dermatology

A 32-year-old male presents to his GP complaining of a new, intensely itchy rash on his wrists and ankles. On examination, there are multiple small, flat-topped, polygonal, violaceous papules. Some of the papules have fine white lines on their surface. What is the most likely diagnosis?

A 35-year-old male presents to his general practitioner with a lesion on his nose that has been present for approximately 3 months. He initially thought it was a persistent pimple but it has not resolved and seems to be slowly growing. He denies pain, itching, or bleeding from the lesion. He has no significant past medical history and takes no regular medications. He works outdoors but reports using sunscreen inconsistently. On examination, vital signs are stable. The lesion is as shown in the image. There are no other skin lesions noted elsewhere. Regional lymph nodes are not palpable. Based on the appearance of the lesion shown, what is the most appropriate next step in the management of this patient?

A 45-year-old male presents to his GP with a lesion on his nose that has been slowly enlarging over the past six months. He reports no pain, itching, or bleeding. He has no significant past medical history and takes no regular medications. On examination, vital signs are stable. The image shows the appearance of the lesion. Given the clinical presentation and morphology, what is the most appropriate initial step in management?

Warts on the left hand for 2 months, no treatment yet. What is the best evidence-based treatment for warts?

A 10-year-old boy presents to his GP with a chronic, intensely itchy rash affecting the flexural areas of his elbows and knees, as well as his neck. His parents report that he has had this condition on and off since infancy, with periods of remission and exacerbation. He also has a history of allergic rhinitis and asthma. On examination, the skin in the affected areas is dry, lichenified, and excoriated. There are also scattered papules and plaques. The patient reports significant sleep disturbance due to the itch. Topical corticosteroids have provided temporary relief in the past, but the rash flares up again soon after stopping treatment. Which of the following is the MOST appropriate next step in managing this patient's atopic dermatitis?

A 45-year-old woman presents with a 3-month history of an intensely itchy rash on her wrists and ankles. On examination, you note violaceous, flat-topped papules. What is the most likely diagnosis?

A 35-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or recent illness. Examination reveals the image shown. What is the most appropriate initial management?

A 62-year-old man presents with a lesion on his nose that has been slowly enlarging over the past 8 months. He reports occasional tenderness but no bleeding. He has a significant history of outdoor work and multiple previous sunburns. His medical history is otherwise clear. On examination, vital signs are stable. The lesion appears as shown in the image. Regional lymph nodes are not palpable. Considering the clinical presentation and the appearance of the lesion, which of the following is the most appropriate initial step in the management of this patient?

A 68-year-old woman presents with a persistent, pruritic rash on her chest wall at the site of a previous mastectomy performed 8 years ago for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation. Examination reveals the area shown. What is the MOST appropriate next step in management?

A 40-year-old man presents with a painless, slowly growing lesion on his nose for the past 8 months. He denies any trauma or previous skin conditions. Examination reveals the pictured lesion. What is the MOST appropriate next step in management?

A 72-year-old woman presents with a 6-month history of a non-healing rash on her chest wall at the site of a previous mastectomy performed 10 years prior for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation. Examination reveals the findings shown. What is the MOST appropriate next step in management?

A 32-year-old woman presents to her GP complaining of a new, intensely itchy rash on her elbows, knees, and scalp. On examination, the GP notes symmetrical, erythematous papules and plaques with overlying silvery scales. The patient reports a family history of similar skin conditions. What is the most likely diagnosis?

A 22-year-old female presents with a strange tongue appearance after brushing her teeth, with no pain. She has a history of pustular psoriasis. What is the next step?

A 70-year-old woman, post-mastectomy, presents with a chronic, pruritic lesion. What is the MOST likely underlying pathophysiology?

A 68-year-old woman presents with a persistent rash on her chest wall at the site of a previous mastectomy performed 8 years ago. She denies pain or itching. What is the MOST appropriate next step in management?

A 68-year-old woman presents to her GP with a 3-month history of a persistent, mildly pruritic skin lesion on her left chest wall. She had a left simple mastectomy for invasive ductal carcinoma 10 years ago, followed by adjuvant therapy. She denies fever, weight loss, or other systemic symptoms. Physical examination reveals the appearance shown. What is the most appropriate initial diagnostic investigation?

A 70-year-old woman presents with a lesion on her chest wall at the site of a mastectomy performed 10 years prior. She reports it started as a small area of redness and has slowly enlarged. What is the MOST likely diagnosis?

A 40-year-old man presents with a solitary, asymptomatic nodule on his nose. Biopsy reveals perivascular eosinophilic infiltrate. What is the MOST likely diagnosis?

