Journal scan: A review of images in clinical medicine of immediate clinical significance, harvested from major international journals

From the desk of the Editor-in-chief

(1). Subcutaneous Panniculitis-like T-Cell Lymphoma

Shinri Okada, Published September 13, 2025, DOI: 10.1056/NEJMicm2503203

Abstract

A 30-year-old woman presented with a 10-week history of painful skin nodules and a 6-week history of fevers and night sweats. A physical examination was notable for palpable subcutaneous nodules with overlying erythema.

(2). What is the most likely diagnosis?

Grace Boyd, B.S., and Carol Cheng. Doxycycline-Induced Phototoxicity. N Engl J Med 2025;393: e19. DOI: 10.1056/NEJMicm2506434

Abstract

A 15-year-old girl presented with a 2-week history of a painful, blistering rash on both hands. One week before the onset of symptoms, she had started oral doxycycline therapy to treat acne.

(3). Primary Varicella Infection

Olivier van Not et al, Published September 17, 2025, N Engl J Med 2025;393: e18, DOI: 10.1056/NEJMicm2505110, VOL. 393 NO. 11

Abstract

A previously healthy 44-year-old man presented with a 4-day history of an itchy rash and a 2-day history of fever and malaise. A pleomorphic eruption of papules and pustules of different sizes and stages of evolution was noted.

(4). Systemic Mastocytosis

Luís Neves da Silva, Published September 20, 2025, DOI: 10.1056/NEJMicm2503821

Abstract

A 65-year-old man presented with a 4-month history of a rash and a 2-month history of diarrhea and weight loss. Examination showed a maculopapular eruption. CT revealed osteosclerosis of thoracic vertebral bodies.

(5). Herpes Simplex Virus Esophagitis

Ankit Agarwal et al, Published September 27, 2025,DOI: 10.1056/NEJMicm2502014

Abstract

A 29-year-old woman presented with a 2-day history of painful swallowing. One week earlier, she had had a fever and sore throat. Upper endoscopy revealed multiple “volcano-like” ulcers in the middle esophagus.

(6). Image Challenge

NEJM Image Challenge, September 25, 2025

A 52-year-old woman with hypertension presented to the hospital with a 1-month history of fatigue, as well as 6 days of vomiting and 1 day of confusion. Over the past 20 years, she had not received regular treatment for hypertension. Physical examination was notable for pallor of the conjunctiva and oral mucosa, as well as for powdery, crystalline deposits on the arms, legs, trunk, and scalp. Which of the following is the most likely diagnosis?

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