Hpi Pe

Labs

Imaging Gross Pathology Micro Pathology Treatment

Discussion

A 19-year-old red-haired female visits her dermatologist at a local clinic because of a rash that appeared after she spent the sunny weekend hiking without sun block protection.

Two months ago, her dermatologist put her on low-dose tetracycline to prevent acne flare-ups.

VS: normal. PE: patient blue-eyed and fair-skinned; red, nonpruritic, macuiopapular rash that blanches on pressure on "V" of the anterior neck, posterior neck, forearms, hands, and face, sparing rest of body (rash is on sun-exposed areas of body); chest, abdomen, and neuro exams fail to disclose pathology.

CBC/Lytes: normal. LFTs within normal limits. UA: mild proteinuria.

Sun protection, both mechanical and pharmacologic, while taking tetracycline.

Tetracyclines are bacteriostatic antibiotics that bind to the 30S ribosomal unit, blocking synthesis of protein by preventing attachment of aminoacyl-tRNA. if taken with alkaline foods such as milk and antacids, GI absorption is decreased. Tetracycline is used both therapeutically and prophylactically for chlamydial genitourinary infections, Lyme disease, tularemia, cholera, and acne. Other side effects include brownish discoloration of the teeth 111 children (com rain dicated in pregnancy), photosensitivity, aminoaciduria, proteinuria, phosphaturia, acidosis, and glycosuria (Fanconi-like syndrome), p.262, 267

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