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Pain Problems—A Photo Essay

Pain Problems—A Photo Essay

A 33-year-old woman presented with frontotemporal headaches and neck pain. Later, she presented to the ED with a worsening headache now accompanied by nausea, vomiting, ankle pain with swelling, and fever. A new rash on the anterior aspect of her lower extremities (below) appeared as erythematous, tender patches, 3 to 4 cm in size. Biopsy of lung tissue was significant for granulomatous disease, and a diagnosis of Lofgren syndrome (a form of acute sarcoidosis) was made.

Lofgren syndrome
Image courtesy of Mohenish Singh, DO, Brandon Hill, MD, and James McDonald, MD.

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