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Consultant Vol 43 No 12

The 2-mm, white, very slightly raised lesion on the vermilion of a 37-year-old
man’s lower lip had been present for 2 months. The lesion was asymptomatic.
There was no history of injury or burn to the area.

A 34-year-old woman (gravida 3, para 2) presented at 28 weeks’ gestation with a 3-week history of a pruritic rash that had progressively worsened. Multiple vesicles and bullae were noted; erosions and crusts on older lesions were also present. The patient had had no prodromal symptoms; she denied fever, chills, nausea, and vomiting. The purplish hue on her body resulted from application of the topical antibacterial agent, gentian violet, which the patient had obtained in Mexico.

A 74-year-old woman was admitted to the hospital with abdominal pain, weight loss, fatigue, and change in bowel habits of 6 months’ duration. Her hemoglobin level was 7 g/dL; carcinoembryonic antigen, 672 ng/dL.

This 3-year-old girl was brought to the physician’s office for evaluation of a nonpruritic,
purple discoloration around her mouth. The patient’s mother reported
that the rash developed after the child had eaten a mango and sucked on a cup.

A 62-year-old woman sought medical
evaluation for persistent swelling
of her lower lip and right cheek. The
condition had been present for 8 to
9 months. A 6-month course of oral
prednisone prescribed by another
practitioner had no effect. The patient
had no history of chronic disease
and no pain, paralysis, ulcerations,
scaling, or dental or tongue problems.

A healthy 32-year-old scuba diver was taken to the emergency department (ED). He had lost consciousness following a dive in which he had held his breath during a rapid ascent to the surface and had performed the Valsalva maneuver to clear his ears.

An uncircumcised 58-yearold man presented with a persistent “rash” on his penis of 5 years’ duration. He complained of localized irritation with coitus. Over-the-counter ointments and corticosteroid preparations had failed to clear the eruption. The patient had hypertension, hyperlipidemia, and coronary artery disease. He had been monogamous for the last decade and denied any risk factors for sexually transmitted diseases.

A 39-year-old man was concerned that his history of long-term
nicotine exposure placed him at increased risk for
throat cancer. He had used about 2 cans of “dip” each week
for many years. The patient habitually placed the tobacco
in the right lower lip area; to avoid spitting, he always swallowed
the spent wad. The patient did not smoke; he used
alcohol occasionally.

The soft “bubble” on the mucosal surface of a 42-year-old
man’s lower lip had developed, disappeared for 3 months,
and returned. The lesion caused no pain or discomfort.

A 38-year-old man was concerned that the small lesions on his lips were flat
warts. A biopsy identified Fordyce, or sebaceous, glands of the lips.

A 34-year-old woman presented with a
3-day history of painful blisters of the
upper lip and nose. Five days earlier,
a rapid antigen test had confirmed
streptococcal pharyngitis; amoxicillin
was prescribed. The patient had no
history of herpes and was immunocompetent.
She had several young
children and did not work outside
the home.

How effective are NSAIDs in the treatment of fibromyalgia?

 

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