MRCP2-2787

MRCP2-2787

A 20-year-old female patient presents with a recent onset of skin lesions and joint pain. She had previously treated herself for vaginal thrush with a clotrimazole pessary, which has now resolved. The patient has a medical history of SLE and takes hydroxychloroquine. On examination, the patient has vesicles on her arms and legs, with some scabbing and necrosis. She also has tenderness, erythema, and reduced range of motion in her left elbow and right wrist, as well as a swollen, hot, and tender right knee joint with reduced range of motion. Blood tests reveal elevated white cell count, CRP, and ESR, as well as low C4 levels. X-ray of the right knee confirms effusion, and synovial tap shows high levels of leucocytes and polymorphs. What would be the most appropriate treatment plan for this patient?