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Lambert-Eaton Myasthenic Syndrome

• Myasthenia gravis

• Polymyositis

• Primary myopathies

• Carcinomatous myopathies

• Polymyalgia rheumatica

• Guillain-Barré syndrome

Lead Poisoning

• Polyneuropathies from other sources

• Anxiety disorder, attention deficit disorder

• Malabsorption, acute abdomen

• Iron deficiency anemia

Leg Ulcers ²⁹

VASCULAR

• Arterial: arteriosclerosis, thromboangiitis obliterans, arteriovenous (AV) malformation, cholesterol emboli

• Venous: superficial varicosities, incompetent perforators, deep venous thrombosis (DVT), lymphatic abnormalities

VASCULITIS/HEMATOLOGIC

• Sickle cell anemia, thalassemia, polycythemia vera, leukemia, cold agglutinin disease

• Macroglobulinemia, protein C and protein S deficiency, cryoglobulinemia, lupus anticoagulant, antiphospholipid syndrome

INFECTIOUS

• Fungus: blastomycosis, coccidioidomycosis, histoplasmosis, sporotrichosis

• Bacterial: furuncle, ecthyma, septic emboli

• Protozoal: leishmaniasis

METABOLIC

• Necrobiosis lipoidica diabeticorum

• Localized bullous pemphigoid

• Gout, calcinosis cutis, Gaucher’s disease

TUMORS

• Basal cell carcinoma, squamous cell carcinoma, melanoma

• Mycosis fungoides, Kaposi’s sarcoma, metastatic neoplasms

TRAUMA

• Burns, cold injury, radiation dermatitis

• Insect bites

• Factitial, excessive pressure

NEUROPATHIC

• Diabetic trophic ulcers

• Tabes dorsalis, syringomyelia

DRUGS

• Warfarin, IV colchicine extravasation, methotrexate, halogens, ergotism, hydroxyurea

PANNICULITIS

• Weber-Christian disease

• Pancreatic fat necrosis, α-antitrypsinase deficiency

Legg-Calvé-Perthes Disease

• Transient synovitis

• Low-grade septic arthritis

• Juvenile rheumatoid arthritis

Lentigo

• Lentigo maligna

• Actinic keratosis

• Flat seborrheic keratosis

• Melanocytic nevus

Leprosy

• Sarcoidosis

• Rheumatoid arthritis

• Systemic lupus erythematosus

• Lymphomatoid granulomatosis

• Carpal tunnel syndrome

• Cutaneous leishmaniasis

• Fungal infections

Leptospirosis

• Bacterial meningitis

• Viral hepatitis

• Legionnaire’s disease

Leukocoria

• Retinal detachment

• Retinoblastoma

• Retinal telangiectasia

• Retrolenticular vascularized membrane

• Familial exudative vitreoretinopathy

Leukoplakia, Oral Hairy (Oral Hairy Cell Leukoplakia)

• Candida albicans

• Lichen planus

• Idiopathic leukoplakia

• White sponge nevus

• Focal epithelial hyperplasia

• Squamous cell carcinoma

Lichen Sclerosus

• Localized scleroderma (morphea)

• Cutaneous discoid lupus erythematosus

• Atrophic lichen planus

• Bowen’s disease

Lichen Simplex Chronicus

• Lichen planus

• Atopic dermatitis

• Insect bite

• Nummular eczema

• Contact dermatitis

• Stasis dermatitis

Listeriosis

• Meningitis caused by other bacteria, mycobacteria, or fungi

• CNS sarcoidosis

• Brain neoplasm or abscess

• Tuberculous and fungal (especially cryptococcal) meningitis

• Cerebral toxoplasmosis

• Lyme disease

• Sarcoidosis

Liver Lesions, Benign, Often Confused with Malignancy

• Fatty infiltration

• Flow artifacts

• Focal nodular hyperplasia

• Nonenhanced vessels

Low-Voltage Electrocardiogram (ECG)

