system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 45-year-old man comes to the physician for evaluation of a recurrent rash. He has multiple skin lesions on his legs, buttocks, and around his mouth. The rash first appeared a year ago and tends to resolve spontaneously in one location before reappearing in another location a few days later. It begins with painless, reddish spots that gradually increase in size and then develop into painful and itchy blisters. The patient also reports having repeated bouts of diarrhea and has lost 10 kg (22 lb) over the past year. One year ago, the patient was diagnosed with major depressive syndrome and was started on fluoxetine. Vital signs are within normal limits. Physical examination shows multiple crusty patches with central areas of bronze-colored induration, as well as tender eruptive lesions with irregular borders and on his legs, buttocks, and around his lips. The Nikolsky sign is negative. His hemoglobin concentration is 10.2 g/dL, mean corpuscular volume is 88 μm3, and serum glucose is 210 mg/dL. A skin biopsy of the lesion shows epidermal necrosis. Which of the following additional findings is most likely to be found in this patient?
assistant
Increased fasting serum glucagon level