Final assessment (part one)
Case Study 1
A 16 year old girl gave a 3 month history of an asymptomatic non-scaly milky white patch over the dorsum of the right hand. It increased in size and a few weeks later a similar patch appeared over the other hand. She was advised by well meaning friends to sunbathe as much as possible to help repigmentation. After sun exposure for several hours a day for many weeks she found that the patches over the hands had turned a pinkish colour but new hypopigmented lesions formed over the face, elbows, knees and the back. She gave no other symptoms and took no drugs. A aunt apparently had thyroid disease but there was no other relevant family history. Laboratory tests which included a serum B12 estimation and fasting blood sugar showed no abnormality.
1- What is the diagnosis?
Choose the best: Tinea corporis - Vitiligo - Psoriasis
2- What are some recognized associations of the disease?
3- Which treatments have been shown to be helpful?
Case Study 2
A 19 year old university student developped flu-like symptoms with headache, coryza, myalgia and loss of appetite. She took aspirin 300 mg every 6 h with some imprevement. On the second day of the illness she noticed vesicles over the lips. She recognized these as being due to herpes simplex as in the past she had suffered from recurrent herpes often exacerbated by sunlight. The aspirins were discontinued on the fifth day of illness. Recovery seemed uneventful until the ninth day when she noticed several target (iris) lesions over the neck, arms, trunk and the lower limbs. The palms and soles showed similar lesions and although widespread the eruption was not pruritic. There were no ocular or genital lesions.
1- What is the skin condition?
Choose the best: Erythema multiforme - Impetigo - Pityriasis rosea
2- What may cause it?
3- How would you confirm the diagnosis?
Case Study 3
A 23 year old woman complained of weakness, easy fatiguability and weight loss which started 2 months previously. There was no associated lymphadenopathy or hepatomegaly. she was advised to take a vacation and chose a holiday in the sun. After 48 h exposure to sunlight she developed a florid erythematous eruption on the malar (butterfly)area and there were similar lesions on the neck and the dorsum of the fingers.
1- What is the probable diagnosis?
Choose the best: Lupus erythematosus - lichen planus - Psoriasis
2- Name other cutaneous signs which can occur with the disease
3- List some complications of the systemic disorder
Cloze Activity
Read the paragraph below and fill in the missing words.
- The commonest and most intractable sequel of H. zoster is
- Lepromin test is weakly positive in
- The density of eccrine sweat gland is highest in
- The major cell found in epidermis is
- A pyogenic infection of the skin characterized by the formation of adherent crusts, beneath which ulceration occurs is