The Nov. 10, 2020 session of Duke Medicine LEADS featured a discussion led by Matthew Labriola, MD, chief resident for Duke University Hospital, who presented "57 year-old female with rash and liver injury."
Experts, Terri Tarrant, MD; Rami Nayef Al-Rohil, MBBS; Meenal Kheterpal, MD; and Julia McQueen, MPH, RD, LDN, CNSC, weighed in for the diagnostic reasoning and discussion.
Here are the pearls and takeaways from the session:
1. PEth testing has almost 100% sensitivity and specificity for assessing chronic ETOH use when alcoholic hepatitis is suspected but unclear based on history with negative serum tox screen.
2. Acral dermatitis refers to lesions that affect hands, feet and genitalia. Differential includes autoimmune disease, drug related, nutritional deficiencies and neoplasia.
3. Patients who undergo gastric bypass surgery require expert nutrition follow up to avoid severe nutritional deficiencies.
4. Necrolytic migratory erythema, classically associated with glucagonomas, can also be seen in zinc deficiency.
Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.