Dermaq5 - spartans1

[ArchivalUser]

A 46-year-old Caucasian man comes to the office and complains of a pruritic rash for the past two months. He was in his usual state of health until two months ago, when he noticed some itching and red colored lesions over his wrist. The lesions progressed and a few weeks later, he had the similar lesions on his lower legs. This morning, he got extremely scared when he saw some whitish lacy streaks in his mouth and called in for an urgent appointment to see you. He denies fevers, chills, weight loss or diarrhea. He has a history of hypertension, which is controlled by hydrochlorothiazide. He denies smoking, alcohol intake or intravenous drug use. His physical examination reveals multiple discrete, violaceous, polygonal shaped papules and plaques over the flexural surfaces of his wrist and lower legs. There is a whitish lacy pattern seen on the surface of the lesions. Examination of the oral mucosa also reveals similar whitish lacy streaks with a slight background erythema of the buccal mucosa. The rest of his physical examination is unremarkable. During the examination, he breaks down and admits to sexual intercourse with multiple partners in the past, but points out that he had used condoms in most of the sexual encounters.

Which of the following is the diagnostic step of choice?


A. Microscopic examination of the skin scrapings in saline solution
B Microscopic examination of the skin scrapings in potassium hydroxide (KOH)
C Perform a skin biopsy
D Perform a chest radiograph
E Refer him to an infectious disease specialist

[ArchivalUser]

CC,

[ArchivalUser]

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[ArchivalUser]

Lichen planus,can occur in high blood pressure medications.Biopsy shows irregular acanthosis and destruction of basal layer.Mostly Genitourinary changes on penis mostly seen in LP.