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DERMATOLOGY QUIZ

DERMATOLOGY QUIZ. Sajid Nazir 2009. What is this?. How would you manage it?. Basal Cell Carcinoma. 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

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DERMATOLOGY QUIZ

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  1. DERMATOLOGY QUIZ Sajid Nazir 2009

  2. What is this? How would you manage it?

  3. Basal Cell Carcinoma • 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. What is this? How would you manage and what treatment would you avoid?

  5. Rosacea • 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. What is this condition? How would you manage it?

  7. Milia • 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 is this condition? What features support diagnosis? What would you do with this patient?

  9. Malignant Melanoma • Asymmetrical, irregular border and colour, increasing size • Urgent referral • Prognosis related to thickness (Breslow)

  10. What is this? How would you manage?

  11. MelanocyticNaevi • Usually appear in first 2 decades • No treatment required • May be excised if malignant change suspected or for cosmetic reasons

  12. What is this lesion?

  13. Squamous cell carcinoma • Characteristically: rapidly expanding painless, ulcerated nodule, rolled indurated margin. • Commonly ulcerate and bleed • Potential to metastasize • Must refer for biopsy/excision

  14. What is this lesion?

  15. Bowen’ s Disease • 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

  16. What is this condition called? What are the erythematous areas called? Name 2 causes

  17. Erythemamultiforme • 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

  18. What are these lesions called? How would you treat them?

  19. Solar Keratosis (Actinic) • 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

  20. What is this rash?

  21. Shingles • Varicella zoster virus • Unilateral • aciclovir administration of 800 mg five times per day for 7 days • Can result in post-herpetic neuralgia

  22. What is this lesion How would you treat it?

  23. Ringworm (Tineacorporis ) • Spares face, hands and feet • topical antifungal therapy or with steroid • Oral terbenfaine/itraconazole

  24. What is this called and what causes it?

  25. 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

  26. What is this and what diseases may it be associated with?

  27. Erythemanodosum • 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

  28. What are these patches?

  29. Alopecia areata • Screen for other autoimmune disorders eg thyroid • No treatment required

  30. What are these patches?They were on the patients back

  31. Pityriasisversicolor • 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

  32. THANK YOU!

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