• Hypothyroidism

• Pericardial effusion

• Pleural effusion

• Pneumothorax

• Amyloidosis

• Aortic stenosis

Lumbar Disk Syndrome

• Soft tissue strain or sprain

• Degenerative arthritis of hip

• Insufficiency fracture of hip or pelvis

Lung Neoplasm, Primary

• Tuberculosis (TB)

• Metastatic carcinoma to the lung

• Lung abscess

• Granulomatous disease

• Carcinoid tumor

• Mycobacterial and fungal diseases

• Sarcoidosis

• Viral pneumonitis

• Benign lesions that simulate thoracic malignant disease

• Lobar atelectasis: pneumonia, TB, chronic inflammatory disease, allergic bronchopulmonary aspergillosis

• Multiple pulmonary nodules: septic emboli, Wegener’s granulomatosis, sarcoidosis, rheumatoid nodules, fungal disease, multiple pulmonary atrioventricular fistulas

• Mediastinal adenopathy: sarcoidosis, lymphoma, primary TB, fungal disease, silicosis, pneumoconiosis, drug induced (e.g., phenytoin, trimethadione)

• Pleural effusion: congestive heart failure, pneumonia with parapneumonic effusion, TB, viral pneumonitis, ascites, pancreatitis, collagen-vascular disease

Lyme Disease

• Acute viral illnesses

• Ehrlichiosis

• Insect bite

• Granuloma annulare

• Seborrheic dermatitis

• Erythema annulare

• Erythema marginatum

Lymphadenopathy ¹⁴

LOCALIZED

Cervical Nodes

• Infections of the head, neck, ears, sinuses, scalp, pharynx

• Mononucleosis

• Malignant neoplasm of head and neck

Scalene/Supraclavicular Nodes

• Lung neoplasm

• Bacterial or fungal infection of thorax or retroperitoneum

• GI malignant disease

Axillary Nodes

• Infections of hands and arms

• Cat-scratch disease

• Neoplasm (lymphoma, melanoma, breast carcinoma)

• Brucellosis

Epitrochlear Nodes

• Infections of the hand

• Sarcoidosis, secondary syphilis (usually bilateral)

Inguinal Nodes

• Infections of leg or foot, folliculitis (pubic hair)

• Lymphogranuloma venereum (LGV), syphilis

• Pelvic malignant neoplasm

• Pasteurella pestis

Hilar Nodes

• Sarcoidosis

• Lung carcinoma

• Fungal infections, systemic

Mediastinal Nodes

• Sarcoidosis

• Lung neoplasm

• Mononucleosis

• Histoplasmosis

Abdominal/Retroperitoneal Nodes

• Exclude other causes of edema (e.g., cirrhosis, nephrosis, congestive heart failure, myxedema, hypoalbuminemia, chronic venous stasis, reflex sympathetic dystrophy, obstruction from abdominal or pelvic malignant neoplasm)

• Neoplasm (ovary, testes, prostate, and other malignant neoplasms)

Lymphedema

• Exclude other causes of edema (e.g., cirrhosis, nephrosis, congestive heart failure)

• Hypoalbuminemia

• Chronic venous stasis

• Reflex sympathetic dystrophy

• Obstruction from abdominal or pelvic malignant neoplasm

Lymphocytopenia

• HIV infection

• Bone marrow suppression from chemotherapeutic agents or chemotherapy

• Aplastic anemia

• Hyperadrenalism

• Neurologic disorders (multiple sclerosis [MS], myasthenia gravis, Guillain-Barré syndrome)

Lymphogranuloma Venereum

• Inguinal adenitis

• Suppurative adenitis

• Retroperitoneal adenitis

• Cat-scratch disease

• Schistosomiasis

Lymphoma, Non-Hodgkin’s

• Hodgkin’s disease

• Viral infections

• Metastatic carcinoma

• Sarcoidosis

Lynch Syndrome

• Familial adenomatous polyposis

• Peutz-Jeghers syndrome

• Juvenile polyposis

• Nonhereditary colorectal cancer

• Gardner’s syndrome

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