Case 1 Resistant verruca

After treating this painful verruca for six months with a topical solution containing salicylic acid this lady attended the surgery to see if you would be able to offer cryotherapy as an alternative treatment.

A Why has the treatment not worked?

B What clues are present on examining the lesion?

Case 2 Lichen planus

The violaceous papules on this man’s wrist are diagnostic of lichen planus. They had been present for a number of weeks and were itchy at times. There was no relevant past medical history and he had no family history of skin conditions.

A Apart from his limbs and trunk where else might lichen planus occur?

B In this case how long is the condition likely to take to resolve?

Case 3 Persistent eczema

When this lady developed eczema around her mouth she decided to treat it herself with her husband’s eczema creams. At the time of presentation she had used increasingly more potent creams but the rash had not responded.

A What is the name of this condition?

B How should it be managed?

Case 4 Nail problem

This man presented with an abnormal looking thumb nail, which had looked like this for the past 12 months. All his other nails were normal and he had no history of any other skin diseases. He said that a friend had recently been diagnosed with a fungal nail infection which had affected all his toe nails and he was now concerned that this might be the cause in his case.

A What is this condition called?

B What is the treatment of choice?

Case 5 Bowen’s disease

This lady had had a small crusted lesion on her lower leg for around six months. It did not itch and there had been little increase in size since she had first noticed it. Thinking it might be eczema she had applied a topical steroid which she had purchased herself but this had made little difference. A biopsy was taken which confirmed the diagnosis as Bowen’s disease.

A Name three types of treatment that can be used for this condition?

B If left untreated what percentage will progress to become an invasive squamous cell carcinoma?

Case 6 Bizarre looking rash

After paddling in the sea among seaweed this girl felt an intense burning sensation in her ankle after which she developed this bizarre looking rash.

A What is the likely cause of her symptoms?

B How should she be treated?