These extensive, smooth, irregular masses of pigmented tissue on the earlobes of a 28-year-old woman are keloids. The patient had her ears pierced at age 6 years; the masses began to develop when she was about 9 to 10 years old. The right earlobe mass arose first and is larger. She had one other keloid of 1 cm on her chest that had developed after a scratch. She denied any other skin lacerations or incisions.

An elderly Asian man is brought to your office by his family for a routine physical examination. The patient speaks no English. The family is not well acquainted with his medical history; however, they know he was “sick” as a teenager and had some type of chest surgery.

A 68-year-old woman was hospitalized because of confusion and agitation of sudden onset. Her history included dementia and multiple infarcts of both cerebellar hemispheres, bilateral basal ganglia, bilateral parietal lobes, and the right occipital lobe.

An 83-year-old woman was hospitalized for generalized abdominal pain with nausea and bilious emesis of 2 days' duration. She had no diarrhea, constipation, melena, hematochezia, hematemesis, or dysphagia. She had undergone subtotal gastrectomy with Billroth I anastomosis for a duodenal ulcer 40 years earlier.

A staff nurse calls the physician to see "something really bizarre—we have no idea what this is": the plastic of a urine collection bag of an 81-year-old woman has turned purple, although the urine within is more orange-brown and distinctly less odd looking. Patient has had an indwelling urethral catheter for 7 months, and this discoloration had not been noted before. Current history includes marked constipation, atrial fibrillation, and symptomatic osteoarthrosis of the hips and knees.

A 53-year-old man with a 30-year history of heavy injection drug use (10 to 15 bags of heroin per day) was hospitalized with fever (temperature, 39.2°C [102.5°F]) and chills of 2 days' duration. Infective endocarditis was diagnosed based on the results of 3 sets of blood cultures, which were positive for methicillin-sensitive Staphylococcus aureus.

This is a case in which we believe vancomycin/Zosyn caused DIHS with lung involvement in form of bilateral pleural effusions, a very rare presentation.

A 58-year-old man with a past medical history of chronic sinus disease and hypothyroidism presented with left periorbital pain and erythema that worsened despite outpatient treatment with topical antibiotics. An outpatient CT scan showed pansinusitis and orbital stranding. The diagnosis was orbital cellulitis and sinusitis.

This 66-year-old black woman presented with a 2-year history of a painless skin eruption. She stated that her skin had “changed overnight” while she was caring for her mother who had been hospitalized.

A 66-year-old woman presented with a 2-day history of acute onset of redness, pain, and swelling of the right breast.

An 87-year-old man experienced a scratchy throat and difficulty speaking, which cleared after taking over-the-counter throat lozenges.