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50 yr old man with ESRD comes to office with complains of skin lesion in arms and legs.he has been on dialysis for 2 yrs and had kidney transplant 3 weeks ago.he has hypothyroidism,DM,severe hyperlipidemia,CAD with multiple CABG done several years ago.he is currently on metformin,aspirin,prednisone,diltiazem and cyclosporine.No family h/o skin diseases.
O/E pt is not in acute distress and vitals are within normal limits.inspection of skin shows dome shaped papules on arms and legs.some have central pustule and some are excoriated.which of the following is associated with the skin disease?
a)CAD
b)CRF
c)hypothyroidism
d)hyperlipidemia
e)prednisone use
f)cyclosporine use

when it started? after transplant? or it was from before transplant?

sorry nimishkum left out duration
skin lesions present for 6 months.

no idea man......either b or f....
will go with bbb

you are right
but any idea what the skin lesion is?

looks like porphyria tarda

itz a case of kyrle's disease.its seen in DM and CRF pateints.
http://emedicine.medscape.com/article/1074469-overview

i never though that......i sware the god...........i never ever thought kyrle's dis...hope i spell correct.......

me too:-)
i never know this before.this que is from kaplan.i learnt now.