Simple cases

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Case 59

59

They started about 4 months ago.

Look for further characteristics as you pursue the diagnosis.

I think I have a fever and I just don't feel well.

Look for further characteristics as you pursue the diagnosis.

They really hurt; I can't even sit at work.

Look for further characteristics as you pursue the diagnosis.

No, no one has mentioned anything.

Could this be an infectious disease?

I had hemorrhoid surgery six months ago, but my problems then were completely different.

Could this be a recurrent disease?

I am way overweight and I smoke.

Look for further characteristics as you pursue the diagnosis.

I am overweight and smoke.

Look for further characteristics as you pursue the diagnosis.

Choose the right efflorescences:

False. Try again or review the different types of lesions.

False. Try again or review the different types of lesions.

Several hyperpigmented scars are scattered about.

Correct. There are multiple livid nodules. Fluid can be expressed from some of them.

False. Try again or review the different types of lesions.

Choose the right diagnosis:

False. This is not syphilis.

False. Lymphogranuloma venereum is associated with massive lymphadenopathy.

False. This is not candidal vulvitis (infection of the vulva with Candida albicans).

Correct. Hidradenitis suppurativa is a variant of acne (acne inversa) with invariable secondary bacterial infection.

False. The ulcers in chancroid are jagged and painful.

Choose the right therapy(ies):

Correct. This is the standard approach. Radical excision is usually required.

False. Such patients require treatment.

False. This therapy is not sufficient.

False. This therapy is not indicated for this clinical problem.

False. CAREFUL!! This patient is allergic to penicillin.

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