A 72-year-old man is newly diagnosed with bullous pemphigoid. Which of the following is the most appropriate next step in the management?
(A) plasmapheresis
(B) low-dose prednisone (10–20 mg/day)
© high-dose prednisone (50–100 mg/day)
(D) azathioprine 150 mg/day
(E) dapsone (100–150 mg/day)
solution
© Severe cases require systemic steroids, often with the addition of azathioprine. Dapsone is useful in mild cases, and occasionally in very mild cases (or for local recurrences) topical glucocorticoid therapy will suffice.
- (D) Nodular melanoma is invasive from the start. Women do better than men; trunk lesions and depigmented lesions carry a worse prognosis. Prognosis is directly related to depth of the lesion. (Wolff, pp. 289, 305© Severe cases require systemic steroids, often with the addition of azathioprine. Dapsone is useful in mild cases, and occasionally in very mild cases (or for local recurrences) topical glucocorticoid therapy will suffice.
solution:
(D) Nodular melanoma is invasive from the start. Women do better than men; trunk lesions and depigmented lesions carry a worse prognosis. Prognosis is directly related to depth of the lesion