BOF: 2.35
A 42-year-old female presents with a blistering rash on
her hands on exposure to sunlight. She is an intravenous drug abuser, drinks
24 units of alcohol per week and smokes 10 cigarettes per day.
On examination of her hands there are blisters, erosions
scars and milia. The skin is pigmented and fragile. She looks emaciated she
has clubbing palmar erythema and spider naevi. There is tense ascites and the
liver and spleen are not palpable.
Investigations reveal a macrocytic anaemia and disordered
liver function. She is hepatitis-C PCR positive and her ferritin levels are
within the normal range.
In this patient treatment of the skin condition should be
with:
a)
Desferrrioxamine
b)
Venesection
c)
Low dose chloroquine
d)
Penicillamine
e)
Dapsone
