Race for the Case

Race for the Case is a clinical quiz feature published quarterly in DermWorld Directions in Residency — and right here!

Answer the questions below to enter. Looking for the Spring 2023 answers? Review them now. To submit cases and questions, email Dean Monti at dmonti@aad.org.

Diagnose this new case by Shiri Nawrocki, MD, and Pooja Srivastava, MD 

A 42-year-old male with past medical history significant for HIV with medication noncompliance, methamphetamine use disorder, and chlamydia, presents with a pruritic eruption that has been ongoing for four months. The patient reports that the rash started on his arms and then rapidly spread to the rest of his body. He denies clearance of any lesions since onset of the rash and reports continued development of new lesions. He denies a personal or family history of any prior dermatologic conditions. Review of systems is significant for an unintentional 15-pound weight loss over two years. 

1. What is the most likely diagnosis and which histologic findings suggestive of the diagnosis are shown in the slide?

2. Describe the clinical findings of the secondary stage of this condition.

3. Describe the two categories of serologic tests that can assist with diagnosis. Which test can be used to monitor treatment response?

4. What is treatment of choice for the secondary stage of this condition?

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