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Consultant. Vol. 49 No. 8
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Dermclinic
A Photo Quiz to Hone Dermatologic Skills 

Is this mildly pruritic eruption a bacterial infection—or something else?

By DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas | August 4, 2009
Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

Case 3:
This pruritic rash developed in a 43-year-old woman who had undergone a lumpectomy and lymph node dissection for breast cancer. She completed radiation therapy and chemotherapy 3 weeks ago. The rash has been present for 5 days. Levofloxacin(Drug information on levofloxacin) was started 1 day ago.

(MORE: What caused this rash that resists antiviral therapy?)

Which of the following would you include in the workup?

A. Bacterial culture.
B. Fungal culture.
C. Viral culture.
D. Skin biopsy.
E. CT scan.

Which of these regimens would you prescribe pending workup results?

F. Cephalexin, 500 mg 3 or 4 times a day.
G. Doxycycline(Drug information on doxycycline), 100 mg bid.
H. Fluconazole, 100 mg/d.
I. Valaciclovir(Drug information on valaciclovir), 500 mg bid.
J. Famciclovir(Drug information on famciclovir), 250 mg bid.
K. Valaciclovir, 1 g tid.
L. Famciclovir, 500 mg tid.
M. Application of a mid-potent topical corticosteroid
cream twice a day.

(answers on next page)

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Derm August 2009

What underlies this persistent facial rash?

Workup for STIs is negative—how do you explain this penile lesion?

Is this mildly pruritic eruption a bacterial infection—or something else?

What caused this rash that resists antiviral therapy?






 
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