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Retired NBME Step 2 CK Free 120 Answers

step2ck_free120/Block 1/Question#2 (reveal difficulty score)
A 56-year-old man has had the painful weeping ...
Herpes Zoster ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: infectious_disease DDX

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 +2  upvote downvote
submitted by โˆ—carolebaskin(109)
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Dewdrop on a rose petal appearance in a CN V1 dermatomal distribution. Rash is painful and weeping. Immunocompromised host (s/p chemo)


Wrong answers

Impetigo: honey colored crusting lesion related to group A strep infection

Pyoderma gangrenosum: think green cheese; usually a single large round ulcer. Rapidly progresses from small papule or pustule to large painful ulcer with purulent, violaceous border. Associated with IBD (crohn disease, UC, RA, trauma). Most commonly lower limbs.

Syphilis: Causes a few types of skin lesions: chancre, gummas, etc. Chancre: most common, painless, genital. Doesn't really fit the story here anyway.

SLE: doesn't fit

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yankee2222  Thank-you for going through each ans choice, that's very helpful in identifying the why, appreciate it! +



 +1  upvote downvote
submitted by โˆ—bwdc(697)
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Dermatomal rash means zoster (a chickenpox/varicella reactivation disease). Immune insults, like chemotherapy, predispose to zoster flares.

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