Case Presentation: A 48-year-old morbidly obese woman with history of sarcoidosis with annual cutaneous flares was admitted for extensive non-healing, necrotic ulcers on her lower extremities. Three months prior to presentation, the patient developed open ulcers on her legs which she attributed to a typical sarcoid flare. She later developed diffuse body malaise and dark [...]

Case Presentation: Our patient is a 42-year-old male with history significant for hypertension, end stage renal disease (ESRD) on hemodialysis (HD), anemia of chronic disease, renal osteodystrophy, and right wrist calciphylaxis who presented with worsening right wrist erythema and bleeding. Patient had reported non-compliance with his dialysis schedule and noted to have multiple previous admissions [...]

Case Presentation: 44 year-old male with ESRD on HD complicated by tertiary hyperparathyroidism, possible calciphylaxis on treatment with sodium thiosulfate, possible adrenal insufficiency on steroids, antithrombin III deficiency with prior pulmonary and splenic infarcts on Coumadin who developed a diffuse cutaneous skin eruption during a recent admission after being on antibiotics for possible pneumonia. He [...]

Case Presentation: A 60 year-old man with a past medical history of end-stage renal disease (ESRD) on hemodialysis (HD) was admitted after a becoming hypotensive during dialysis. The patient denied any fevers or chills, but endorsed progressive malaise and increased pain on the tip of his penis. Physical exam was significant for a blood pressure [...]

Case Presentation: 59 year old African American male with a history of sarcoidosis on prednisone, pulmonary HTN, CKD 3, NIDDM, and NICM presented to the ED with a 2 week history of leg swelling/pain. He was febrile on presentation. He was prescribed cephalexin for cellulitis and discharged. He returned 2 days later with worsening lower [...]

Case Presentation: A 74 year old female with history of atrial flutter on warfarin presented to the emergency department with altered mental status and bilateral leg pain. She was found to have a leukocytosis (WBC 14.7), pre-renal azotemia and an elevated INR of 8.2. Exam was notable for bilateral lower extremity ulcers. She was treated [...]

Case Presentation: A 47-year-old woman with obesity, diabetes mellitus, hypertension, and liver cirrhosis presented with septic shock and acute renal failure along with volume overload necessitating urgent dialysis. She received broad-spectrum antibiotics, which were later narrowed to cover extended spectrum beta-lactamase-producing (ESBL) Enterobacter found in her blood cultures. Fifteen days after admission and initiation of [...]

Case Presentation: A 47-year-old female with ESRD, chronic hypotension, anemia of chronic disease, depression and anxiety presented with painful chronic non-healing bilateral lower extremity wounds. Her wounds started about 3 months prior as superficial hyperpigmented painful areas which had gradually become indurated and subsequently ulcerated. Her wounds were extremely painful, limiting her ability to move [...]

Case Presentation: A 62-year-old man presented with 5 weeks of progressive right lower extremity ulceration associated with pain, swelling, erythema, fevers, and diaphoresis. Initially, outpatient providers diagnosed patient with cellulitis following minor trauma and complicated by chronic venous stasis. Medical history included poorly-controlled insulin-dependent type 2 diabetes, atrial fibrillation on warfarin, recurrent venous stasis ulcers, [...]

Case Presentation: A 60-year-old female presented to the emergency department with shortness of breath, worsening edema, and a tender, non-purulent, erythematous rash on her medial thighs bilaterally. Her medical history was significant for atrial fibrillation, heart failure with reduced ejection fraction, and chronic myelomonocytic leukemia. The patient had been recently discharged after an admission for [...]