A 58-year-old man presented to the family medicine skin clinic with a 4-month history of intensely pruritic vesicles on his forehead, back, elbows, dorsum of his hands, and knees. The patient also reported lesions inside his mouth; however, they were not visible at the time of the office visit....
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Malnutrition in hospitalized adults: A systematic review
Objectives. To review the association between malnutrition and clinical outcomes among hospitalized patients, evaluate effectiveness of measurement tools for malnutrition on clinical outcomes, and assess effectiveness of hospital-initiated interventions for patients diagnosed with malnutrition...
Vulvar lichen sclerosus
An otherwise healthy 71-year-old woman presented to our clinic with a history of pruritus and burning of the vulva. On examination, we observed an atrophic, white, shiny plaque involving the vulva, perineum and perianal areas. The clitoral hood and labia minora were completely scarred and the...
Infant with edematous, erythematous toe
A 3-month-old baby presented with a tender and swollen fourth toe and increasing irritability. On examination, the distal portion of the digit was pale and cold to the touch. There was a delay in capillary refill time.
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Occupational causes of hypersensitivity pneumonitis: a systematic review and compendium
Background: Hypersensitivity pneumonitis (HP) is caused by a variety of antigens and low-molecular-weight chemicals, often through occupational exposure. Making a diagnosis of HP and identifying a cause are challenging. Cryptogenic cases are frequently reported, and missing or incomplete...
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The Management of Type 1 Diabetes in Adults. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) convened a writing group to develop a consensus statement on the management of type 1 diabetes in adults. The writing group has considered the rapid development of new treatments and...
Axillary and inguinal erythrasma
A 50-year-old man presented to the dermatology department with a 1-year history of itchy axillary and groin lesions. He had been treated with a topical antifungal preparation (cyclopyroxolamin), without improvement, by his family physician, who had suspected fungal intertrigo. On physical...
Button battery ingestions in children
1. Injuries in children from ingesting button batteries are
increasing
2. The type and size of the ingested battery influence the
likelihood of complications
3. Urgency of management depends on the location of the battery
4. Honey or sucralfate should be...
Can family physicians accurately screen for AAA with point-of-care ultrasound?
EVIDENCE-BASED ANSWER:
LIKELY YES. POINT-OF-CARE ULTRASOUND (POCUS) SCREENING FOR ABDOMINAL AORTIC ANEURYSM (AAA) BY NONRADIOLOGIST PHYSICIANS IS 98% SENSITIVE AND 99% SPECIFIC, COMPARED WITH IMAGING PERFORMED BY RADIOLOGISTS (STRENGTH OF RECOMMENDATION [SOR]: B, META-ANALYSIS OF...
Do carotid artery calcifications seen on radiographs predict stenosis in asymptomatic adults?
EVIDENCE-BASED ANSWER:
NOT VERY WELL. IN ASYMPTOMATIC PATIENTS, CAROTID ARTERY CALCIFICATION SEEN ON RADIOGRAPH HAS A POSITIVE PREDICTIVE VALUE OF 70% AND A NEGATIVE PREDICTIVE VALUE OF 75% FOR CAROTID ARTERY STENOSIS (STRENGTH OF RECOMMENDATION [SOR]: B, SYSTEMATIC REVIEW OF OBSERVATIONAL...