| operations |
| comment | | "parent_author":"",<br>"parent_permlink":"medical",<br>"author":"shaktalks",<br>"permlink":"52-year-old-male-presents-to-the-family-medicine-office",<br>"title":"52-year-old male presents to the family medicine office...",<br>"body":"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/b\/b6\/Geert_Wilders_op_Prinsjesdag_2014_%28cropped%29.jpg\/1200px-Geert_Wilders_op_Prinsjesdag_2014_%28cropped%29.jpg\n\nhttps:\/\/4.bp.blogspot.com\/-IPhRKUt95C4\/Vwh5HDcpMNI\/AAAAAAAAA-c\/M9OZ2S5bDggEmS_Lk8kmF00r-3_Ch1bRA\/s320\/Obat%2BTradisional%2BPemfigoid%2BBulosa.jpg\n\nA 52-year-old male presents to the family medicine office for follow-up in regards to a blister that was treated on his right arm two weeks ago. He has completed his course of ciprofloxacin,<br> as prescribed,<br> with little to no improvement. During the last two weeks,<br> a similar rash has appeared on his right forearm. He denies any travel,<br> trauma,<br> new hygiene products,<br> or insect bites. The patient states he has had no fever or chills,<br> GI symptoms,<br> joint pain,<br> or numbness. Physical examination of his extremity reveals a large erythematous patch with clusters of hemorrhagic vesicles and bullae as shown in the exhibit. There is no inguinal lymphadenopathy or mucosal involvement. Nikolsky sign is negative. \n\n### The most likely diagnosis is?\nA. bullous pemphigoid\nB. dermatitis herpetiformis\nC. erythema multiforme\nD. pemphigus vulgaris\nE. porphyria cutanea tarda\n\n### Laboratory evaluation will most likely reveal?\nA. acantholysis\nB. decreased uroporphyrinogen decarboxylase\nC. hemidesmosomal autoantibodies\nD. increased lymphocytes and necrotic keratinocytes\nE. positive antistreptolysin O titer\n\n### The best course of treatment for this patient is?\nA. phlebotomy\nB. phototherapy\nC. potassium iodide\nD. rituximab\nE. topical corticosteroids",<br>"json_metadata":" \"tags\":[\"medical\",<br>\"comlex\" ,<br>\"image\":[\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/b\/b6\/Geert_Wilders_op_Prinsjesdag_2014_%28cropped%29.jpg\/1200px-Geert_Wilders_op_Prinsjesdag_2014_%28cropped%29.jpg\",<br>\"https:\/\/4.bp.blogspot.com\/-IPhRKUt95C4\/Vwh5HDcpMNI\/AAAAAAAAA-c\/M9OZ2S5bDggEmS_Lk8kmF00r-3_Ch1bRA\/s320\/Obat%2BTradisional%2BPemfigoid%2BBulosa.jpg\" ,<br>\"app\":\"steemit\/0.1\",<br>\"format\":\"markdown\" " |
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