numerous firm purple papules measuring 1 to 2 mm in diameter and covering the scrotum.
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Original Article
Brodalumab, an Anti–Interleukin-17–Receptor Antibody for Psoriasis
Psoriasis is a chronic T-cell–mediated autoimmune disease that affects 2 to 3% of the U.S. population, and 0.6 to 6.5% of the European population. Emerging data identify a subset of helper T cells, Th17, that preferentially produce interleukin-17 and play a major role in orchestrating…
- March 29, 2012
- Papp K.A., Leonardi C., Menter A., et al.
- N Engl J Med 2012; 366:1181-1189
- CME
In this 12-week, phase 2 trial, an anti–interleukin-17–receptor antibody was effective in treating moderate-to-severe psoriasis. Adverse events included neutropenia. Larger trials of longer duration are needed to assess the risk of infections.
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Original Article
HLA Class II Locus and Susceptibility to Podoconiosis
Podoconiosis (endemic nonfilarial elephantiasis) is a noninfectious geochemical disease that results in bilateral swelling of the lower legs (Figure 1). It is found among subsistence farmers whose feet are exposed over many years to red-clay soil derived from volcanic rock. Podoconiosis is an…
- March 29, 2012
- Tekola Ayele F., Adeyemo A., Finan C., et al.
- N Engl J Med 2012; 366:1200-1208
Podoconiosis is a tropical form of noninfectious lymphedema associated with exposure to red-clay soil. It affects over 4 million people and is associated with substantial morbidity. In this genomewide association study in Ethiopia, associations were identified in two HLA class II loci.
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Original Article
Anti–Interleukin-17 Monoclonal Antibody Ixekizumab in Chronic Plaque Psoriasis
Psoriasis vulgaris (plaque psoriasis) is a chronic, frequently painful, and often debilitating skin disorder. The estimated prevalence of diagnosed psoriasis in the United States is 3%, with approximately 17% of these patients having moderate-to-severe plaque psoriasis. Psoriasis is characterized…
- March 29, 2012
- Leonardi C., Matheson R., Zachariae C., et al.
- N Engl J Med 2012; 366:1190-1199
In this 12-week phase 2 trial, a humanized anti–interleukin-17 monoclonal antibody was effective for chronic plaque psoriasis. Larger studies of longer duration are necessary to assess the safety and efficacy of long-term treatment.
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Original Article
Ingenol Mebutate Gel for Actinic Keratosis
Actinic keratoses are premalignant lesions that are common in light-skinned populations worldwide. In the United States, the most common form of lesion-directed therapy for actinic keratoses is cryosurgery, although other locally ablative therapies are used. In addition to potential scarring,…
- March 15, 2012
- Lebwohl M., Swanson N., Anderson L.L., et al.
- N Engl J Med 2012; 366:1010-1019
Actinic keratosis is a common precursor to squamous-cell carcinoma. Several topical treatments are effective but require weeks of application. In four randomized trials, topical treatment with ingenol mebutate for 2 to 3 days was effective in clearing actinic keratoses.
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Medical Meetings Pediatrics Conferences and Meetings

2012 Certifying Examinations of the American Board of Pediatrics

The general pediatrics examination will be held in various cities, Oct. 16-18. Registration for first-time applicants is ongoing through May 3. Registration for re-registrants is ongoing through May 24. The following subspecialty examinations will be held in various cities: "Hospice and Palliative Medicine" (Oct. 4); "Pediatric Transplant Hepatology" (Oct. 11); "Pediatric Cardiology" (Nov. 7); "Pediatric Pulmonology" (Nov. 8); "Medical Toxicology" (Nov. 12); and "Pediatric Critical Care Medicine" (Nov. 14). Registration for first-time applicants is ongoing through April 30. Registration for re-registrants is ongoing through June 15.

Contact the American Board of Pediatrics, 111 Silver Cedar Court, Chapel Hill, NC 27514-1513; or call (919) 929-0461; or fax (919) 918-7114 or (919) 929-9255; or see http://www.abp.org .

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