Saturday, October 18, 2008

Test Cases

These cases will be analysed using the nemonics previously learned.




This is obviously a red scaly lesion. Note there are two other smaller lesions near it.
The PMs PET nemonic applies. Is it psoriasis, eczema or tinea?
Treated psoriasis can heal in the middle leaving a scaly outer edge. It is not broken on the surface for eczema. It has a peripheral scale for tinea so it could be a fungal infection.
Now what about the PM bit. Pityriasis rosea possible if this was the big herald patch early lesion. Pit rosea often has a trailing scale that points inward. Pit versicolor is less likely with the central clearing.
On balance this could be a tinea( ringworm) infection or the herald patch of pityriasis rosea. The history would help but you should do some scrapings of the lesion's scaly edge for fungal microscopy and culture. Examination of this patient elsewhere showed the typical oval lesions following the lines of the ribs seen in pityriasis rosea. What we have been examining is the herald patch. View DermNet for more information on Pit rosea.