“I tell everyone who comes into her room now, ‘You will not disrespect my daughter again. No one will,’” recounts Sarah’s mother. “Every time a [provider] acts rude to her, Sarah tells me, ‘Ma, I’m used to it now,’ and I have to insist ‘No! Baby, you should never get used to that.’ … Dr….
Saddle Nose & Cauliflower Ear Deformities in Relapsing Polychondritis These images depict a 32-year-old man who presented with five weeks of left-sided hearing loss, weight loss and discomfort in the nose, ear, chest wall and knee. He had an erythrocyte sedimentation rate (ESR) of 120 mm/hr, and a C-reactive protein level of 225.4 mg/L. The…
Featured Image from Europe & Central Asia Rheumatic Diseases of Childhood: Scleroderma These images depict a patient with a clinical presentation of juvenile dermatomyositis with typical skin manifestations of Gottron’s papules over the extensor surfaces of the joints, as well as hyperpigmentation. Yulia Vyzhga, MD, PhD, is a pediatric rheumatologist at National Pirogov Memorial Medical…
Rheumatic Diseases of Childhood: Juvenile Dermatomyositis with Calcinosis Cutis These images depict a 14-year-old boy with a two-year history of proximal muscle weakness affecting both upper and lower limbs, and a skin rash affecting his face. He was diagnosed with juvenile dermatomyositis and developed calcinosis over both legs with skin infection and ulceration. Plain X-ray…
Lichenoid Cutaneous Lupus Erythematosus Mimicking Acanthosis Nigricans The photos depict a 45-year-old woman who presented to the Lupus Clinic of the University of São Paulo, Brazil, with lesions closely resembling acanthosis nigricans on her neck (A and B). The lesions had been present for four months. The patient had lived with systemic lupus erythematosus (SLE)…
Erosive Polyarticular Chronic Tophaceous Gout in a Young Man A 27-year-old man was referred to us for joint pain and nodular swelling over multiple joints. His symptoms started when he was 13 years old, but he was sub-optimally treated. On examination, we found marked digital deformity, with multiple large tophi over the small joints of…
People’s Choice: Keratoderma Blennorrhagica Submitted by Kunal Chandwar, MD, MBBS, King George’s Medical University, Lucknow, India, the photo depicts extensive keratoderma blennorrhagica in a patient with reactive arthritis. Spondyloarthropathies An 18-year-old man presented with psoriasiform plaque-like lesions that began on the limbs and progressed to involve his entire body (including his face) over a month….
Best Overall: Cutaneous Manifestations of Dermatomyositis These images, submitted by Santhanam Lakshminarayanan, MD, associate professor of medicine in the Division of Rheumatology the University of Connecticut School of Medicine, Farmington, show a 32-year-old Black woman with classic cutaneous manifestations of dermatomyositis: heliotrope rash; periorbital edema with complete closure of the eyes; erythema nodosum on the…
On Dec. 17, 1903, at 10:35 a.m., the restraining wire was released. The Wright brothers—Orville and Wilbur—owned a bicycle sales and repair shop called the Wright Cycle Exchange, in Dayton, Ohio. At the time, the popularity of bicycles was exploding, thanks to an innovation that made them much easier (and safer) to ride. The money…
Implicit bias negatively affects patients and clinicians alike in a variety of healthcare settings. Unconscious feelings and attitudes about others can damage professional and personal relationships. Demystifying Bias At the virtual ACR Division & Program Directors Conference in March, three physician leaders presented a panel called, Demystifying Bias: Empowering You to Have Courageous Conversations, and…