The Anatomy of a Question
Question
A 52-year-old woman presents to her primary care provider’s office with complaints of a pruritic rash on her chest. She has a past medical history of morbid obesity, type 2 diabetes mellitus, and hypertension. On exam, there is a sharply demarcated area of erythema underneath both breasts. Direct microscopy of skin scrapings reveals oval budding yeast and pseudohyphae. Which of the following is the most appropriate management?
Answer choice options
- A. Oral fluconazole
- B. Oral prednisone
- C. Topical econazole
- D. Topical mupirocin
The incorrect options (distractors) are not totally wrong. These options can be diagramed as follows:
-
C.Topical econazole Topical antifungals are first-line treatment
-
A.Oral fluconazole Indicated in severe, recalcitrant infections and has increased side effects.
-
D.Topical mupirocin Used to treat impetigo, not intertrigo.
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B.Oral prednisone Increases the risk for candidal infections.
The Anatomy of an Explanation
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