A 6-month-old infant is brought to the general practitioner by his parents, who are concerned about a persistent, itchy rash. The rash initially appeared on his cheeks and scalp a few weeks ago and has now spread to his trunk and extensor surfaces of his arms and legs. The parents report that the infant is constantly scratching, which disrupts his sleep. He has no known allergies, and there is no family history of asthma or allergic rhinitis. On examination, the infant is alert and active. There are erythematous, papular lesions with areas of weeping and crusting on his cheeks, scalp, trunk, and extensor surfaces. The skin is dry and flaky in other areas. Which of the following is the MOST appropriate initial management strategy for this infant's condition?

A 32-year-old woman presents to her general practitioner complaining of a persistent, intensely itchy rash that started a few weeks ago. She reports that it began on her wrists and ankles and has now spread to her elbows and knees. She denies any new medications, travel, or changes in personal care products. On examination, you observe symmetrical, excoriated papules and plaques on her wrists, elbows, knees, and upper back. Some of the papules have small blisters. Which of the following is the most appropriate initial investigation?

A 32-year-old woman, G1P1, presents to her general practitioner at 34 weeks gestation complaining of a new, intensely itchy rash. The rash started on her abdomen around the umbilicus and has now spread to her thighs and buttocks. On examination, there are erythematous papules and plaques, some with vesicles, located within the striae distensae of her abdomen. She denies any personal or family history of eczema or other skin conditions. She is otherwise well, with normal blood pressure and no proteinuria. Fetal movements are normal. Which of the following is the most appropriate initial management?

A 35-year-old man presents with a painless lesion on his nose, present for 6 months. Examination reveals the image shown. What is the MOST likely diagnosis?

A 65-year-old lady weighing 70 kg has an enlarging papule on her right neck, measuring 8 mm, raised with a keratotic horn. A keratinocytic tumor is suspected. What is the maximum safe dose of 1% lidocaine with adrenaline for local anesthesia in this patient?

A 35-year-old man presents to his general practitioner reporting a lesion on his nose that he first noticed approximately three months ago. He describes it as initially resembling a persistent pimple, but notes it has not resolved and appears to be slowly increasing in size. He denies any associated pain, itching, or bleeding from the site. His past medical history is unremarkable, and he is not currently taking any regular medications. He works outdoors in a role involving significant sun exposure but admits to inconsistent use of sun protection measures. On physical examination, his vital signs are within normal limits. The lesion in question is located on his nose and has the appearance shown in the accompanying image. No other suspicious skin lesions are identified elsewhere on his body, and regional lymph nodes are not palpable. Considering the clinical presentation and the appearance of the lesion depicted, what is the most appropriate initial step in the management of this patient?

A 35-year-old male presents to his general practitioner with a lesion on his nose that has been present for approximately 3 months. He initially thought it was a persistent pimple but it has not resolved and seems to be slowly growing. He denies pain, itching, or bleeding from the lesion. He has no significant past medical history and takes no regular medications. He works outdoors but reports using sunscreen inconsistently. On examination, vital signs are stable. The lesion is as shown in the image. There are no other skin lesions noted elsewhere. Regional lymph nodes are not palpable. Based on the appearance of the lesion shown, what is the most appropriate next step in the management of this patient?

A 55-year-old man presents to his GP with a lesion on his nose that he first noticed about 6 months ago. It has gradually increased in size but is not painful or itchy. He has no significant past medical history and takes no regular medications. On examination, vital signs are stable. The image shows the lesion. Based on the appearance of this lesion, what is the most appropriate next step in management?

A 55-year-old man presents with a slowly growing lesion on his nose that he first noticed about 6 months ago. He reports occasional mild discomfort but no bleeding. He has a history of significant sun exposure due to his occupation. His medical history is otherwise unremarkable. On examination, vital signs are normal. The lesion appears as shown in the image. Regional lymph nodes are not enlarged. Considering the patient's history, risk factors, and the appearance of the lesion, what is the most appropriate initial step in the management of this patient?

A patient has Bowen's disease on their trunk. Which exposure is a significant risk factor for Bowen's disease, especially in non-sun-exposed areas?

A 45-year-old man presents to his GP with a lesion on his nose that has been present for several months and seems to be slowly enlarging. He denies pain, itching, or bleeding. He works outdoors but reports using sunscreen inconsistently. His past medical history is unremarkable, and he takes no regular medications. On examination, vital signs are stable. Regional lymph nodes are not palpable. The lesion is as shown in the image. Considering the clinical presentation, risk factors, and the appearance of the lesion, which of the following represents the most appropriate initial step in establishing a definitive diagnosis and guiding management?

A 55-year-old man presents to his GP with a persistent lesion on his nose that has been present for several months and has not changed significantly in size or appearance. He reports it is occasionally itchy but otherwise asymptomatic. His medical history is unremarkable, and vital signs are within normal limits. On examination, you observe the lesion shown in the image. Considering the appearance of this lesion, what is the most appropriate initial step in the management of this patient?

