You are correct. The patient had secondary syphilis confirmed by serology. She was initially diagnosed with pemphigus, but biopsy showed abundant plasma cells prompting syphilis testing. Secondary syphilis is highly contagious.

You are correct. Orbital and skull fractures were excluded by CT scan. Subsequent brain MRI demonstrated an acute infarct of the right medial longitudinal fasciculus (MLF). Internuclear ophthalmoplegia (INO) is an impaired conjugate gaze characterized by adduction paresis of the affected eye and abduction nystagmus of the contralateral eye, leading to horizontal diplopia. It usually occurs in multiple sclerosis or cerebrovascular disease, and is extremely rare after head injury. INO may persist for months. This patient received conservative tx and recovered within 3 days.

You are correct. Interdigital pilonidal sinus is an occupational disease that usually affects hairdressers’ hands; few cases have been described affecting the feet. Freshly cut hairs are able to penetrate the skin and start the disease process. The condition may be prevented by avoiding exposure of the interdigital skin to freshly cut hair. Treatment is by surgical excision.