A 39-year-old G3P2 patient at 27 weeks reported a 2-month ev…

A 39-year-old G3P2 patient at 27 weeks reported a 2-month evolution of pruritic papules on the lower back.  Physical examination revealed grouped erythematous papules, some of which were pustular, and others showed central crusts in the lumbar region (see figure).  What is the likely diagnosis?     

A 39 year old G1P1 began profusely bleeding 30 minutes after…

A 39 year old G1P1 began profusely bleeding 30 minutes after an unremarkable spontaneous vaginal delivery.  Pitocin 10 IU IM was given in active third stage management.  The patient’s medical history includes an allergy to penicillin and asthma.  What is the BEST second line medication to use with this patient?