Thursday, November 8, 2012

Picture This


This patient has seen doctors for years without a diagnosis. She has crampy abdominal pain, fatigue, nonbloody diarrhea, weight loss, and fever. She attributes her weight loss to mouth pain and pain with swallowing. A colonoscopic image is shown below as are two interesting skin rashes.



Challenge: What's the diagnosis?

First two images shown under GNU Free Documentation License. Last image is in the public domain.

3 comments:

Reflex Hammer said...

IBD, causing erythema nodosum and pyoderma gangrenosum?

Anonymous said...

IBD with extraintestinal manifestions, ie pyoderma gangrunosum, mouth ulcers, dd behcet.

Craig said...

yes, nicely done, classic internal medicine boards questions
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Picture This

The first image shows a serpiginous ulcer; the second image shows erythema nodosum; the third image shows pyoderma gangrenosum. This is consistent with Crohn's disease.

Sources: UpToDate; Wikipedia.