A 50-year-old man with a long-standing history of extensive psoriasis affecting the trunk, arms, buttock and nail beds is seen for review in Dermatology Outpatients. He has previously completed a course of phototherapy, with minimal improvement, and has shown no benefit on methotrexate for the past 12 months.
What is the next most appropriate step in the management of this patient?
Bethany Johnson, a 20-year-old student, visits her GP complaining of generalized itching. She reports no allergies or recent changes in cosmetic or detergent products. During the examination, the GP observes multiple excoriation marks throughout her body. Bethany also mentions experiencing fatigue and weight gain recently. What is the probable cause of her systemic pruritus?
A 56-year-old woman comes to her General Practitioner (GP) with an irregular mole on her back. The mole is oval in shape, 2 cm in length, and has an irregular border throughout. The colour is uniform, and there has been no change in sensation. The GP wants to evaluate the lesion using the weighted 7-point checklist for assessment of pigmented lesions to determine if the lesion requires referral to Dermatology.
What is a significant feature that scores 2 on the checklist?
A 16-year-old girl has been diagnosed with scabies.
Scabies is a skin condition caused by tiny mites that burrow into the skin and lay eggs. It is highly contagious and can spread through close physical contact or sharing of personal items such as clothing or bedding. Symptoms include intense itching, rash, and small bumps or blisters on the skin. Treatment typically involves prescription creams or lotions that kill the mites and their eggs. It is important to seek medical attention if you suspect you have scabies to prevent further spread of the condition.
A 50-year-old man was seen in the Dermatology Outpatient Clinic with a chronic ulcer on his left forearm. On enquiry by the consultant, he revealed that he suffered full-thickness burn at the site of the ulcer nearly 20 years ago. The consultant told the patient he had a Marjolin’s ulcer.
Which of the following statements best describes a Marjolin’s ulcer?
A 35-year-old lifeguard presents with a lesion on the ear. The lesion had been present for a number of months and he claims it is slowly growing. On examination, there is 1 cm red, ulcerating exophytic nodule with heaped up margins. Excision of the lesion is performed and histology reveals a completely excised lesion containing irregular masses of anaplastic epidermal cells proliferating down to the dermis with keratin pearls.
Which of the following is true regarding this lesion?
A 35-year-old woman presents with a 4-year history of a progressively worsening rash on her face, characterised by dark-coloured lesions with periodic background scaling, burning and pruritus. Physical examination reveals well-defined patches of flaky skin which is yellow and dry on the scalp. There is also flaking in the nasolabial folds, eyebrows and behind the ears. The patient’s eyelids are also red and inflamed. They report itchiness and discomfort.
Given the likely diagnosis of this patient, what is the most appropriate treatment?
A 6-year-old girl is brought to the General Practitioner (GP) by her mother. She has suffered an insect bite, and her mother is concerned about a small lump on the back of her hand.
Which of the following conditions is not pre-malignant?
An 80-year-old nursing home resident with a history of hypothyroidism and heart failure presents to you with a complaint of dry, itchy skin that is particularly bothersome on her legs. Upon examination, you observe erythematosus, dry skin on her legs with an unusual pattern. What is the most probable diagnosis?
A 14-year-old boy comes to the clinic with scaly patches on his scalp. Upon examination, circular areas of hair loss with scaling and raised margins, measuring 2-5 cm in diameter, are observed. There is no scarring. What is the probable cause of this condition in the patient?