A 50-year-old woman came to the skin clinic with flaccid blisters on the inside of her mouth and the front of her chest, with some areas appearing red and weeping. The dermatologist performed a skin biopsy, which revealed a superficial intra-epidermal split just above the basal layer with acantholysis. What is the most probable diagnosis?
A 25-year-old man without prior history of skin issues comes in with severe itching that worsens at night. The rash is made up of small, red, extremely itchy bumps on the limbs and torso. His girlfriend is also experiencing itching. Upon closer examination of his skin, what finding would most likely confirm the diagnosis?
A 25-year-old female with a history of systemic lupus erythematosus presents with symmetrical reticulated, violaceous patches. These patches become more prominent in cold weather and involve both lower limbs. What is the probable diagnosis?
An 80-year-old female comes to the clinic from her nursing home with an atypical rash on her arms and legs. The rash appeared after starting furosemide for her mild ankle swelling. Upon examination, there are multiple tense lesions filled with fluid, measuring 1-2 cm in diameter on her arms and legs. What is the most probable diagnosis?
A 36-year-old African-American man undergoes a pre-employment health check. Chest radiograph demonstrates bilateral hilar lymphadenopathy. More detailed history and examination reveals painful red papules on both shins of recent onset. He is otherwise well. Basic blood tests are normal.
What rash does the patient have?
A 29-year-old Romanian immigrant presents to his general practitioner, complaining of firm and tender reddish-blue raised nodules on the front of both shins. These have been present for a number of months. He has also lost weight and suffered from a chronic cough since the beginning of the year. On examination, there are multiple red/purple, firm, painful lesions affecting both shins. Investigations:
Investigation Result Normal value
Haemoglobin 105 g/l 135–175 g/l
White cell count (WCC) 9.2 × 109/l 4–11 × 109/l
Platelets 220 × 109/l 150–400 × 109/l
Sodium (Na+) 139 mmol/l 135–145 mmol/l
Potassium (K+) 4.5 mmol/l 3.5–5.0 mmol/l
Creatinine 110 μmol/l 50–120 µmol/l
Chest X-ray Calcified hilar lymph nodes,
area of upper lobe fibrosis in the right lung
Induced sputum Acid- and alcohol-fast bacilli seen
Which of the following is the most likely diagnosis for his rash?
A 35-year-old music teacher who presented to her General Practitioner (GP) with a skin lesion on her forearm. On examination, the lesion is a 4-mm red, raised lesion with multiple scratch marks surrounding it. The GP wishes to refer Mrs Green to a local dermatologist.
Which of the following descriptions most accurately describes this lesion?
A 32-year-old woman presents with shiny, flat, red papules over her anterior wrists and forearms. The papules are extremely pruritic and some of them have a central depression. Similar papules are seen along the scratch line at the volar surface of the forearm. The patient is a nurse and has had at least three needlestick injuries during the past 2 years. Human immunodeficiency virus (HIV) enzyme-linked immunosorbent assay is negative. Hepatitis B surface antigen and anti-HBc antibody are negative, but anti-HBs antibody is positive. Anti-hepatitis C (HCV) antibody is positive.
What is the most likely diagnosis for this patient?
For her 4-year-old son Oliver’s atopic eczema, Mrs Simpson takes him to the general practice surgery. Despite using aqueous cream regularly, Oliver has not seen much improvement. The general practitioner suggests trying a topical steroid cream. Which topical steroid would be the most suitable option to try next?
A 29-year-old male patient comes to you with a complaint of an erythematosus rash in his groin area. He reports that the rash was initially raised and red, but it has now healed and left behind hyperpigmentation. Interestingly, he mentions that he has experienced this same rash in the same location before. Upon further questioning, he reveals that he had taken ibuprofen for a strained ankle prior to the onset of the rash. What is the probable cause of this presentation?