A Snowflake-Like, Powdery Substance on the Head and Neck of an Adult Male

Patient: 53-year-old African-American male Chief Complaint: Shortness of breath, lower extremity swelling, nausea, vomiting, diarrhea, altered taste sensation, and decreased urine output. History of Present Illness: Patient presented to the emergency room (ER) with complaints of nausea and vomiting for 2 months, shortness of breath for the last few days, altered taste sensation, and worsening of preexisting lower extremity swelling. Other complaints included blurred vision, diarrhea, and extreme weakness. Past Medical and Surgical History: Type II diabetes mellitus and hypertension for about 10 years. No significant surgical history. Social History: No tobacco use, occasional alcohol use, and no IV drug abuse. Physical Exam Vital Signs: Temperature, 97.7°F; respiratory rate, 20/minute …