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Case 1 The patient was a 13-year-old boy who was born to consanguineous parents and was seen for fragility of the skin and mucous membranes that began at age 5 years with small erosions that formed on the hands and feet after minimal trauma, pain and bleeding of the gums, diarrhea, and intermittent constipation

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Key takeaways Smoking disrupts menstrual cycle, affecting flow and pain

Cigarettes, as a prop, have certainly not gone away

In practical terms: The product inside may look similar from a distance, but the packaging format changes how the pack is handled, stored, carried, displayed, and perceived

That little bit of drama was only the beginning of the type of spectacle that characterized his career