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Dermatology quiz

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  • 1. Sajid Nazir 2009
  • 2. How would you manage it?
  • 3.
    • almost never metastasizes but it may kill by local invasion
    • 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
  • 4. How would you manage and what treatment would you avoid?
  • 5.
    • Flushing, papules and pustules - forehead, bridge of the nose and cheeks
    • Unknown aetiology
    • Precipitated by topical steroids, sunlight, alcohol, hot drinks
    • topical metronidazole
    • topical azelaic acid
    • oral tetracycline
  • 6. How would you manage it?
  • 7.
    • Small white yellow papules that occur on face and neck
    • Common in newborns and are transient
    • Believed to originate from maldeveloped sweat glands
    • Often rupture and skin and no treatment is required
  • 8. What features support diagnosis? What would you do with this patient?
  • 9.
    • Asymmetrical, irregular border and colour, increasing size
    • Urgent referral
    • Prognosis related to thickness (Breslow)
  • 10. How would you manage?
  • 11.
    • Usually appear in first 2 decades
    • No treatment required
    • May be excised if malignant change suspected or for cosmetic reasons
  • 12.  
  • 13.  
  • 14.
    • Characteristically: rapidly expanding painless, ulcerated nodule, rolled indurated margin.
    • Commonly ulcerate and bleed
    • Potential to metastasize
    • Must refer for biopsy/excision
  • 15.  
  • 16.
    • Slowly expanding pink, scaly plaque that has a sharply defined border
    • Risk of invasive SCC (3-5%)
    • Histology required
    • Management options include watchful waiting, topical fluorouracil, cryotherapy, curettage, excision, laser
  • 17. What are the erythematous areas called? Name 2 causes
  • 18.
    • Target Lesions
    • Causes: barbiturates, aspirin, sulphonamides, herpes simplex , TB, mycoplasma, typhoid, pregnancy, vit c deficiency, collagen vascular disease, IBD
    • Treat causes
    • Symptomatic Rx e.g. Antihistamines
    • Heals in 3 weeks
  • 19. How would you treat them?
  • 20.
    • hyperpigmented or scaly lesions, usually brown with a scaly base
    • marked thickening of the keratin layer
    • Can progress to SCC
    • Topical diclofenac 3%, 5-fluorouracil, topical retinoids
    • physical treatment e.g. cryotherapy, curettage, local excision
  • 21.  
  • 22.
    • Varicella zoster virus
    • Unilateral
    • aciclovir administration of 800 mg five times per day for 7 days
    • Can result in post-herpetic neuralgia
  • 23. How would you treat it?
  • 24.
    • Spares face, hands and feet
    • topical antifungal therapy or with steroid
    • Oral terbenfaine/itraconazole
  • 25. What is this called and what causes it?
  • 26. Erythema Ab Igne
    • Reddened skin due to longterm infrared radiation exposure
    • 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
  • 27. What is this and what diseases may it be associated with?
  • 28.
    • Erythema nodosum is a reactive process of unknown pathogenesis
    • 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
  • 29. What are these patches?
  • 30.
    • Screen for other autoimmune disorders eg thyroid
    • No treatment required
  • 31. What are these patches? They were on the patients back
  • 32.
    • yeast infection
    • 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
  • 33. THANK YOU!