October 05, 2010

PLAB Question 5

A 35 year old farmer develops a carbuncle-like painless ulcer on his hands. The ulcer has pustules and a black, necrotic central scab and is surrounded by extensive soft tissue swelling.

This is suggestive of:

a) behcet's disease
b) dermetitis herpetiformis
c) psoriasis
d) anthrax
e) chickenpox
f) smallpox
g) candidiasis
h) gonococcal septicemia
i) acne rosacea
j) syphilis

The correct answer is D


Infection with anthrax is usually seen in people who have come in contact with animal products, especially those who live in the countryside (eg, 'Woolsorter's disease' which is pulmonary anthrax).

Typically there is a typical painless lesion (ulcer) at site of infection with a black, necrotic (dying tissue) eschar (scab). Local swelling is prominent.

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