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Common skin conditions
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For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately five minutes to complete. There is a list of suggested further reading material at the end of the quiz.
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What is the diagnosis?
He has rosacea and rhinophyma. Note crusted inflammatory papules and pustules, prominent follicular orifices and irregular sebaceous hyperplasia.
What medical treatment would you advise?
The inflammatory component can usually be controlled with an oral tetracycline antibiotic such as doxycycline 50-100mg daily for 6 to 12 weeks. Advise the patient to take the antibiotic with a full glass of water after a meal and to protect against sun exposure.
Topical treatment using metronidazole or azelaic acid is helpful long term.
Patients rarely report benefit from the usual advice to avoid dietary and environmental triggers of flushing such as hot drinks, spicy foods, alcohol and temperature changes.
What surgical treatment is available?
Once the inflammatory component has been controlled, the patient may wish to consider cosmetic reshaping of the nose by mechanical dermabrasion, electrosurgery, laser resurfacing or surgical shave.
Vascular lasers are very effective at reducing residual telangiectasia.