A 32-year-old woman comes to the emergency department because of a generalized erythematous
skin rash. She was recently started on trimethoprim-sulfamethoxazole (Septra) for a urinary tract infection. Examination shows the diffuse rash involving her whole body including the palms and soles. Except for generalized lymphadenopathy, the rest of the examination is normal. Which of the following is the most
appropriate interpretation of the generalized lymphadenopathy finding?
(A) a viral infection
(B) pyoderma
© lymphoma
(D) leukemia
(E) nothing specific
solution:
Most cases of exfoliative dermatitis will have widespread lymphadenopathy, whether they are primary or secondary forms. Biopsy will usually reveal nonspecific changes and is only warranted if there is a suspicion of lymphoma