By Rachael Morris-Jones
A 23-year-old African Caribbean girl provides within the emergency division with an acute onset facial rash. in the course of preliminary overview she complains of a week background of basic malaise, fatigue, fever, and weightloss. you've been assigned her examination...
100 situations in Dermatology offers a hundred eventualities with a dermatological manifestation as a rule obvious via scientific scholars and junior medical professionals. A succinct precis of the patient's heritage, exam and preliminary investigations, together with complete color photos displaying presentation, is by way of questions about the prognosis and administration of every case. the reply features a distinct dialogue on every one subject, with additional representation the place applicable, supplying an important revision relief in addition to a realistic advisor for college kids and junior doctors.
Making medical judgements and selecting the simplest plan of action is among the so much difficult and tough elements of educating to develop into a physician. those circumstances will train scholars and junior medical professionals to acknowledge very important dermatological signs and indicators and, the place acceptable, their courting to different health conditions, and to boost their diagnostic and administration skills.
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Additional info for 100 Cases in Dermatology
Medical practitioners should suspect photosensitivity if skin disease affects exposed skin sites – classically the face, hands and anterior chest. On direct questioning, patients may report a worsening of their skin condition during the summer or following a holiday abroad. This patient was diagnosed with porphyria cutanea tarda (PCT) which usually presents between the 3rd to 5th decades. The condition is characterized by skin fragility leading to blister formation following minor trauma. Initially, skin changes include tense vesicles/bullae and erosions on a background of normal-looking skin.
The lesions themselves consist of erythematous annular rings with a central papule or vesicle. However, as the name suggests, the cutaneous eruption can be variable in appearance (multiforme). With EM there may or may not be involvement of mucous membranes. EM minor is cutaneous involvement at the typical acral sites; EM major has the same cutaneous eruption (Ͻ10 per cent epidermal detachment) plus involvement of one or more mucous membrane sites. This can be distinguished from Stevens–Johnson syndrome that has 10–30 per cent skin surface area with epidermal detachment and always significant mucous membrane involvement.
Questions • What is the most likely diagnosis? • What is the underlying cause? • How would you manage this patient? 1 35 ANSWER 16 This patient is suffering from phytophotodermatitis, which is a phototoxic skin eruption. This acute inflammatory condition is triggered by the combination of skin contact with photosensitizing chemicals in plants plus sunlight. Patients usually report burning or itching of their skin prior to the onset of blistering. The characteristic skin patterns result from the plant brushing against bare skin whilst outdoors.
100 Cases in Dermatology by Rachael Morris-Jones