Photoclinic Challenge

Can You Diagnose These Painful Lesions on the Patient's Right Palm?

Volume 64 - Issue 4 - April 2024

Consultant360’s Photoclinic Challenge is an interactive quiz based on an image featured in a Photoclinic article. View the slideshow for a brief overview of the case, patient history, and a key hint. For more Photoclinic Case Reports, visit our archive.

Figure. Several discrete areas of purplish discoloration on her right palm can be found, involving the 1st, 2nd, 3rd, and 5th digits.

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Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Consultant360 or HMP Global, their employees, and affiliates.

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Case. A 57-year-old woman with a past medical history of essential thrombocytosis, COPD, hypertension, and chronic hepatitis C presented to the ER with several discrete areas of purplish discoloration on her right palm, fingertips, and bilateral feet.

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Diagnostic testing. Notable lab findings included WBC 7.3 k/µL, hemoglobin 13.1 g/dL, and platelets 1273K mcL. No blasts were present on blood smear, and liver function tests and alkaline phosphatase were within normal limits.

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Diagnostic testing (continued). Rheumatology specialists ordered serum protein electrophoresis, rheumatoid factor, cryoglobulin, and antineutrophil cytoplasmic antibody tests as well as blood cultures, which were all negative.

For more Photoclinic Case Reports, visit our Issue Archive

Hint. Retiform purpura may be precipitated by numerous conditions, including small and medium vessel vasculitides and microvascular occlusion from a thrombotic, infectious, or embolic cause.

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Can You Diagnose These Painful Lesions on the Patient's Right Palm?

© 2023 HMP Global. All Rights Reserved.Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Consultant360 or HMP Global, their employees, and affiliates.

© 2023 HMP Global. All Rights Reserved.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Consultant360 or HMP Global, their employees, and affiliates.