Congratulations to the following individuals for their outstanding submissions to the Image Competition!
Grand Prize - Lauren Harper, MD, Columbus, OH
A 12-year-old female with a diagnosis of Moebius syndrome presented for evaluation of progressive tongue hemi-atrophy for one year, resulting in feeding and speech difficulties. Brain MRI demonstrated tongue hemi-atrophy without the involvement of the hypoglossal nerve. Tongue biopsy showed atrophy of skeletal muscle, variably sized nerves, stromal calcification, mild hyperplasia of overlying mucosa, parakeratosis, and mild subepithelial inflammation. She had forehead and post-auricular skin discoloration. She was diagnosed with Parry Romberg syndrome and en coup de sabre scleroderma. This rare complication of scleroderma can result in cosmetic disfigurement and functional impairments with speech and eating if the diagnosis is delayed.
Grand Prize - Santhanam Lakshminarayanan, MD, Farmington, CT
Cutaneous Manifestations of Dermatomyositis
A 32-year-old African American woman with classic cutaneous manifestations of Dermatomyositis - Heliotrope rash, periorbital edema with complete closure of the eyes, erythema nodosum on the lower extremity overlying the tibia, hyperkeratosis of hands (Mechanic's hands), post-inflammatory hypopigmentation on the MCP joints, PIP joints and DIP joints, Gottron's sign over PIP joints and elbow, periungal infarcts and hyperkeratosis of feet (Hiker's feet).
Grand Prize - Aleksandra Bukiej, MD, Chicago, IL
A 32-year old woman presented with a new skin lesion on her face. Four months previously, the patient was diagnosed with Behcet disease based on pulmonary embolism, inflammatory arthritis, oral ulcers, and a positive pathergy test. She was treated with adalimumab, with full resolution of the arthritis and aphthous ulcers, however, one month after beginning therapy, she noticed skin lesion on her left cheek (Figure 1). The lesion was scraped for fungal culture, which was positive for Blastomyces dermatidis and was confirmed by DNA probes. The patient was treated with itraconazole and had improvement by 4-months follow up (Figure 2).
Grand Prize - Tara McGrath, MD, British Columbia, Canada
Not Just a Disease of Ancient 'C-farers': A Case of Scurvy Presenting as Knee Pain and Refusal to Walk in a Developmentally Normal Toddler
Grand Prize - Manjinder Kaur, DO, Tucson, AZ
Thoracic Immunoglobulin G4 (IgG4)-Aortitis: Chest
Grand Prize - Koji Takasugi, MD, Nagoya, Japan
Polyarteritis Nodosum (PAN), Coronary and Other Aneurysms
Still Image - Nibha Jain, MD, Ahmedbad, India
Hypertrophic Osteoarthropathy: Pachydermia (“Bull-Dog” Appearance)
Case Study - Laura Tasan, MD, Pittsburgh, PA
Rosai-Dorfman Disease: Nodal and Extranodal Disease
Grand Prize - Giorgio Treglia, MD, Bellinzona, Switzerland
3-Dimensional Volume Rendering 18-Fludeoxyglucose-Positron Emission Tomography in Large Vessel Vasculitis
Still Image - Ernest Brahn, MD, Los Angeles, CA
Environmental Electron Microscopic Image of Articular Cartilage
Case Study - Cuoghi Edens, MD, Cleveland, OH
Palmoplantar Psoriasis and Psoriatic Arthritis in a Toddler Before and After Treatment with Infliximab
Grand Prize - Olga Goodman, Houston, TX
Spinal Cord Compression from Tophaceus Gout
Still Image - Karim Masri, MD, Baltimore, MD
IgA Nephropathy: Mesenteric Vasculitis
Case Study - Matthew Koster, MD, Rochester, MN
Atypical Swollen Hand: Mycobacterium Arupense Infection