Dermatology Q43

A 23-year-old woman is evaluated for 2 weeks of painful lumps on her legs. The lumps persist for several days and make it difficult for her to go to work as a waitress. She is a college student in Ohio where she has lived her whole life. She has not traveled outside of the state for the last 2 years. She has no swollen or painful joints. She denies abdominal pain, diarrhea, weight loss, night sweats, and fever. She is sexually active with one partner for the past 2 years. She is taking oral contraceptive pills.

On physical examination, vital signs are normal. There are tender faint pink-brown nodules on the shins bilaterally. The throat and tonsils appear normal. There is no joint swelling.

Pregnancy test is negative. Complete blood count, erythrocyte sedimentation rate and antistreptolysin O titers are pending.

Barrier contraceptive methods are recommended in lieu of oral contraceptives.

Which of the following tests should be done next?

Nucleic acid amplification testing for gonorrhea

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