Jules B. Lipoff, MD; Katherine T. Steele, MD; Neha Jariwala
A 41-year-old man who had immigrated from Costa Rica 10 years prior presented with paresthesias in his hands and feet, loss of the eyebrows and eyelashes, and skin changes including mild erythema of the earlobes, fingers, and toes. He reported taking no medications. What would you do next?