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

Images in clinical medicine

(1). Facial Synkinesis

Authors: Ranjan Gupta, M.D., D.M., and Rudra Prosad Goswami, M.D., D.M.

Published March 21, 2026,DOI: 10.1056/NEJMicm2506222

Abstract

A woman with Bell’s palsy presented with a 1-month history of involuntary facial movements. Her face was nearly symmetric at rest, but when she raised her eyebrows, one side of her mouth involuntarily lifted (shown in a video).

(2). Eczema Herpeticum

Heba H.A.Published March 25, 2026,N Engl J Med 2026;394:1215,DOI: 10.1056/NEJMicm2516038,VOL. 394 NO. 12

Abstract

A 33-year-old pregnant woman with previously controlled atopic dermatitis presented with 3 days of fever and an itchy, painful rash. Erythematous vesiculopapular lesions were noted on the face, neck, chest, and arms.

(3). Minocycline-Induced Hyperpigmentation

Aarti Maharaj, Published April 1, 2026, N Engl J Med 2026;394: e24,DOI: 10.1056/NEJMicm2513782,VOL. 394 NO. 13

Abstract

A 68-year-old woman with rosacea presented with a 6-week history of dark patches on the skin of her arms and legs. Two weeks before the onset of the skin changes, she had started taking minocycline daily.

(4).Silent Aspiration

Shuo-Ting Jian, Published April 4, 2026,DOI: 10.1056/NEJMicm2516115

Abstract

A 68-year-old man who had undergone intubation 25 days earlier had difficulty swallowing after extubation. A swallowing study showed fluid penetrating into the trachea without triggering a cough reflex

(5). Massive Intravascular Hemolysis from Clostridium perfringens Bacteremia

Ann Tran, Published March 11, 2026,N Engl J Med 2026;394: e19,DOI: 10.1056/NEJMicm2514135, VOL. 394 NO. 11

Abstract

A 73-year-old woman presented in shock with a 1-day history of malaise, dyspnea, and confusion. Serum samples could not be processed owing to gross hemolysis. Dehemoglobinized red cells and bacilli were seen on a peripheral-blood smear.

(6) .Soft Tick Relapsing Fever

Lisa DePledge, Published March 11, 2026,, Engl J Med 2026;394: e18

DOI: 10.1056/NEJMicm2514982,VOL. 394 NO. 11

Abstract

A 74-year-old man was admitted to the hospital with a 3-week history of intermittent fevers, muscle aches, and vomiting. Thin blood smears showed spirochetes.

(7). Necrolytic Migratory Erythema

 Jia-An Hung,Published April 8, 2026,N Engl J Med 2026;394:1430,DOI: 10.1056/NEJMicm2516331,VOL. 394 NO. 14

Abstract

An 83-year-old woman with worsening type 2 diabetes presented with a 6-month history of painful rash. Hyperpigmented plaques with coalescing erosions and blisters were seen. Abdominal CT revealed a mass in the tail of the pancreas.

(8). Image Challenge

April 16, 2026https://www.nejm.org/image-challenge?ci=20260416&query=TOC&cid=DM2446125_NEJM_Non_Subscriber&bid=-836738352

Abstract

A 74-year-old man presented to the emergency department with a 3-day history of a painful laceration on his right leg that he had sustained while jumping into waters off the Gulf Coast of Florida. Two days after the injury to his leg, skin changes had appeared on his right arm. Physical examination is shown of the right lower leg and right forearm. He had no known history of chronic liver disease or an immunocompromising condition.

Which of the following is the most likely diagnosis?

Aeromonas cellulitis

Clostridium perfringens gas gangrene

Pseudomonas aeruginosa cellulitis

Mycobacterium marinum skin and soft tissue infection

Vibrio vulnificus skin and soft-tissue infection

(9). Intraosseous Abscess from Subacute Osteomyelitis

Haijian Li,  et al, Published April 11, 2026,N Engl J Med 2026;394:1529,DOI: 10.1056/NEJMicm2514540,VOL. 394 NO. 15

Abstract

A 16-year-old girl presented with 1 month of ankle pain and 11 days of fever. Radiographs showed an ill-defined, radiolucent distal tibial lesion; on MRI, the lesion was hypointense and surrounded by a hyperintense sclerotic rim.

(10). Adult-Onset Still’s Disease

Gabrielle Cognacq,Published April 15, 2026

N Engl J Med 2026;394: e29,DOI: 10.1056/NEJMicm2514594,VOL. 394 NO. 15

Abstract

A 27-year-old woman presented with a 2-week history of joint pain, fever, sore throat, and a nonpruritic rash that worsened during fever. Laboratory tests showed an elevated ESR and elevated C-reactive protein and ferritin levels.

Nightingale Journals

Kauvery Hospital
Find Doctor
Book Appointment