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!