Robert P. Blereau, MD

September 14, 2005

This striking picture of a bifid uvula in an asymptomatic 57-year-old man was taken by Robert P. Blereau, MD of Morgan City, La.

September 14, 2005

For 3 years, a gradually enlarging, raised, purple, cystic lesion had been present on the left upper lip vermilion of a 51-year-old man. The asymptomatic lesion measured 0.5 cm in diameter. The patient was given a local anesthetic, and the lesion was excised by wedge resection in the office; pathologic examination confirmed the diagnosis of benign cavernous hemangioma.

September 14, 2005

This asymptomatic lesion on the upper arm of a 60-year-old man had been present for 2 years. The patient had used several over-the-counter antifungal and hydrocortisone creams to treat what he thought was ringworm.

September 14, 2005

Enterobiasis-an infection by pinworms-is caused by the nematode Enterobius vermicularis. Treatment is a single dose of oral albendazole, mebendazole, or pyrantel pamoate.

September 14, 2005

The left ear of a 1-month-old infant girl shows a congenital papillomatous lesion at the preauricular area. She had no other apparent abnormalities.

September 14, 2005

Highly pruritic, 2- to 4-mm, papular lesions with central ulceration erupted on the back of a 66-year-old woman. She had had 2 similar outbreaks in the past. The patient was taking conjugated estrogens, alprazolam, and alendronate.

September 14, 2005

A 43-year-old woman requested removal of a lesion from her left axilla because it had recently become irritated. The polypoid lesion with dried terminal ulceration had been present for 17 years.

September 14, 2005

A 15-year-old boy presented with sharp, right lower quadrant abdominal pain, nausea, vomiting, and fever of 2 days' duration. His white blood cell count was 15,000/mL with a shift to the left on the differential. Right lower quadrant rebound tenderness was noted.

September 14, 2005

A 65-year-old man had had an asymptomatic lesion on his left lateral lower leg for several weeks. The dark maroon, almost black, 3- to 4-mm, circular, elevated lesion had a convoluted surface of dilated vessels.

September 14, 2005

The diagnosis of acute appendicitis is usually straightforward. When the presenting symptoms are atypical, abdominal ultrasonography can be of diagnostic assistance if it shows the thickened walls of the appendix and a distended, noncompressible lumen.