Davidia Crockett, a 52-year-old female, comes in to pick up her refills for enalapril and hydrochlorothiazide on October 2. She specifically requests to talk with a pharmacist. She shows you two approximately 2-cm plaques on the ulnar surface of each elbow. Covered with whitish silvery scales, the lesions are clearly due to psoriasis. According to her patient history, these lesions appeared over the last week. She was treated briefly for more severe psoriasis with "tar" and steroids 15 years ago, but the condition had not bothered her again until last week. Her primary care physician does not want to deal with it and referred her to a dermatologist. However, she cannot get an appointment for 7 weeks and wants your advice on what she can do in the meantime. When you ask her what other symptoms are associated with the lesions, she mentions that she has had aches and pains in her hands for about 2 weeks, and her manicurist noted some new depressions in her fingernails last week. Continue Reading >

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