Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
A 68-year-old woman came into the clinic for treatment of a painful, erythematous skin rash over the bridge of her nose. She’d had the rash for 4 days, and it was spreading to the malar area and up around her eyelids and forehead (FIGURE 1). The patient said she felt “out of sorts,” was nauseous, and had a low fever. She said she’d recently had a sore throat. Her past medical history included hypertension.
The patient had elevated and indurated shiny skin plaques involving the nose, cheeks, eyelids, and forehead. She also had some blisters and crusty lesions. On palpation, the skin was hot and tender. The pharynx was unremarkable and the neck supple, with no palpable nodes.
FIGURE 1
Spreading rash
The 68-year-old patient said that she’d recently had a sore throat. She indicated that she felt nauseous and out of sorts.
WHAT IS YOUR DIAGNOSIS?
HOW WOULD YOU TREAT THIS PATIENT?