Picture 1

What is this lesion?Basal Cell Carcinoma (BCC) 

What are the predisposing factors for getting this lesion?

Celtic “freckling” skin Males more than in females Exposure to the sun (outdoor occupations) Increased age

3 Characteristics features of this skin lesion are: Rodent ulcers (pearly papules) Raised rolled edge Central ulceration Overlying blood vessels (Telangiectasic vessels)

Name 3 methods of treatment

Surgical excision Adequate resection margins are important Radiotherapy Unsuitable for lesions on the nose or ear because of the

possibility of radiation necrosis.

Cryotherapy Suitable for smaller lesions in low risk sites

Curettage and cauteryMay be suitable for smaller lesions in low risk sites

Topical 5 Fluorouracil May be useful for low risk, non facial BCCs eg multiple superficial spreading BCCs on the trunk and lower limbs

Picture 2

This is a Malignant Melanoma (MM)

When evaluating these lesions, important characteristics include:

ABCDES

Asymmetry Border Irregularity Color change/ variation Diameter > 6 mm Elevation Symptoms eg pain/ bleeding/ itch

Picture 3

Plane Warts

List 3 methods of treating warts:

Topical treatment Salicylic acid and lactic acid

Cryotherapy ( Liquid nitrogen)

Curettage and cautery

Treat human papilloma virus infection

Extra Notes:

These warts are usually multiple, and are most commonly seen on the hands.They are dome shaped with a papilliferous surface.

These are smooth, flat-topped papules, often slightly brown in colour, and are commonest on the face and dorsum of the hands.

Picture 4

What are these lesions?

Molluscum Contagiosum

What causes them?

Caused by a DNA pox virus

They can resolve spontaneously. True / False

Where on the body do they commonly occur?

Face Neck Trunk

How it maybe treated?

Cryotherapy in older children

Picture 5

What type of skin lesions are typically associated with this condition?

Acne Vulgaris

Comedones "blackhead": partially blocked; "whitehead": fully blocked Papules Nodules Cysts Scars

Males get this condition more frequently than females. True/ False

Diet has a major role in the aetiology of this skin condition. True / False

List 4 approaches to treatment of this skin condition:

Treatment is based on degree and type of acne, and may be: Topical:

o Salicylic acido Rretinoids (Skin irritation may be a side effect. These are best used at

night, and should be avoided in pregnancy).o Benzoyl peroxide (a peeling agent—may cause skin irritation)o Antibiotics (eg erythromycin, tetracycline, clindamycin)

Systemic o Antibioticso OCP (Dianette)o Isotretinoin o Roaccutane

Picture 6

This picture shows the classic psoriatic Plaque

What causes psoriasis?

Increased epidermal turnover (epidermal turnover time reduced from 28 days to ~ 4 days!)

Genetic predisposition

List 3 possible precipitants of a flare of psoriasis? Infection: eg streptococcal throat infection may precipitate guttate* psoriasis.

HIV infection can cause a severe flare of psoriasis. Drugs: eg beta blockers, anti malarials, lithium, steroids (oral and moderately

potent topical) can trigger a flare of psoriasis Metabolic factors: eg hypocalcaemia can trigger a flare of psoriasis Alcohol: excess can trigger a flare of psoriasis Smoking: can trigger a flare of psoriasis Psychological factors: difficult to quantify! It can be difficult to ascertain if

stress precipitates or is secondary to psoriasis. Trauma: to the epidermis and dermis can precipitate psoriasis in the damaged

skin: this is known as the Koebner phenomenon. Sunlight: in the majority, sunlight has a beneficial effect. In ~ 10%, exposure to

sunlight can aggravate psoriasis.

Picture 7

Impetigo

What organisms are responsible for causing this skin condition?

This is a superficial skin infection caused by staphlococci/ streptococci/ both.

The characteristic features of this infection include:

Vesicles Golden –yellow “ honeycomb “ crust Contagious.

It generally occurs in children around the angle of the lips, and around the nostrils.

This skin condition is not contagious. True / False

Treatment of this condition consists of: Crust removal Topical antibiotic cream or ointment (fusidic acid/ mupirocin). Systemic treatment oral flucloxacillin or erythromycin is given for more

widespread infection. Hygiene prevent re spread

Picture 8

Herpes Zoster (Shingles)

Characteristics of this skin condition include:

Papules Vesicles

Pustules

Crusts

Dermatomal distribution

This skin condition is usually self- limiting, but may be complicated by:

Ophthalmic disease (Corneal Scarring, Ophthalmic trigeminal involvement) Motor Palsy

Ramsy Hunt Syndrome

Dissemination

Pneumonia

Encephalitis

Post Herpetic Neuralgia

Picture 9

This is a picture of Tinea pedis (athlete foot)

This is a typically an itchy skin condition True/False

3 Factors which contribute to this condition are:

Fungal Infection Adults

Occlusive footwear (Sweaty Foot)

Hot weather

Swimming Pools

Hot weather

Picture 10 & 11

Pic 10: Atopic Eczema Cheeks Infected eczema

Pic 11: Eczema flexures

This is a child has eczema. It is not an itchy skin condition. True / False

List 3 things which can aggravate eczema Viral/bacterial infection Pain Stress Foods (In ~ 10 %) Irritants (soaps detergents chlorine) Heat

Wool/ Synthetics/ Animal dander

List 3 potential complications of eczema Growth retardation Fatigue Family life disruption Social complications (eg due to bullying) Psychological complications (eg due to low self esteem) Infections Ocular complications (Blindness)

List 3 potential therapies used in the treatment of eczema

Avoid aggravators Emollients Topical steroids Antibiotics Antihistamines Wraps Tacrolimus Light treatment Immunosuppression

Picture 11 demonstrates the phenomenon of eczema on arm creases

Extra Notes:

Eczema is itchy.Acute eczema is characterised by vesicles.Chronic eczema is characterised by lichenification.

Erysipelas:

Cold Sore:

Pompholyx:

Eczema:

Acral Lentiginous:

Measles:

Tinea capitis:

Chicken Pox (Varicella Zoster):

Rubella (German Measles)

Melanoma:

Squamous cell carcinoma:

Tinea corporis:

Scabies: