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 review she complains of a week historical past of common malaise, fatigue, fever, and weight-loss. you've been assigned her examination...
100 situations in Dermatology offers a hundred situations with a dermatological manifestation normally obvious through clinical scholars and junior medical professionals. A succinct precis of the patient's background, exam and preliminary investigations, together with complete color photos displaying presentation, is through questions about the analysis and administration of every case. the reply contains a distinct dialogue on each one subject, with additional representation the place applicable, offering a vital revision relief in addition to a pragmatic consultant for college students and junior doctors.
Making medical judgements and selecting the simplest plan of action is among the so much demanding and hard components of teaching to develop into a physician. those instances will educate scholars and junior medical professionals to acknowledge vital dermatological signs and symptoms and, the place applicable, their dating to different health conditions, and to strengthen their diagnostic and administration skills.
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This is a scaly skin eruption that appears rapidly after the onset of a streptococcal throat infection. This type of psoriasis is predominantly seen in adolescents and young adults. The word guttate is derived from the Latin name gutta which means ‘drop-like’. The differential diagnosis includes Pityriasis rosea. Classically, in guttate psoriasis lesions are symmetrical mainly over the trunk and limbs with crops of papules and small plaques with overlying scale. Throat swabs may confirm the presence of group A ␤-haemolytic Streptococcus.
When urticaria persists for more than 6 weeks it is classified as chronic urticaria. It represents a tissue reaction pattern and can be precipitated by a variety of stimuli or triggers. Many skin eruptions are known which may present with ‘urticated’ lesions that are not transient. There may be more than one precipitant of urticaria in any one affected individual. Although there is an element of physical provocation, which you have demonstrated by exercising the patient, the eruption can be present on waking and therefore there is more to this than cholinergic urticaria.
Physical trauma can be a major factor in triggering lesions, the so-called Koebner phenomenon. 2 Nail disease in psoriasis is common, affecting the fingernails and toenails. Nail changes (Fig. 2) include pitting and onycholysis (separation of the nail plate from the nail bed), and subungal hyperkeratosis. Oil spots are pathognomic and appear as yellow-brown spots under the nail plate. Basic histopathology shows there is marked thickening of the epidermis (plaques) and dilated blood vessels just beneath the epidermis (erythema), and neutrophils infiltrate up into the stratum corneum where they form microabscesses of Munro (inflammation).