Endgames

An unlucky “double blow” to the fingers

Black dots on the scalp of a child

Generalised annular plaques on the trunk

A teenager with horizontal purple stripes on the lower back

A young man with sudden onset persistent chest pain

An unusual cause of urinary incontinence in a nonagenarian

A woman with white deposits in her eye

A man in his 30s with recurrent cough, fever, dyspnoea, and chest pain

A man with a cavitating lung lesion

Discoloured finger in a young girl

Unresolving fever, headache, cough, and negative covid-19 PCR result

A woman with erythema and pustules

A young child in respiratory distress

A white patch on the tongue

Isolated dilated pupil

Nodules in a sporotrichoid (lymphangitic) distribution

Post-traumatic weakness of elbow extension

A young man with red eye

A half tingling throat

A rapidly progressing, painful ulcer at a surgical wound site

Pruritus ani in a school age boy

A teenage girl with knuckle hyperpigmentation

Teenage girl with asymmetrical shoulder height

A tropical electrocardiogram wave

A case of non-traumatic shoulder pain

Erythematous plaques on the skin folds

Unexplained metabolic acidosis

Sudden loss of vision at the gym

Lower limb ecchymosis in a man with a history of alcohol misuse

A painful swollen ankle after a fall

Facial rash and ocular pain

Nails with bloodstained discoloration

Chronic unilateral nasal obstruction

Multiple oral erosions and ulcers in a patient with malignant melanoma

Fever, arthritis, and painful skin nodules

An intramedullary mass

A boy with annular erythema on the nose

A woman with recurrent erythema and vesicles on her legs

A recurrent rash on the penis

Why can’t I see in the dark?

A lump in the hand

An unusual presentation of prolonged delirium

A young man with shortness of breath

Pain in right buttock after carbon monoxide poisoning

A verrucous plaque on the hand

Wrist pain that should not be missed

Hypopigmented atrophic plaques in a young woman

Chronic suppurative skin lesions in a young woman

Unilateral nipple rash in a man

Deranged liver function in pregnancy

An unusual cause of sciatica in an immunocompromised patient

Acute onset dysphagia and neck pain after eating

A 5 year old girl with fever and rash

A boy with purpura on the legs

Multiple itchy lesions after recent travel

An irregular ulcer in the rectum

A wrist injury

A woman with headache, hemiplegia, and recent toothache

A lichenoid rash with hepatic origins

A guttural cough

A child with multiple hypopigmented lesions

A traumatic elbow injury

Maculopapular eruptions and vesicles on the limbs and buttocks

Painful nasal and oral lesions

Diffuse bruising on left breast

Just an odd rash?

Chest pain with a cold

An unusual case of acquired facial pigmentation

A rapidly enlarging neck swelling

Sudden onset homonymous quadrantanopia

A post-traumatic painful deformity of the elbow

Recurrent blisters on the lip

An annular plaque on the hand

Acute onset rash in a limited distribution

Computed tomography of covid-19 pneumonia

Ptosis that resolves with application of an ice pack

Unilateral bloodstained nasal discharge

Intranasal pain in a patient with Behçet’s disease

A painful swollen hand

A woman with spreading erythema after caesarean section

An unexpected finding on a chest radiograph

New onset weakness in the face and arm

A woman with nail changes

A woman with acute dyspnoea

Syncope in a young woman

Oedema over an inoculation site

A pigmented lesion on the eye

New onset unilateral arm swelling in a child with periorbital oedema

White eggs and yellow-brown spots on the pubic-perineal hairs

Acute paraplegia in a healthy child

A man with a traumatic lower limb injury

A pain in the neck

Umbilicated papules on the face

A man with weak limbs

A 44 year old woman with episodic sweating and hypertension

A young woman with dyspnoea and oedema

A baby with a widespread itchy rash

Pruritic annular concentric plaques

Recurrent epistaxis in an adolescent

Congenital blistering