A 55-Year-Old Woman Comes to the Physician with a Rash

question 757

Multiple Choice

A 55-year-old woman comes to the physician with a rash on her face for the past 4 weeks.  The rash seems to get worse when she spends time outdoors, but it does not flare with food intake.  She has no flushing or itching.  The patient denies fever, weight loss, or muscle weakness.  She was recently diagnosed with hypertension and type 2 diabetes mellitus and started on lisinopril, metformin, and sitagliptin.
Physical examination reveals a 1-cm ulcer in the roof of the hard palate.  A photograph of the rash is shown below.

Which of the following conditions is the most likely diagnosis?

• A)Erythema multiforme
• B)Erythematotelangiectatic rosacea
• C)Fixed drug eruption
• D)Seborrheic dermatitis
• E)Systemic lupus erythematosus

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Definitions:

Depression

A mental health disorder that is marked by persistent feelings of sadness, apathy, and loss of interest, significantly affecting daily functioning.

Mood Disorders

A category of psychiatric disorders characterized by the disturbance of a person's mood, leading to periods of depression or elevated mood.

Imagined Loss

Freudian theory that the individual unconsciously interprets all types of loss events (e.g., job loss) in terms of grief, thereby raising the risk for depression.