09-17-2010, 07:48 PM
A 25-year-old Hispanic college student comes to your office for evaluation of a rash. He started noticing the rash approximately two months ago. The rash started over his face and progressed over time to involve his upper chest, upper back, and axillary areas. He has also noticed a lot of "dandruff" in his hair recently. His only symptom is occasional mild pruritus. He has no other medical illnesses. On physical examination, there are erythematous plaques seen over his eyebrows, nasal bridge, nasolabial folds, upper lip, upper chest, and back. The plaques have an indistinct margin and are covered by fine, greasy scales. Which of the following is the most appropriate next step in the management of this patient?
1. Send the patient for a chest x-ray
2. Obtain consent for HIV serology
3. Order rheumatoid factor and antinuclear antibodies
4. Refer to dermatology for a skin biopsy
5. Send the scrapings for viral cultures
1. Send the patient for a chest x-ray
2. Obtain consent for HIV serology
3. Order rheumatoid factor and antinuclear antibodies
4. Refer to dermatology for a skin biopsy
5. Send the scrapings for viral cultures