A 16-year-old male with recurrent inflammation and hearing loss.

Editor’s note: Each month, this department features a discussion of an unusual diagnosis in genetics, radiology, or dermatology. A description and images are presented, followed by the diagnosis and an explanation of how the diagnosis was determined. As always, your comments are welcome via e-mail at [email protected]. Josephine L. Reece, MD, is Internal Medicine and Pediatric Resident, West Virginia University School of Medicine. Jeffrey D. Lancaster, MD , is Assistant Professor of Pediatrics, West Virginia University School of Medicine. Linda S. Nield, MD, is Associate Professor of Pediatrics, West Virginia University School of Medicine. Address correspondence to: Josephine L. Reece, MD, West Virginia University School of Medicine, Morgantown, WV 26506; fax: 304-293-1216; e-mail: jreece@ hsc.wvu.edu.