06-20-2007, 10:52 AM
A 32-year-old man presents complaining of severe pruritus over the past 2 weeks. He has a history of ulcerative colitis for the past 7 years, which has remained well controlled on sulfasalazine and cortisone enemas. His physical examination is unremarkable except for evidence of diffuse excoriations on his extremities and trunk. Laboratory studies reveal a mild iron deficiency anemia and normal electrolytes. Liver function tests are normal, except for an alkaline phosphatase that is 322 U/L (normal, <110 U/L). Which of the following is the most likely explanation for his symptoms?
A. Erythema nodosum
B. Hepatitis C
C. Primary biliary cirrhosis
D. Primary sclerosing cholangitis
E. Pyoderma gangrenosum
A. Erythema nodosum
B. Hepatitis C
C. Primary biliary cirrhosis
D. Primary sclerosing cholangitis
E. Pyoderma gangrenosum