A 32-year-old woman presents to her general practitioner complaining of a persistent, intensely itchy rash on her elbows, knees, and scalp for the past 6 months. She reports that the itching is worse at night and after hot showers. She has tried over-the-counter hydrocortisone cream without relief. On examination, the GP notes symmetrical, excoriated papules and plaques on the extensor surfaces of her elbows and knees, as well as some scaling on her scalp. The patient also mentions a history of recurrent mouth ulcers. Which of the following is the MOST appropriate initial investigation to confirm the suspected diagnosis?

A 68-year-old woman recently started on warfarin for a pulmonary embolism presents with a painful, rapidly expanding purpuric lesion on her thigh, which developed two days ago. Her INR is 2.5. She has no history of trauma to the area. Considering the clinical presentation and the appearance of the lesion, what is the most likely underlying pathophysiological process?

A 62-year-old man presents with a painless lesion on his nose, present for 8 months. He denies trauma or fever. Examination reveals the image shown. Histopathology is MOST likely to show which of the following?

A 45-year-old man presents with the finding shown. He denies pain but is concerned about its appearance. What is the MOST appropriate initial step?

A 50-year-old man presents with a slowly growing, asymptomatic nasal lesion. He reports no trauma or fever. Examination reveals the image shown. What is the MOST likely long-term outcome if left untreated?

A 40-year-old patient presents with a persistent, slightly raised lesion on their nose that has been present for several months. It is asymptomatic except for occasional mild itching. There is no history of trauma or recent changes in size or colour. The patient is otherwise healthy. Considering the appearance of the lesion shown and the clinical presentation, which of the following represents the most appropriate initial approach?

A 55-year-old man presents to his GP with a lesion on his nose that has been slowly enlarging over the past 4 months. He reports no associated pain, itching, or bleeding. He is otherwise well, with no significant past medical history. On examination, vital signs are within normal limits. The lesion is as shown in the image. Considering the clinical presentation and the appearance of the lesion, what is the most appropriate initial step in the management of this patient?

A 50-year-old man presents with a slowly growing nasal lesion. Examination reveals the image shown. What is the MOST appropriate initial management?

A 35-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or previous skin conditions. Examination reveals the image shown. What is the MOST appropriate initial management step?

A 68-year-old woman presents to her general practitioner with a persistent, pruritic rash on her chest wall. She reports a history of left mastectomy for invasive ductal carcinoma 8 years ago, followed by adjuvant chemotherapy and radiation therapy. She denies any recent trauma or changes in soaps or detergents. Physical examination reveals the findings shown. A punch biopsy is performed. Which of the following immunohistochemical stains would most likely be positive in this patient's biopsy sample, supporting the suspected diagnosis?

A 45-year-old male presents with a painless lesion on his nose that has been present for 6 months. He denies any trauma or previous skin conditions. Examination reveals the lesion seen in the image. What is the MOST appropriate next step in management?

A 45-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or recent illness. Examination reveals the image shown. What is the MOST appropriate initial management?

A 68-year-old woman presents with a persistent, pruritic rash on her chest wall at the site of a previous mastectomy performed 8 years ago for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation at that time. Examination reveals the area shown. What is the MOST appropriate next step in management?

A 68-year-old woman presents with a persistent rash following a mastectomy 5 years prior. What is the MOST appropriate next step in management?

A 45-year-old man presents to his GP with a lesion on his nose that he first noticed about 6 months ago. It has slowly increased in size but is not painful or itchy. He has no significant past medical history and takes no regular medications. On examination, vital signs are stable. The image shows the appearance of the lesion. Considering the clinical presentation and the appearance of the lesion shown, what is the most appropriate initial management step?

A 68-year-old patient on warfarin for a recent DVT presents with a painful, rapidly expanding skin lesion on their leg that started 48 hours ago. Their INR is 2.9. Given the clinical context and the appearance of the lesion, what is the most appropriate immediate management step?

A 32-year-old woman presents to her general practitioner complaining of a persistent, intensely itchy rash that started a few weeks ago. She reports that it began on her wrists and ankles and has now spread to her elbows and knees. She denies any new medications, travel, or changes in personal care products. On examination, you observe symmetrical, intensely pruritic, violaceous, flat-topped papules and plaques on her wrists, ankles, and shins. Some of the lesions show fine, white lines on the surface. There are also a few small, similar lesions on her buccal mucosa. Which of the following is the most appropriate initial management?

A 72-year-old woman presents with a 6-month history of a non-healing rash on her chest wall at the site of a previous mastectomy performed 10 years prior for invasive ductal carcinoma. She has completed adjuvant chemotherapy and radiation. Examination reveals the findings shown. What is the MOST appropriate next step in management?

A 55-year-old lady presents with a painless, white, lacy pattern on her buccal mucosa that has been present for several weeks. She feels well and has no significant medical history. What is the likely diagnosis?

29-year-old lady with postpartum hair loss, sparse hair, positive pull test, and normal scalp. Diagnosis?