CRITICAL SITUATIONS SECTION EDITOR: ANITA G. LICATA, MD Purple Toes in a Patient With End-Stage Rheumatoid Arthritis Hossein C. Nousari, MD; Arash Kimyai-Asadi, MD; Justin Stebbing, MD, MRCP; John H. Stone, MD, MPH; the Division of Dermatoimmunology, Department of Dermatology (Drs Nousari and Kimyai-Asadi), and the Division of Rheumatology, Department of Medicine (Drs Stebbing and Stone), Johns Hopkins Medical Institutions, Baltimore, Md Critical Situations: Dermatology in the Acute Care Setting REPORT OF A CASE Physical examination revealed an obese woman with a temperature of 38.7°C. Her musculoskeletal examina- A 57-year-old Puerto Rican woman was admitted with a tion demonstrated extensive joint deformities, including 4-week history of painful, purple toes associated with mal- decreased range of motion in the shoulders, flexion con- aise, fevers, sweats, and intermittent discomfort in the traction of the elbows, loss of flexion and extension at both middle part of her chest. She had initially presented to wrists, and “opera glass” deformities of the hands an outside hospital, where blood cultures, a transthor- (Figure 1). However, there was no active synovitis and acic echocardiogram, and an angiogram of the lower ab- rheumatoid nodules were absent. A 3-component peri- dominal aorta with runoff revealed no abnormalities. How-
JAMA Dermatology – American Medical Association
Published: Jun 1, 1999
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera