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 overview she complains of a week background of normal malaise, fatigue, fever, and weightloss. you've been assigned her examination...
100 circumstances in Dermatology offers a hundred situations with a dermatological manifestation quite often visible by means of scientific scholars and junior medical professionals. A succinct precis of the patient's historical past, exam and preliminary investigations, together with complete color photos exhibiting presentation, is via questions about the analysis and administration of every case. the reply features a precise dialogue on each one subject, with additional representation the place applicable, offering a vital revision relief in addition to a pragmatic advisor for college kids and junior doctors.
Making scientific judgements and selecting the easiest plan of action is among the so much tough and tough components of teaching to develop into a physician. those situations will train scholars and junior medical professionals to acknowledge very important dermatological indicators and symptoms and, the place acceptable, their dating to different health conditions, and to improve their diagnostic and administration skills.
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Additional info for 100 Cases in Dermatology
A skin biospy was taken. Questions • What is the most likely cause of this patient’s sudden-onset skin eruption? • What is the prognosis for the patient and her baby? • How would you manage them? 49 ANSWER 23 This presentation with widespread skin loss is typical of drug-induced toxic epidermal necrolysis (TEN). Nikolsky’s sign is positive when lateral pressure is applied to the skin and the top layer sloughs off, and is found in TEN, Stevens–Johnson syndrome and staphylococcal scalded skin syndrome and immuno-bullous diseases.
Questions • What is the likely diagnosis? • What is the differential diagnosis? • How would you manage this patient? • What are the potential complications? 1 31 ANSWER 14 The most likely diagnosis is erythrodermic psoriasis. Erythroderma is when almost the entire skin (Ͼ 90%) becomes red; in the case of psoriasis the skin is also thickened and scaly. There is usually hyperkeratosis of the palmar/plantar sites. There may be onycholysis (lifting of the nail plates) and even shedding of the nails.
Patients should be kept in a warm room. Fluid and enteral nutrition are essential to compensate for high insensible fluid losses and high protein demands.
100 Cases in Dermatology by Rachael Morris-Jones