What diagnostics would you want to do on this patient?

Mr. Kramer is a 78 year oldrecent widower. His wife just recently passed away and he felt an irritation under his right arm. When he got home, he noticed a rash. He relates this to sweating in a new suit jacket. He denies other new hygienic products and no new laundering agents. Since yesterday,he states the rash is beginning to spread.

PMedHx:DM 2 (1990)

HTN (1994)

PSurgHx: Left knee arthroscopy

Family Hx: Father, deceased: CAD

Mother, deceased: complications from Lupus

Brother, alive 74: HTN, Lupus

Soc Hx: Retired banker with 3 grown kids

Walks three times a week in a trail behind his house in a nature preserve; walks his dog on walking trails in woods

Never a smoker; rare social ETOH use; no illicit drugs

Watches carbs d/t DM

Meds: Metformin 500mg BID

Lisinopril 10mg QD

ASA 81mg QD

Atorvastatin 10mg QD (started on this 3 weeks ago)

Allergies: PCN


General: feels fatigued, associates this to wife’s passing; denies fever or chills;hard to sleep d/t rash

Skin: rash under right arm; doesn’t itch a lot, but “burns”

Neck: supple; no lymphadenopathy

Lung: clear

CV: RRR@78; normal S1 and S2; no mrg

Abd: soft, non tender

Skin: Vesicular rash on erythematous base; linear in appearance; about 8-10 lesions noted

#1 Based on this patient’s case, you believe he has what type of dermatology problem?

#2 What other subjective data would be important to inquire about in this patient?

#3 What diagnostics would you want to do on this patient?

#4 What would your treatment plan be for him?

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