Sthanu Profile picture
Feb 24 7 tweets 2 min read
A 53-year-old woman

👉presented with intensely itchy skin lesions and burning in her mouth

Wrist area,...

What is the diagnosis?

Lichen sclerosus

Lichen planus

Psoriasis

Eczema

Tinea cruris
The correct answer is Lichen Planus
This is a condition that can manifest in the oral cavity, skin, or anogenital regions;

clinical presentation of lichen planus varies depending on the area involved
Cutaneous lichen planus is characterized by flat-topped, violaceous papules.

👉 lesions may resolve spontaneously;

👉 goal of treatment is to shorten the time between onset and resolution of the lesions and to reduce itching.
Lichen planus

Ddx
Lichen Planus

nejm.org/image-challeng…

Treatment

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More from @Sthanu5

Feb 25
68-year-old woman

👉2-hour history of sudden, diffuse lower abdominal pain

👉marked rebounding tenderness and varying tympanic sound on percussion

Diagnosis? Image
X-ray of the abdomen reveals

👉pneumoperitoneum

👉 an intrauterine device located in the right lower quadrant
Intrauterine device embedded in specimen of the omentum (arrow) Image
Read 5 tweets
Feb 25
Sign?

Diagnosis? Image
Answer

Football Sign
Lucencies show outline of the falciform ligament showing large pneumoperitoneum (in this case a pediatric patient).

If you see the football sign, think free air! Image
Read 7 tweets
Feb 25
Abdominal USG or CT is usually the test of choice for abdominal aortic aneurysm, but which imaging test may be most appropriate for hemodynamically unstable patients?

A.
Abdominal ultrasonography

B.
CT

C.
Magnetic resonance angiography

D.
Plain abdominal x-ray Image
Answer

A.
Abdominal ultrasonography
Answer: A:

For hemodynamically unstable patients with presumed rupture, ultrasonography provides bedside results more rapidly than CT (choice B),

👉 but intestinal gas and distention may limit its accuracy. Image
Read 8 tweets
Feb 25
This patient developed progressive thickening of the skin following failure of a transplanted kidney.

What is the most likely diagnosis?

Eosinophilic fasciitis

Myxedema

Nephrogenic fibrosing dermopathy

Scleroderma

Vitiligo Image
Diagnosis

Nephrogenic Fibrosing Dermopathy Image
👉 flexion contracture of his right elbow with prominent induration of the skin.

👉 skin of his legs and lower abdomen was also affected,

👉but that of his upper abdomen, chest, left (dominant) arm, and face was spared.
Read 9 tweets
Feb 24
Young female presenting with vomiting and abdomial pain.

Diagnosis? Image
Plain abdominal x-ray in supine position (Red arrows: multiple dilated small bowel loops (jejunum and ileum).

Blue arrow: Air fluid level in large bowel loop in the right upper quadrant suspected to be sigmoid colon).
Abdominal CT with contrast, two coronal views:

(a) white arrow shows suspected sigmoid volvulus in the right upper quadrant.

Green arrow shows dilated small bowel loop. Image
Read 7 tweets
Feb 24
What is Hypopyon sign in dermatology? Image
Hypopyon sign describes

👉the presence of small, discrete, vesicles either flaccid or tense .

👉that become secondarily infected

👉 pus accumulates in the lower half of the pustule Image
It is a clinical sign seen in

pyodermas

👉 secondarily infected vesicobullous disorders

pemphigus

bullous pemphigoid,

linear IgA dermatosis) Image
Read 5 tweets

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