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 Best of Five 2.35

 

   

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BOF: 2.35

A 42-year-old female presents with a blistering rash on her hands on exposure to sunlight. She is an intravenous drug abuser, drinks 24 units of alcohol per week and smokes 10 cigarettes per day.

On examination of her hands there are blisters, erosions scars and milia. The skin is pigmented and fragile. She looks emaciated she has clubbing palmar erythema and spider naevi. There is tense ascites and the liver and spleen are not palpable.

Investigations reveal a macrocytic anaemia and disordered liver function. She is hepatitis-C PCR positive and her ferritin levels are within the normal range.

In this patient treatment of the skin condition should be with:

a)      Desferrrioxamine

b)      Venesection

c)      Low dose chloroquine

d)      Penicillamine

e)      Dapsone

 

 

 

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