- Email: [email protected]
Woman With Bleeding Lesion on Her Back
IMAGES IN EMERGENCY MEDICINE Natasha LaBelle, MD; Michael Menchine, MD, MPH 0196-0644/$-see front matter Copyright © 2014 by the American College of Emergency Physicians. http://dx.doi.org/10.1016/j.annemergmed.2013.10.004
Figure. Large lesion with many multicolored proliferative nodules on the patient’s left midback.
[Ann Emerg Med. 2014;64:95.] A 50-year-old woman presented to the emergency department, reporting 1 day of bleeding from a lesion on her back (Figure), which had been present since birth and progressively increased in size. The lesion had become painful and swollen during the past 2 weeks, without associated pruritus, trauma, or constitutional symptoms. Physical examination revealed a 2015-cm midback lesion with many multicolored proliferative nodules of varying size, without active bleeding, ulceration, or purulence.
For the diagnosis and teaching points, see page 100. To view the entire collection of Images in Emergency Medicine, visit www.annemergmed.com Volume 64, no. 1 : July 2014
Annals of Emergency Medicine 95
Correspondence Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje. org). The authors have stated that no such relationships exist and provided the following details: This report was supported by the National Institute on Aging of the National Institutes of Health under Award Number K23AG038548. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. 1. Acierno R, Hernandez MA, Amstadter AB, et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and
100 Annals of Emergency Medicine
2. 3.
4.
5. 6.
7.
potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health. 2010;100:292-297. Lachs MS, Williams CS, O’Brien S, et al. ED use by older victims of family violence. Ann Emerg Med. 1997;30:448-454. Dong X, Simon MA. Association between elder abuse and use of ED: findings from the Chicago Health and Aging Project. Am J Emerg Med. 2013;31:693-698. Stevens TB, Richmond NL, Pereira GF, et al. Prevalence of non-medical problems among older adults presenting to the emergency department. Acad Emerg Med. In press. Pillemer K, Finkelhor D. The prevalence of elder abuse: a random sample survey. Gerontologist. 1988;28:51-57. Mandl KD, Overhage JM, Wagner MM, et al. Implementing syndromic surveillance: a practical guide informed by the early experience. J Am Med Informat Assoc. 2004;11:141-150. Fulmer T, Guadagno L, Bitondo Dyer C, et al. Progress in elder abuse screening and assessment instruments. J Am Geriatr Soc. 2004;52:297-304.
Volume 64, no. 1 : July 2014
Figure. Large lesion with many multicolored proliferative nodules on the patient’s left midback.
[Ann Emerg Med. 2014;64:95.] A 50-year-old woman presented to the emergency department, reporting 1 day of bleeding from a lesion on her back (Figure), which had been present since birth and progressively increased in size. The lesion had become painful and swollen during the past 2 weeks, without associated pruritus, trauma, or constitutional symptoms. Physical examination revealed a 2015-cm midback lesion with many multicolored proliferative nodules of varying size, without active bleeding, ulceration, or purulence.
For the diagnosis and teaching points, see page 100. To view the entire collection of Images in Emergency Medicine, visit www.annemergmed.com Volume 64, no. 1 : July 2014
Annals of Emergency Medicine 95
Correspondence Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje. org). The authors have stated that no such relationships exist and provided the following details: This report was supported by the National Institute on Aging of the National Institutes of Health under Award Number K23AG038548. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. 1. Acierno R, Hernandez MA, Amstadter AB, et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and
100 Annals of Emergency Medicine
2. 3.
4.
5. 6.
7.
potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health. 2010;100:292-297. Lachs MS, Williams CS, O’Brien S, et al. ED use by older victims of family violence. Ann Emerg Med. 1997;30:448-454. Dong X, Simon MA. Association between elder abuse and use of ED: findings from the Chicago Health and Aging Project. Am J Emerg Med. 2013;31:693-698. Stevens TB, Richmond NL, Pereira GF, et al. Prevalence of non-medical problems among older adults presenting to the emergency department. Acad Emerg Med. In press. Pillemer K, Finkelhor D. The prevalence of elder abuse: a random sample survey. Gerontologist. 1988;28:51-57. Mandl KD, Overhage JM, Wagner MM, et al. Implementing syndromic surveillance: a practical guide informed by the early experience. J Am Med Informat Assoc. 2004;11:141-150. Fulmer T, Guadagno L, Bitondo Dyer C, et al. Progress in elder abuse screening and assessment instruments. J Am Geriatr Soc. 2004;52:297-304.
Volume 64, no. 1 : July 2014