A 50-year-old African American female patient presented to the
emergency department with a complaint of severe shortness of breath
and a swollen right hand. On admission, she was unable to walk. She
gave no past medical history of diabetes mellitus or of treatments
for other pathologies. A physical examination was significant for
severe edema in the right upper extremity accompanied by excoriation
and necrosis of the skin and soft tissue of the limb and the right
chest wall. A chest radiograph showed a massive pleural effusion with
near complete collapse of the right lung. A photograph of the patient
(Figure 1) and a computed tomographic
scan of the chest (Figure 2) are shown.
A. Caustic burn injury
B. Locally advanced breast cancer
C. Iatrogenic high-dose radiation
injury
D. Necrotizing fasciitis
Answer