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He now sees the podiatrist every two months and on this visit, he is complaining of a rash on the plantar surface of his feet, which is red and itchy. Mr Lewis is Wegeners granulomatosis. In this condition, there is polyarthritis and vasculitis of small and medium sized blood vessels throughout the body. Mr Lewis also has type Mr Lewis is on a complex regime of drug therapy (and you may need to consult the BNF): Metformin Prednisolone Asasantin one capsule twice daily Omeprazole Sertraline Temazepam Salbutamol Glyceryl trinitrate Amlodipine Perindopril Acetazolamide Erythromycin Discuss the treatment of this patient using the questions below as a guide. They are intended to stimulate discussion not limit debate.

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