Photoclinic

These photos are of the left hand of a full-term, newborn infant with focal ring constrictions of the third, fourth, and fifth fingers; secondary edema and discoloration are also seen.

A 63-year-old African American man presented with orthopnea and pedal edema that had worsened during the past 4 months. Macroglossia was noted.

Persistent, purulent drainage from the perirectal region for 3 months prompted a 60-year-old man to seek medical evaluation. He also complained of minimal bleeding from the anus and perianal itching. The patient reported that he recently obtained some relief after a boil in the same area spontaneously burst.

Three days after having eaten fish, a 66-year-old woman with a known allergy to fish and a history of schizophrenia was brought to the emergency department because of macroglossia—a presentation of anaphylaxis. The patient refused airway management (intubation or cricothyrotomy) and was therefore admitted to the medical intensive care unit for monitoring of her airway and hemodynamic status. She received corticosteroids, ranitidine, diphenhydramine, epinephrine, and oxygen (via nasal cannula).

The frontal and bitemporal hair recession generally seen in men with androgenetic alopecia is not typical in women, who instead tend to undergo a diffuse thinning of hair on the crown.