Classic Presentations

Question 1

Patient presents with red, itchy rash covering the chest, back and face that turns into itchy, fluid-filled blisters and lasts for 4-7 days and is accompanied by a fever

Answer 1

Chickenpox

Question 2

Elderly patient presents with itchy rash in a dermatomal pattern accompanied by fever and neuropathic pain

Answer 2

Shingles

Question 3

A child presents with extensive ulceration around the mouth, fever and pain

Answer 3

Primary gingivostomatotis

Question 4

A patient with eczema presents with monomorphic, punched out lesions accompanied by itch and fever

Answer 4

Eczema herpeticum

Question 5

Patient suddenly develops red papules on the back of the feet/hands, trunk and face in symmetrical distribution. Papules then evolve to plaques and then target lesions (dusky red centre, a paler area around this, and then a dark red ring round the edge).

Answer 5

Erythema Multiforme

Question 6

Small clusters of waxy-looking, round papules appear in the armpit, behind the knees and the groin

Answer 6

Molluscum Contagiosum

Question 7

Child presents with sudden fever, sore throat, headache and loss of appetite. Within 2 days, grayish lumps form in the mouth and develop into vesicles, then ulcers which last 1-7 days.

Answer 7

Herpangina

Question 8

A child has nonspecific flu-like symptoms and, several days later, a“slapped-cheek” appearance and a symmetric, maculopapular rash on the arms, legs and trunk which lasts 5 to 10 days.

Answer 8

Erythema Infectiosum

Question 9

A firm, fleshy nodule appears on the hand of a farmer

Answer 9

Orf

Question 10

Patient presents with unilateral red, hot, swollen leg and systemic symptoms (eg fever, chills and rigors)

Answer 10

Cellulitis

Question 11

Child presents with itchy, honey-yellow crusting and blisters around the mouth

Answer 11

Impetigo

Question 12

Baby presents with fever, irritability and widespread redness of the skin. Within 24-48 hours fluid-filled blisters form. These rupture and result in blistering skin rash that resembles a burn

Answer 12

Staphylococcal scalded skin syndrome

Question 13

Patient presents with single, painless ulcer on genitles

Answer 13

Syphilis

Question 14

Patient presents with a red, ring-like rash and then a flu-like illness with low-grade fever, chills, fatigue and joint pain

Answer 14

Lyme disease

Question 15

Patient presents with what looks like cellulitis but they are in extreme pain

Answer 15

Necrotizing fasciitis

Question 16

Patient presents with an itchy, red, ring shaped rash with a healed centre

Answer 16

Tinea/ringworm

Question 17

Patient presents with rash and white scaly spots in the skin folds

Answer 17

Candida

Question 18

Eldery patient presents with itch affecting the trunk and limbs, and grey irregular tracks in the web spaces between the fingers, on the palms and wrists

Answer 18

Scabies

Question 19

Older patient presents with a slow growing, pearly nodule on the face with central depression and telangiectasia

Answer 19

BCC

Question 20

Older patient presents with a crusty lump on the face that has been growing bigger over the past few weeks and is painful

Answer 20

SCC

Question 21

Older patient presents with a scaly, red patch on the leg with an irregular border

Answer 21

Bowen’s disease

Question 22

Older patient presents with a rapidly growing brown lump on their face that has irregular boarders and bleeds

Answer 22

Melenoma

Question 23

Parents bring their teenager in, who has epilepsy and behavioural problems. They believe the teenager may also be developing acne, but you recognise it as facial angiofibromas. You also find that the child has ash leaf macules on their skin, enamal pitting in their teeth and longitdinal ridging in the nails

Answer 23

Tuberous Sclerosis

Question 24

Patient presents with fragile skin and digit fusion

Answer 24

Epidermolysis bullosa

Question 25

Patient presents with café au lait macules, axillary/inguinal freckling and neurofibromas

Answer 25

NF1

Question 26

A patient has a genetic 2000-fold risk of skin cancer before age 20

Answer 26

Xeroderma pigmentosum

Question 27

Patient presents with well-delineated red, scaly plaques on their elbows, knees, scalp and lower back. Auspitz sign is +ve. Their nails have pitting, onycholysis, dystrophy and subungal hyperkeratosis.

Answer 27

Psoriasis

Question 28

A patient presents with symmetrical psoriasis on the extensors (elbow, knee), scalp, sacrum, hands, feet, trunk, nails. The plaques are sharply demarcated, scaly and erythematous

Answer 28

Chronic plaque psoriasis (psoriasis vulgaris)

Question 29

Following a strep throat/URT infection, a patient presents with multiple small, salmon pink bumps on the trunk and limbs (looks like a shower of red, scaly teardrops that have fallen down on the body)

Answer 29

Guttate psoriasis

Question 30

A patient presents with psoriasis confined to the palms and soles of feet

Answer 30

Palmoplantar pustular psoriasis

Question 31

A patient presents with a patches of depigmented skin

Answer 31

Vitiligo

Question 32

A 40 year old woman presents with papules, pustules and erythema (but no comedones) on her nose, cheeks and forehead. She also reports facial flushing exacerbated by sudden change in temperature, alcohol & spicy food. On examination you note telangectasia and rhinophyma

Answer 32

Rosacea

Question 33

A middle aged patient presents with itchy, violaceous (pink/ purple) flat-topped shiny papules on the volar wrists/ forearms, shins and ankles. On examination you find nail ridges and wickham's striae in the mouth. The gums are also inflammed and peeling and there are white streaks, ulcers and diffuse redness in the mouth

Answer 33

Lichen planus

Question 34

An elderly patient presents with large tense bullae on the skin that began as itchy erythematous plaques and papules. When they burst they leave non-scarring errosions. Nikolsky sign is negative (a positive sign is when the top layers of the skin slip away from the lower layers when slightly rubbed)

Question 35

A middle aged patient presents with flaccid vesicles/bullae that rupture to leave raw areas. Nikolsky's sign is +ve. Both the skin and the mucosa is involved

Answer 35

Pemphigus vulgaris

Question 36

A patient presents with a blistering, itchy skin rash on knees, elbows, back and buttocks. DIF shows deposits of IgA in dermal papillae

Answer 36

Dermatitis herpetiformis

Question 37

A child presents with generalized dry skin in a flexural distribution

Answer 37

Eczema/atopic dermatitis

Question 38

A patient presents with scattered, roundish patches of eczema

Answer 38

Discoid eczema

Question 39

A patient presents with scaly dry skin on the face, scalp and centre of the chest

Answer 39

Seborrhoeic dermatitis

Question 40

A patient presents with hand/foot eczema characterised by vesicles or bullae

Answer 40

Pompholyx eczema

Question 41

A patient presents with localised area of chronic, lichenified eczema/dermatitis due to scratching/rubbing

Answer 41

Lichen simplex

Question 42

A patient presents with a sunburn like reaction on sun exposed areas

Answer 42

Photosensitive dermatitis

Question 43

An elderly patient presents with itchy red, blistered and crusted plaques on the lower legs. Their legs also have numerous varicose veins and are 'champagne bottle' shaped

Answer 43

Stasis dermatitis

Question 44

A patient presents with a leg ulcer that is relatively painless. On examination their legs are also swollen and have varicose veins and a 'champagne bottle' shape

Answer 44

Venous ulcer

Question 45

A patient presents with a painful leg ulcer. The pain is worse at night on and leg elevation. On examination the patient's legs are pale and cold with reduced pulses. The patient has a PMH of intermittent claudication

Answer 45

Arterial ulcer

Question 46

An insulin dependant diabetic presents with tender, yellowish-brown patches on the lower legs that have delevoped slowly

Answer 46

Necrobiosis lipoidica

Question 47

A patient with an autoimmune condition (rheumatoid, IBD etc) presents with a purple hued, very painful, rapidly enlarging ulcer

Answer 47

Pyoderma gangrenosum

Question 48

A young patient attends clinic for regular nosebleeds. On their skin you notice red dots on their fingertip pads, lips and the lining of their nose

Answer 48

Hereditary haemorrhagic telangiectasia