zx_stien
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A 53-year-old man who is status post renal transplant 3 years earlier, returns to the clinic for routine follow up for multiple warts on his hands and feet. Since his last visit 1 month ago he has been using large amounts of salicylic acid 40% plasters to treat his widespread warts. He tells you in passing that over the past week he has developed ringing in his ears. He currently takes many medications, including prednisone, cyclosporine, and lansoprazole. His temperature is 38.3 C (101.0 F), blood pressure is 110/80 mm Hg, and pulse is 105/min. Physical examination shows approximately 20 verrucous papules on the plantar surface of the feet as well as involvement of multiple fingers on the hands. The most appropriate next step in the management of this patient is to
A. discontinue cyclosporine
B. discontinue lansoprazole
C. discontinue topical wart therapy
D. refer him for an audiology exam
E. tell him to continue current therapy until he sees an otolaryngologist about this problem
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| kpmle2
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C. discontinue topical wart therapy .
salicylic acid presents with tinnitus.
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| docnit
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| docnit
Forum Senior
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but isnt is wierd? topical salicylate producing systemic symptoms 
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| kpmle2
Forum Guru
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well the Q says he has widespread warts for which he is using large amounts of salicylic acid 40%.
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| zx_stien
Forum Senior
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docnit yet it s weird, BUT not anymore when this patient is on Steroid,
what does steroid do?? yeah it causes skin thinning so much more ASA is being absorbed!
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| ngaybinhyen
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Good one. Thanks, zx_stien
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| zx_stien
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Posts: 164
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