Acute onset of polyarthralgia and skin plaques.
نویسندگان
چکیده
Previously published Photo Quizzes are now featured in a mobile app. Get more information at http:/www. aafp.org/afp/apps. A 52-year-old Hispanic man presented with two weeks of severe pain and swelling in his knees and wrists that affected his ability to walk. He had a rash on his thighs, knees, hands, and lower back. He did not have fever, dysuria, or eye pain. He had no significant medical history. His vital signs were normal. He had redpurple, round plaques with scale on his bilateral lower extremities, dorsum of his hands, over the sacral region of his lower back, and in the inguinal region (Figure 1). His palms were normal, but the soles of his feet had a thick, yellow, keratotic scale. There was no fingernail pitting. There was prominent joint swelling and effusion in his wrists and knees (Figure 2), with mild tenderness and limited range of motion. There was diffuse swelling of the right thumb with nail dystrophy. Laboratory studies revealed an elevated C-reactive protein level of 222 mg per L (2,114.33 nmol per L) and erythrocyte sedimentation rate of 113 mm per hour. Serology tests were positive for Chlamydia trachomatis immunoglobulin M and G.
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عنوان ژورنال:
- American family physician
دوره 91 10 شماره
صفحات -
تاریخ انتشار 2015