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Fever and Necrotic Nodules on the Extremities—Quiz Case

Anatoli Freiman, MD; Marie St-Jacques, MD; Ronald Onerheim, MD; Denis Sasseville, MD
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Michael E. Ming, MD
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Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

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Arch Dermatol. 2005;141(8):1035-1040. doi:10.1001/archderm.141.8.1035-a
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REPORT OF A CASE

A previously healthy 30-year-old man presented with a spontaneous onset of a skin ulcer on his left leg and multiple deep-seated necrotic nodules on his extremities (Figure 1). His condition subsequently worsened; he became febrile and developed polyarthralgia, myalgia, and hypoesthesias of his extremities. Laboratory investigations revealed marked anemia, thrombocytopenia, and evidence of hepatic failure. A deep wedge biopsy specimen was obtained from a skin nodule (Figure 2 and Figure 3).

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Figure 1.

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Figure 2.

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Figure 3.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

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To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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