This patient arrived in the ER unsure of why his fingernails had become so dark. His hemoglobin was found to be 22 g/dL and he explained that his skin became itchy after a shower. These findings are typical of polycythemia vera, one of the chronic myeloproliferative diseases, which is characterized by an elevated hemoglobin, pruritus upon bathing, erythromelalgia (red, painful extremities), and thrombosis. Do you know what other indicators may be present for polycythemia vera? by figure1 http://instagram.com/p/vy3574mVIL/
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