Reference ranges End and review Question 9 of 55 A 52 year old male was referred to the outpatients dermatology clinic with a four month history of a persistent rash. He described the rash as a very itchy blistering rash occuring behind his knees but also on his buttocks. He had been prescribed levocetirizine 5mg OD as well as a four week course of eumovate BD and diprobase QDS but despite the treatment his symptoms had worsened. He had a past medical history comprising refractory eczema, gout, angina, hypertension and DIABETESmellitus type 2 for which he was prescribed allopurinol 100mg OD, aspirin 75mg OD, simvastatin 40mg OD, ramipril 5mg OD and metformin M/R 1g BD. Regarding his eczema, this is presently in a state of remission, having been treated with azathioprine six months ago. Other than the rash he was otherwise well though he mentioned he had a many year history of abdominal bloating and diarrhoea which was diagnosed as irritable bowel syndrome several years ago. On examination he was systemically well with a blood pressure of 142/76 mmHg. Examination of the cardiovascular, respiratory and gastrointestinal systems were unremarkable. Examination of his skin revealed the presence of multiple bullae and papules on the extensor surface of his knees and buttocks, with excoriation. Which of the following is the most likely diagnosis? Bullous pemphigoid disease Linear IgA bullous dermatosis Dermatitis herpetiformis Transient acantholytic dermatosis Eczema
Posted on: Sat, 08 Nov 2014 15:06:50 +0000
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