robin082006
Forum Hero
Topics: 471
Posts: 5,123
|
An 18-year-old boy with Hodgkin's lymphoma is admitted to the hospital for his third course of chemotherapy which includes prednisone. On his 6th hospital day, you are called by the nurse to assess a new rash which has slowly progressed to cover the entire anterior and posterior trunk, as well as his arms and part of the face. The nurse is concerned about a possible allergic reaction, secondary to the multiple medications this patient is taking. On examination, you note numerous, small, pinpoint pustules and inflammatory papules of the same stage scattered mostly over his trunk and proximal arms. There are some pustules of the same stage over his forehead as well. The patient denies any significant history of acne prior to the initiation of chemotherapy. At this time the most correct statement about his condition is:
A. This is acne vulgaris and should be treated with oral minocycline and topical benzoyl peroxide
B. This is a drug eruption and you should stop all the medications and reinitiate one every week
C. This is a drug eruption secondary to his chemotherapy and topical corticosteroid will alleviate the problem
D. This is miliaria secondary to the occlusion effect by his hospital gown
E. This is steroid acne and topical tretinoin cream may help
___________________
The Key to Succeed is Patience.
|
| cirus
Forum Guru
Topics: 108
Posts: 740
|
I'm between B & C but I don't think we should stop the chemotherapy, before trying some tropical steroids so I'd choose C but I'm not sure
|
| khorshid
Forum Guru
Topics: 32
Posts: 591
|
Yes either B or C, but the surface area involved is big, and usually topical steroids are not useful in this kind of drug reaction, so I'll go with B. And you should find the guilty drug anyways.
|
| ts97
Forum Senior
Topics: 13
Posts: 128
|
E
Steroid acne is observed as monomorphous papulopustules located predominantly on the trunk and extremities, with less involvement of the face. Characteristically, it appears after the administration of topical or systemic corticosteroids, including intravenous and inhaled therapy. The eruption usually resolves after discontinuation of the steroid and, in addition, may respond to the usual treatments of acne vulgaris. For more information, see Acne Vulgaris.
from
http://www.emedicine.com/derm/topic620.htm
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,123
|
Answer is E
___________________
The Key to Succeed is Patience.
|
|
| |
| | | | | |
