almost never metastasizes but it may kill by local
commonest skin cancer
incidence is related to sunlight exposure
75% occur in the head and neck
Initial small pearly white lesion, telengectasia, central
ulceration and rolled edges, bleed-ulcerate-heal again
Treatment is excision by specialist, send for histology
How would you manage and what treatment would you avoid?
Flushing, papules and pustules - forehead, bridge of
the nose and cheeks
Precipitated by topical steroids, sunlight, alcohol, hot
topical azelaic acid
Small white yellow papules that occur on face and
Common in newborns and are transient
Believed to originate from maldeveloped sweat glands
Often rupture and skin and no treatment is required
What features support diagnosis?
What would you do with this patient?
Asymmetrical, irregular border and colour, increasing
Prognosis related to thickness (Breslow)
Usually appear in first 2 decades
No treatment required
May be excised if malignant change suspected or for
Characteristically: rapidly expanding painless,
ulcerated nodule, rolled indurated margin.
Commonly ulcerate and bleed
Potential to metastasize
Must refer for biopsy/excision
Slowly expanding pink, scaly plaque that has a sharply
Risk of invasive SCC (3-5%)
Management options include watchful waiting,
topical fluorouracil, cryotherapy, curettage, excision,
What are the erythematous areas called?
Name 2 causes
Causes: barbiturates, aspirin, sulphonamides, herpes
simplex , TB, mycoplasma, typhoid, pregnancy, vit c
deficiency, collagen vascular disease, IBD
Symptomatic Rx e.g. Antihistamines
Heals in 3 weeks
hyperpigmented or scaly lesions, usually brown with a
marked thickening of the keratin layer
Can progress to SCC
Topical diclofenac 3%, 5-fluorouracil, topical retinoids
physical treatment e.g. cryotherapy, curettage, local
Varicella zoster virus
aciclovir administration of 800 mg five times per day
for 7 days
Can result in post-herpetic neuralgia
Erythema Ab Igne
Reddened skin due to longterm infrared radiation
Common in elderly who sit in front of heater
Or use of a hot water bottle as in this case
Laptops may cause it!!
Mild cases resolves spontaneously if you remove
source, others are permanent
What is this and
what diseases may it
be associated with?
Erythema nodosum is a reactive process of unknown
Causes: streptococcal infection, sarcoidosis.
Pregnancy, the oral contraceptive pill, inflammatory
bowel disease, tuberculosis
In 50% of cases the cause is not identified.
Must to bloods and CXR to investigate
Screen for other autoimmune disorders eg thyroid
No treatment required
What are these patches?
They were on the patients back
Usually noted after a holiday when normal skin tans
Mild or localised pityriasis versicolor may clear with
repeated applications of a topical imidazole cream
oral imidazole (ketoconazole, fluconazole or
itraconazole) for extensive infections