Image of the Week: The classic findings of a rare condition

A 36-year-old female anxiously presents to the emergency department with a severe headache, palpitations, and diaphoresis. She mentions she has had similar self-limiting episodes over the last few years and a chronic history of diarrhea. On examination, her blood pressure is 160/100 mmHg and multiple pruritic, pigmented lesions are seen on her back. A 24-hour urine collection reveals elevated catecholamines ...