By Rachael Morris-Jones
A 23-year-old African Caribbean girl offers within the emergency division with an acute onset facial rash. in the course of preliminary evaluate she complains of a week heritage of basic malaise, fatigue, fever, and weightloss. you've been assigned her examination...
100 situations in Dermatology provides a hundred situations with a dermatological manifestation as a rule visible via scientific scholars and junior medical professionals. A succinct precis of the patient's background, exam and preliminary investigations, together with complete color photographs displaying presentation, is by means of questions about the analysis and administration of every case. the reply features a specified dialogue on each one subject, with additional representation the place applicable, supplying a vital revision relief in addition to a realistic consultant for college students and junior doctors.
Making scientific judgements and selecting the easiest plan of action is likely one of the so much tough and hard elements of teaching to develop into a physician. those instances will train scholars and junior medical professionals to acknowledge very important dermatological signs and symptoms and, the place acceptable, their courting to different health conditions, and to boost their diagnostic and administration skills.
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Extra resources for 100 Cases in Dermatology
Examination She is unwell and distressed. 2 °C, blood pressure 180/100 mmHg and pulse rate 110 beats/ min. There is crusting and bleeding of her lips, her conjunctiva are severely injected and she has inflamed nasal mucosa. 1 thematous. She has numerous flaccid and tense blisters over her face, limbs and trunk with many areas becoming confluent with small areas of complete tissue necrosis and skin loss (Fig. 1). More than 30 per cent of her skin surface is affected, Nikolsky’s sign is positive.
45 ANSWER 21 When patients present with a sore ulcerated mouth the differential diagnoses include aphthous ulcers, viral stomatitis such as caused by herpes simplex virus (HSV), shingles (herpes zoster virus), Behçet’s disease, immunobullous disease (pemphigus vulgaris), vitamin/iron deficiency, neutropenia, and adverse drug reactions. The clue to the underlying cause of this patient’s oral ulceration was the preceding sore on his upper lip – herpes labialis (‘cold sore’) caused by HSV type 1 was isolated from a viral swab.
Differential diagnoses of chronic plaque psoriasis include discoid eczema, tinea corporis, lichen simplex and mycosis fungoides (T-cell lymphoma). Risk factors for psoriasis include a positive family history. In addition, possible triggering and exacerbating factors include stress, smoking, alcohol, streptococcal infection and medications such as ␤-blockers and non-steroidal antiinflammatory drugs (NSAIDs). Physical trauma can be a major factor in triggering lesions, the so-called Koebner phenomenon.