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Dermatologist

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JOB OUTLOOK

Stable

Real-Life Activities

Real-Life Decision Making

Your patient, a 30-year-old female, has a severe case of psoriasis. This disease has caused numerous reddish-brown, silver-scaled spots and patches across her upper and middle back. She has been to six different specialists in the past nine months, to no avail.

As a dermatologist, it is your duty not only to deal with your patient's problem, but to make sure it never comes back. After four weeks of an intramuscular cortisone, she developed a potentially lethal form of pustular psoriasis. Along with this worsened condition are painful lesions -- boils that itch and burn.

After much thought, you resolve to put your patient on a drug called Soriatane. This is a potent oral drug used to treat psoriasis. It does not respond well to other treatments.

The problem? There are some potentially serious side effects of Soriatane, one of which is the risk of birth defects to developing fetuses. Usually, women who are on Soriatane are advised to avoid pregnancy for a number of years after they stop taking the drug. But your patient is not pregnant and she's not married.

What do you do?