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Question: Can you identify this condition?

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Vol 56: DECEMBER • DÉCEMBRE 2010 Canadian Family Physician•Le Médecin de famille canadien

1303

Practice

Dermacase

Can you identify this condition?

Salvador Arias-Santiago

MD

María Sierra Girón-Prieto

MD

Husein Husein-El-Ahmed

MD

María Antonia Fernández-Pugnaire

PhD

Ramón Naranjo-Sintes

PhD

A

38-year-old man was referred to our clinic with a 2-week history of painful lesions located on the penis. He had no past medical history for this event. During the first few days of onset, he had a fever (38.5ºC) without any other systemic symp- toms. Treatment with ketoconazole cream and topical steroids had worsened the lesions. A physi- cal examination revealed a number of small ulcers with a fibrin surface and a herpetiform distribu- tion in the coronal sulcus and glans penis. Bilateral inguinal palpation revealed the presence of small and mobile lymph nodes. Tzanck test results showed multinucleated giant cells and epithelial cells containing eosinophilic intranuclear inclusion bodies. Laboratory workup included a hemogram and biochemistry and coagulation tests, which all had negative or normal results.

The most likely diagnosis is 1. Primary syphilis 2. Chancroid 3. Reiter syndrome 4. Genital herpes 5. Behçet syndrome

Answer on page 1304

Ophthaproblem

Can you identify this condition?

Jason Noble

MD

Paul Nijmeh

MD

A

53-year-old man presents to his family doc- tor with complaints of gradual visual loss. He denies a history of flashes, floaters, or visual field loss. Fundus examination is shown in the image above.

The most likely diagnosis is 1. Retinal detachment 2. Exudative age-related macular degeneration

3. Central retinal vein occlusion 4. Nonproliferative diabetic retinopathy

Answer on page 1308

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