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Dermatology

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Vasculitis

Question
10 out of 11
 

A 52-year-old man is concerned about changes in the appearance of his skin. He has developed thick skin on his forearms, face, and the dorsum of his hands. He occasionally develops vesicles and bullae that will rupture, leaving moist erosions that heal slowly. He has noticed increased hair growth in these areas as well. Past medical history is significant for hepatitis C infection that he cleared spontaneously 3 years ago. He takes no medications. He drinks alcohol socially.. What is the best treatment option for this patient? (AIPG 2010)



A β-carotene
B Fluconazole

C Glucocorticoids
D Phlebotomy

E UV-A and UV-B protection

Ans. D
Phlebotomy

1). This patient has porphyria cutanea tarda (PCT).

2). The description and appearance are classic for this disease, and a history of hepatitis C virus infection is an independent risk factor for PCT.

3). Treatment consists of repeated phlebotomy to diminish excessive hepatic iron stores. β-carotene is a treatment option for erythropoietic protoporphyria which is differentiated from PCT by the acute photosensitivity, burning, and stinging that occurs after sun exposure in the former.

4). UV protection is not specifically part of the treatment of PCT but is helpful for preventing the photoaging process.

5). This is not an autoimmune process where glucocorticoids would potentially be of benefit.

6). Secondary fungal infections may occur that require antifungal therapy.

Vasculitis Flashcard List

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