MKSAP: 72-year-old man with a laceration on his left index finger

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man sustains a laceration on his left index finger while preparing chicken. He immediately washes the area and applies neomycin and an occlusive bandage. He changes the bandage and reapplies the medication twice daily. Two days later, he develops itching and redness at the wound site. He has had no fever or other systemic symptoms. Medical history is significant for well-controlled type 2 diabetes mellitus. His only medication is metformin. On physical examination, vital signs are normal. The left index finger shows a 1.0-cm superficial wound with well-approximated margins without purulence or drainage, and no pain on palpation. There are pinpoint papules and vesicles in an area extending 0.5 cm around the laceration site in a rectangular pattern approximating the bandage. There is no lymphangitic streaking. The remainder of the physical examination is unremarkable. Which of the following is the most likely diagnosis? A: Allergic contact dermatitis B: Group A streptococcal infection C: Herpes simplex virus infection D: Staphylococcus aureus infection Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Dermatology Source Type: blogs