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Clinical Case 6
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1

A 32 year-old man has come to your clinic for the evaluation of a recent development of thick, red, scaly, plaques on his elbows, palms, eyebrows and periauricular skin. The lesions do not itch. He states he has never had similar rashes in the past. He has no known health problems. He was last seen in the clinic 6 months ago and prior to that 2 years previously (both for episodes of urethritis). His weight has decreased 8 Kg from the last clinic visit. He has also had occasional night sweats in the past few months which began after a flu-like illness in July. His physical examination is notable for widespread, thick, indurated plaques with silvery scales overlying them in the areas described as well as in the groin and palmar creases. He has a few pustules across his shoulders and has shallow dimples in several of his nails.

Which of the following medications is most appropriate in treating this patient initially?
A)Antiretrovirals
B)Coal Tar
C)Corticosteroids- topically or systemically
D)Ultraviolet light







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