MKSAP: 27-year-old woman is evaluated for a 4-week history of wheals

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 27-year-old woman is evaluated for a 4-week history of wheals, characterized by a burning sensation without pruritus. Each individual lesion persists for 48 hours and slowly resolves, leaving a bruise. Current medications are diphenhydramine, hydroxyzine, cetirizine, and oral contraceptives. The patient’s mother has systemic lupus erythematosus.On physical examination, vital signs are normal. She has scattered edematous indurated erythematous plaques consistent with wheals. There are scattered ecchymoses at the sites of fading lesions. The patient has no facial lesions or rash, and her mucous membranes are normal. There is no joint swelling or tenderness.Which of the following is the most appropriate management?A: Discontinue oral contraceptives B: Radioallergosorbent testing C: Skin biopsy D: Thyroid function testingContinue reading ... Follow KevinMD.com on Facebook, Twitter, Google+, and LinkedIn.
Source: Kevin, M.D. - Medical Weblog - Category: Family Physicians Tags: Conditions Dermatology Source Type: blogs