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 BOF 5

 

   

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BOF: 5

A 26-year-old female presents with a history of a rash of two weeks duration. The rash has appeared on her lower legs, the lesions are tender to touch.

She also gives a history of recurrent ulcers in her mouth and she also says she has had recurrent episodes of diarrhoea and abdominal pain and has lost some weight. No history of sore, throat, cough or breathlessness. No history of genital ulceration.

She is a secretary, unmarried, does not take alcohol but smokes 20 cigarettes a day.

On examination she looked underweight, there were several tender, erythematous nodules over the anterior aspect of her lower legs. No other abnormalities were detected.

Investigations:

Hb 12. 2 g/dL

WBC 12.9 x 10 9 /L

ESR 85 mm in 1st hour

CXR: normal

In this patient which one of the following investigations is likely to lead to a definitive diagnosis:

a)      Serum angiotensin converting enzyme level

b)      Colonoscopy

c)      Skin biopsy

d)      Slit skin smear

e)      CT chest

 

 

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