A Pregnant Woman with Skin Lesions

A Pregnant Woman with Skin Lesions

A 30-year-old woman in her second trimester of pregnancy complained of multiple skin lesions that occurred in wheal patterns whenever she pressed firmly on her skin. Sometimes her skin would itch, causing her to apply pressure or rub and produce the wheal. Upon exam, the doctor could see a linear configuration on her arms from scratching and geometric configurations on her back, produced by her clothing View the image taken (Figure 1) and consider what …

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Hyperpigmented Skin Patches

Hyperpigmented Skin Patches

A 70-year-old man presents to an urgent care center after becoming concerned about brown hyperpigmented patches on his legs and arms. He says that he thinks some of his teeth are turning gray, but it has been happening so slowly that he is not sure. He reports that he has been in good health recently, especially after starting to take antibiotics last year to treat his rheumatoid arthritis. View the image taken (Figure 1) and …

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Shoulder Pain After Falling from a Tree

Shoulder Pain After Falling from a Tree

A 57-year-old man climbs a tree in his yard to trim branches, and then falls to the ground and onto his shoulder. In presenting to his local urgent care center, he reports that he has pain over his right shoulder and scapula area that is sharp and worsens when he moves through the range of motion. He says that he took 600 mg of ibuprofen after he was injured but that his pain did not …

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Wrist Pain After Tripping and Falling

Wrist Pain After Tripping and Falling

A 35-year-old woman presents to an urgent care center with severe right wrist pain after a fall onto her outstretched hand after tripping on the sidewalk. She has significant pain throughout the range of motion as well as at rest. She has minimal numbness of the fingers. She has no other visible injuries, and on questioning, she reports that she has no elbow, shoulder, head, or neck pain. View the image taken (Figure 1) and …

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Ankle Injury Sustained During a Step Off a Curb

Ankle Injury Sustained During a Step Off a Curb

A 56-year-old woman with a past medical history of hypertension presents to an urgent care center 1 hour after she injured her ankle while stepping off a curb. She believes that the ankle “twisted inward” but is not sure. She reports sharp, severe, constant pain throughout the joint and that worsens when she attempts to move the ankle through the range of motion. There is no numbness of the foot or ankle, no pain at …

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