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A 45-year-old man is evaluated for itching with dry scaling skin of 1 month's duration. His medical history is noncontributory, and he takes no medications. On physical examination, vital signs are normal. Skin findings are shown, and the remainder of the examination is unremarkable.

Which of the following is the most appropriate diagnostic test to perform next?

1) Potassium hydroxide examination
2) Scabies preparation
3) Tzanck preparation
4) Wood lamp examination

Answer :

Final answer:

Given the patient's symptoms, the most appropriate diagnostic test to perform next is a Potassium hydroxide examination, which is used to detect fungal elements by dissolving keratin in the skin, nails, and hair.

Explanation:

In the context of the patient's clinical presentation of itching with dry, scaling skin of one month's duration, the most appropriate diagnostic test to perform next would be a Potassium hydroxide examination. This is because the symptoms reflect a probable fungal infection, and potassium hydroxide preparation is an effective method for detecting fungi.

Potassium hydroxide dissolves the keratin in hair, nails, and skin cells, enabling visualization of fungal elements. It's typically used on skin scrapings or hair and nail samples to identify fungal infections. As in this case, the patient’s symptoms are non-specific, the potassium hydroxide examination would be appropriate to help in the differential diagnosis.

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