A medium-sized brown pigmented lesion had been present on the right temple of a 61-year-old man since birth. The patient complained that during the last several months the lesion had formed a fine scale and begun to itch. Actinic keratoses and inclusion cysts were also noted on his face.
A 75-year-old man was brought to the emergency department with fever, cough, and abdominal pain of 2 days’ duration. The pain was most severe in the epigastric and umbilical regions. The patient’s history included type 2 diabetes mellitus, hypertension, and hypercholesterolemia. He had smoked cigarettes for 40 years and recently lost 50 lb. The patient was tachypneic and diaphoretic.