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dc.contributor.authorPatel, Tarangeng
dc.contributor.authorKarle, Ethaneng
dc.contributor.authorNelson, Tayloreng
dc.contributor.authorDandachi, Dimaeng
dc.date.issued2019-07eng
dc.description.abstract"The patient is a 75-year-old Caucasian male who was admitted in May for management of a penile ulceration and a generalized rash. He has a medical history of Type II Diabetes Mellitus, tobacco abuse, and Rheumatoid Arthritis (RA) on adalimumab. One week prior to his presentation, the patient noted an ulcer proximal to the glans penis (Figure 1). Upon further questioning, he reported noticing a small tick attached to his thigh one week prior. He has no history of sexually transmitted illnesses, incarceration, animal exposures, or meningeal signs. Two days prior to admission, the patient developed a large, dark, vesicular lesion on the anterior scalp, followed by smaller lesions over the rest of his body including the hard palate (Figures 2-6). Laboratory studies demonstrated a mildly elevated Erythrocyte Sedimentary Rate, C-Reactive Protein, and transaminitis. The patient was started on empiric doxycycline and intravenous acyclovir. Infectious work-up was negative for gonorrhea, chlamydia, syphilis, HIV, Ehrlichia, and Rocky Mountain Spotted Fever. Shave biopsies were obtained of the penile lesion and a lesion from the patient's upper back. Dermatopathology evaluation demonstrated herpetic dermatitis in both sites, and a penile swab polymerase chain reaction for Varicella Zoster Virus was positive. Treatment for disseminated Herpes Zoster was initiated with marked improvement of the lesions noted at follow-up."eng
dc.description.bibrefIncludes bibliographical referenceseng
dc.description.statementofresponsibilityTarang Patel (1), Ethan Karle (1), Taylor Nelson (2), Dima Dandachi (2); 1. Department of Medicine, University of Missouri. 2. Department of Medicine, Division of Infectious Diseases, University of Missouri.eng
dc.format.extent5 pages ; illustrationseng
dc.identifier.citationAm J Hosp Med 2019 July;3(3):2019.010 https://doi.org/10.24150/ajhm/2019.010eng
dc.identifier.urihttps://hdl.handle.net/10355/80985
dc.identifier.urihttps://doi.org/10.24150/ajhm/2019.010eng
dc.languageEnglisheng
dc.publisherUniversity of Missouri, Department of Medicine, Division of Hospital Medicineeng
dc.relation.ispartofAmerican journal of hospital medicine, volume 3, issue 3 (2019 July-September)eng
dc.relation.ispartofseriesID corner (AJMH)eng
dc.rightsOpenAccess.eng
dc.rights.licenseThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License.
dc.sourceHarvested from the American Journal of Hospital Medicine website (https://medicine.missouri.edu/departments/medicine/divisions/hospital-medicine/american-journal-of-hospital-medicine) in 2021.eng
dc.subjectCase reporteng
dc.subjectHerpes zostereng
dc.titleA rash that cannot be missed : disseminated herpes zoster as a result of immunomodulation by Adalimumabeng
dc.title.alternativeDisseminated herpes zoster as a result of immunomodulation by Adalimumabeng
dc.typeArticleeng


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