PMC5204093_01
Physical findings of (a) violaceous patchy, discoid-like lesions above eyebrows, on side of face, ears, extensor surface of elbows, and knees, and malar-like rash on bridge of nose, (b) subcutaneous purpuric rash on palmar surface of fingers, and (c) alopecia of the head and hirsutism of the back.
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fig1
Several interesting findings were present in the patient and shown in Figure 1, including painful mucocutaneous ulcers on upper and lower lips, possible malar rash across the bridge of his nose, discoid-like rash on various parts of his face, chest, extensor surface of his elbows, and possibly knees, and subcutaneous purpuric rash on the palmar surface of his fingers, as well as both alopecia and hirsutism with overgrowth of hair on his back.
Peripheral blood smear showing normochromic RBCs with anisocytosis/poikilocytosis, thrombocytopenia, and paucity of PMNs and lymphocytes.
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fig2
See Figure 2 for one example of patient's peripheral smear.
Patient's drawing of a watch at "ten past eleven," part of MOCA test administered. Patient scored 6/30, with severe deficiencies in visuospatial/executive function, attention, and delayed recall.
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fig3
The patient's drawing on a clock on MOCA test can be seen in Figure 3.