dermatology

‫هالة‬.‫د‬
Part2

Case:20 years old male patient presented with

asymptomatic lesion in his face for 1 year
Description: in face and upper neck (site) multiple
scattered(distribution) papules, pustules, white and
black comedones (pathognomonic)in addition to
scars with oily skin

Definitive diagnosis: acne vulgaris

Note: sometimes even if it looks acne but we can’t
Said Its acne ex: in old age or in infants so we should
focus in history.
Simple exposure for neck, shoulder, chest and upper
back (seboric area)
Case:16 years old male patient come with this
asymptomatic lesion in his face
Description: in face(checks and forehead) multiple
scattered papules, pustules, white and black
comedons in addition to cystic lesion and there is
hemorrhagic clusters
Definitive diagnosis: severe nodulo-cystic acne
vulgaris (due cystic lesion, severe inflammation,
abscess and more complicated(scars) so need
aggressive treatment
Treatment:
Topical and systemic antibiotic
Topical and systemic retinoid
Hormonal therapy (anti androgens)

Note: D.D of polymorphic lesion are acne and

chicken pox
Severity of acne depends on type and number of
lesions
Definitive diagnosis: severe nodulo-cystic acne
vulgaris

Description: in face multiple scattered papules,

pustules, white and black comedones in addition to
abscess and sinus with scars

We can’t say there’s plaques because it not solid but

its soft full with fluid or pus and shining

Case:40 years old male presented with this

asymptomatic lesion for last 3 years with positive
family history triggered by stress
Describe this lesion?
Description: in extensor surface of forearm and
elbow well demarcated erythematous plaque
covered by thick white silvery scales with multiple
erythematous papules covered by scales

Characteristic feature: Auzpitz sign (by blunt object)

(pathognomonic of psoriasis)
Note: if he was taking drug, we said psoriasiform
drug eruption

Classical psoriasis
Description: multiple well defined erythematous
plaques and papules covered by thick slivery white
scales in the back and buttock

Definitive diagnosis: Classical psoriasis

Description: multiple well defined erythematous

small scattered papules covered by thick slivery
white scales in the buttock
Definitive diagnosis: guttate psoriasis (rain drops)

Triggered factors: URTI(Streptococcus tonsillitis)

Description: well defined erythematous plaque
covered by thick slivery white scales
Cross the hair line (defernite it from seborric
dermatitis which not cross the hair line, less
erythematous, less defined border, greasy yellow
scales)
Definitive diagnosis: scalp psoriasis
Definitive diagnosis: seborric dermatitis
less erythematous, less defined border, greasy
yellow thin scales than psoriasis

Seborric area(scalp, forehead ,eyebrow ,eyelashes

,nasolabial folds, submental, chest ,axilla,groin)

psoriasis
Characteristic features (cardinal features):
1-nail pitting
2-longtudinal striation
3-subangular hyperkeratosis

Every patient should exam his hair, nail,

mucocutaneous to make definitive diagnosis

Psoriatic arthropathy (joint deformity)

Systemic treatment methotrexate to treat psoriasis
and joint