dermatology quiz
DESCRIPTION
TRANSCRIPT
Sajid Nazir 2009
How would you manage it?
almost never metastasizes but it may kill by local invasion
commonest skin cancerincidence is related to sunlight exposure75% occur in the head and neckInitial 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
Unknown aetiologyPrecipitated by topical steroids, sunlight,
alcohol, hot drinkstopical metronidazole topical azelaic acid oral tetracycline
How would you manage it?
Small white yellow papules that occur on face and neck
Common in newborns and are transientBelieved to originate from maldeveloped
sweat glandsOften 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 size
Urgent referralPrognosis related to thickness (Breslow)
How would you manage?
Usually appear in first 2 decadesNo treatment requiredMay be excised if malignant change
suspected or for cosmetic reasons
Characteristically: rapidly expanding painless, ulcerated nodule, rolled indurated margin.
Commonly ulcerate and bleedPotential to metastasizeMust refer for biopsy/excision
Slowly expanding pink, scaly plaque that has a sharply defined border
Risk of invasive SCC (3-5%)Histology requiredManagement options include watchful
waiting, topical fluorouracil, cryotherapy, curettage, excision, laser
What are the erythematous areas called?Name 2 causes
Target LesionsCauses: barbiturates, aspirin, sulphonamides,
herpes simplex , TB, mycoplasma, typhoid, pregnancy, vit c deficiency, collagen vascular disease, IBD
Treat causesSymptomatic Rx e.g. AntihistaminesHeals in 3 weeks
How would you treat them?
hyperpigmented or scaly lesions, usually brown with a scaly base
marked thickening of the keratin layer Can progress to SCCTopical diclofenac 3%, 5-fluorouracil, topical
retinoidsphysical treatment e.g. cryotherapy,
curettage, local excision
Varicella zoster virusUnilateralaciclovir administration of 800 mg five times
per day for 7 days Can result in post-herpetic neuralgia
How would you treat it?
Spares face, hands and feettopical antifungal therapy or with steroidOral terbenfaine/itraconazole
What is this called and what causes it?
Erythema Ab IgneReddened skin due to longterm infrared
radiation exposureCommon in elderly who sit in front of heaterOr use of a hot water bottle as in this caseLaptops 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 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
What are these patches?
Screen for other autoimmune disorders eg thyroid
No treatment required
What are these patches?They were on the patients back
yeast infectionUsually noted after a holiday when normal
skin tansMild or localised pityriasis versicolor may
clear with repeated applications of a topical imidazole cream
oral imidazole (ketoconazole, fluconazole or itraconazole) for extensive infections
THANK YOU!