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Had a patient like this in my preceptorship and we couldn't diagnose them. We gave them a derm referral and now this is an oddly similar board style question I ran across just now. However, no freaking answer! I'm curious. Any help would be wonderful!
A 28 year old male presents to the clinic with a painful, blistering lesion localized to his lower lip and a white rash proximal to the lower lip. His concerns are with the cosmetic aspect of having the lesion localized to his face. In addition, while interviewing the patient, they state that they also noticed a weird issue on their penis and have been experiencing occasional night-sweats. Upon examination you notice multiple purple lesions diffusely arranged on the glans penis, with small portions extending over the proximal and distal prepuce. The lesions are not raised, however they slightly reflect light when examined with a flashlight and demonstrate a slightly white center. The lesion does not drain nor cause pain. There is no pruritus. Physical examination shows a well-dressed male in no distress. BP 100/88; HR 88; SpO2 98 at room air; with a low grade fever. What is the most likely diagnosis for this patient? What is the next step management?
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A 28 year old male presents to the clinic with a painful, blistering lesion localized to his lower lip and a white rash proximal to the lower lip. His concerns are with the cosmetic aspect of having the lesion localized to his face. In addition, while interviewing the patient, they state that they also noticed a weird issue on their penis and have been experiencing occasional night-sweats. Upon examination you notice multiple purple lesions diffusely arranged on the glans penis, with small portions extending over the proximal and distal prepuce. The lesions are not raised, however they slightly reflect light when examined with a flashlight and demonstrate a slightly white center. The lesion does not drain nor cause pain. There is no pruritus. Physical examination shows a well-dressed male in no distress. BP 100/88; HR 88; SpO2 98 at room air; with a low grade fever. What is the most likely diagnosis for this patient? What is the next step management?
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