In a follow-up visit, Ms. Whiting has flat red and purple lesions on her forearms that are tender. What is the best course of action?

The best course of action in this scenario is to inquire about how Ms. Whiting acquired the tender flat red and purple lesions on her forearms. This approach is crucial for several reasons. First, understanding the patient's history regarding the lesions can provide valuable information about their etiology. Potential causes could range from allergic reactions, infections, or even a manifestation of underlying systemic conditions, such as vasculitis or thrombocytopenia.

Asking the patient directly about the lesions encourages open communication and allows for a more thorough examination of her current health status. It also demonstrates attentiveness and care from the healthcare provider, which can foster trust in the patient-provider relationship. By gathering more information, the clinician can better assess the urgency and significance of the findings, leading to an appropriate further evaluation or treatment plan.

In contrast, concluding that the lesions are old without exploring further can lead to missing out on critical diagnostic information. Waiting for the patient to mention the lesions risks overlooking potentially significant symptoms that could lead to a timely diagnosis or treatment. Proceeding with the visit normally without addressing these lesions could neglect a potentially important issue in the patient's health that merits attention.