RT Journal A1 Olitsky SE T1 PIcture of the month—quiz case JF Archives of Pediatrics & Adolescent Medicine JO Archives of Pediatrics & Adolescent Medicine YR 2011 FD March 1 VO 165 IS 3 SP 275 OP 276 DO 10.1001/archpediatrics.2011.2-a UL http://dx.doi.org/10.1001/archpediatrics.2011.2-a AB Her medical history was significant for frequent nosebleeds. These occurred spontaneously several times a week and sometimes lasted 20 to 30 minutes. She had no other history of bleeding problems. Her family history was remarkable for a history of recurrent nosebleeds in her father's family, a paternal grandfather who died secondary to a cerebrovascular accident of unknown cause, and a paternal great great grandfather who died of complications of gastrointestinal bleeding. Examination of the patient’s father showed similar lesions on his hands (Figure 3) and in his nose (Figure 4).