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Medicine
A 68-year-old man complains of several blisters arising over the back and trunk for the preceding 2 weeks. He takes no medications and has not noted systemic symptoms such as fever, sore throat, weight loss, or fatigue. The general physical examination is normal. The oral mucosa and the lips are normal. Several 2- to 3-cm bullae are present over the trunk and back. A few excoriations where the blisters have ruptured are present. The remainder of the skin is normal, without erythema or scale. What is the best diagnostic approach at this time?
Culture of vesicular fluid for herpes viruses
Trial of corticosteroids
Biopsy of the edge of a bulla with some surrounding intact skin
CT scan of the chest and abdomen looking for occult malignancy
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