California State University, Fresno
ORCID: 0000-0002-0973-8031Publishes on Antenna Design and Analysis, Antifungal resistance and susceptibility, Fungal Infections and Studies. 3 papers and 9 citations.
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Although MRH can mimic rheumatoid arthritis, its ability to rapidly progress to arthritis mutilans and association with malignancy in up to 25% of patients warrant prompt recognition and treatment along with age-appropriate malignancy work-up.
Merkel cell carcinoma (MCC) accounts for less than 1% of cutaneous malignancies. As the lesion may mimic benign entities, clinicians' differential should include rare entities to improve outcomes by early intervention. We present a case of primary MCC in the nasal vestibule requiring partial rhinectomy, suprahyoid lymphadenectomy, and radiation therapy.
A 26-year-old Hmong man, a central California farm laborer with no medical history, presented with 1 week of productive cough and intermittent fevers. A chest radiograph found probable lobar pneumonia with a cavitary lesion, and he was discharged with azithromycin for presumptive community-acquired pneumonia. Despite initial improvement, a pruritic skin eruption developed on his extremities and spread centripetally after completion of azithromycin. Upon re-evaluation in the emergency department, examination found erythematous nodules with central ulceration in the setting of ongoing cough. He denied arthralgia and recent travel but reported an 8-pound weight loss. Punch biopsy specimens were obtained (Fig