CPD SPOT DIAGNOSIS ,

Self-Recorded CPD: Spot Dx – Dermatology – DER009

You can self-report this CPD/PDP activity by logging it online with the RACGP/ACRRM. The activity has been allocated 1 hour (0.5 hour EA and 0.5 hour RP). Certificates are not available for this CPD.

Test your clinical knowledge by taking the 6 quizzes below. If you select the wrong answer, have another go — you can try as many times as you like.

RACGP Activity Number: DER009

ACRRM Activity Number: DER009

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1. What are these erythematous patches on her fingers and toes?

What is the most likely diagnosis?

<section data-block="SingleChoice"> <h3>What is the most likely diagnosis?</h3> <p><p><span style=”font-size: 14px”>Minnie, aged six, attends with tender, erythematous, shiny patches affecting her finger and toe pads, as well as her heels, that have been present for five days. Minnie is otherwise well, with no past history of note. She has been eating and drinking as usual and has continued to happily play with her neighbours in their backyard pool for 1-2 hours a day, as she has done most days since the start of the school holidays, 10 days ago. She has had no known sick or COVID-19 contacts and has not recently been in any hotspots. On examination, she appears well, is afebrile and has no clinical findings of note apart from the palm and sole lesions (pictured).</span></p></p> <ul> <li>a. Hand, foot and mouth disease</li> <li>b. Kawasaki disease</li> <li>c. COVID-19</li> <li>d. Frictional dermatitis</li> </ul> </section> <p></p>Photo: BMJ 2015

Author

Author: Dr Kate Kelso is a GP and medical editor at Australian Doctor.

2. Is this a garden-variety rash?

What is the most likely diagnosis?

<section data-block="SingleChoice"> <h3>What is the most likely diagnosis?</h3> <p><p><span style=”font-size: 14px”>Sven is a 53-year-old carpenter who presents with two days of uncomfortable rash on his torso and arms. The rash is irregularly distributed and consists of oddly shaped erythematous patches, linear areas and some blistering. Self-treatment with an oral antihistamine has not helped. Sven spent the previous weekend getting his property ready for Christmas, including mowing, weeding and pruning large overhanging lillypilly and fig trees. He didn’t wear a shirt or sunscreen because it was warm and he wanted to even up his “tradie tan”. The rash developed the following day. Sven has no significant medical history. He is systemically well, with no clinical findings of note apart from the rash (pictured).</span></p></p> <ul> <li>a. Shingles</li> <li>b. Solar urticaria</li> <li>c. Phytophotodermatitis</li> <li>d. Bullous impetigo</li> </ul> </section> <p></p>Photo: BMJ 2020; 368:l6969

Author

Author: Dr Kate Kelso is a GP and medical editor at Australian Doctor.

3. Could this rash be caused by COVID-19?

What is the most likely diagnosis?

Author

Author: Dr Kate Kelso is a GP and medical editor at Australian Doctor.

4. What’s causing this patchy face?

What is the most likely diagnosis?

Author

Author: Professor Dédée Murrell is head of dermatology, St George Hospital; professor, faculty of medicine, University of NSW; and honorary professorial fellow, The George Institute for Global Health, Sydney.

5. What’s causing this everlasting rash?

What is the most likely diagnosis?

<section data-block="SingleChoice"> <h3>What is the most likely diagnosis?</h3> <p><p><span style=”font-size: 14px”>A 34-year-old woman presents with a 15-year history of a widespread hyperpigmented macular rash with a reticular network, associated with left-sided cervical lymphadenopathy. She also reports developing wheals over the lesions when she rubs her skin. She is otherwise well, with no past history of note. She takes no regular medications and uses low-irritant shower and laundry products. On examination, she is afebrile and appears well apart from the rash, pictured.</span></p></p> <ul> <li>a. Allergic contact dermatitis</li> <li>b. Adult blaschkitis</li> <li>c. Shingles</li> <li>d. Linear cutaneous lupus</li> </ul> </section> <p></p>

Author

6. Is this a benign or malignant lesion?

What is the most likely diagnosis?

<section data-block="SingleChoice"> <h3>What is the most likely diagnosis?</h3> <p><p><span style=”font-size: 14px”>Kurt, a 52-year-old lawyer, presents with a growth on the back of his left ear. He is extremely worried as his brother has recently been diagnosed with a squamous cell carcinoma, and they have both been keen surfers since childhood. The lesion was first noted six months ago and has enlarged since then. It is becoming increasingly painful, is non-pruritic and has not bled. He was diagnosed with myopia at the age of seven and has worn glasses since then but otherwise remains well and medication free. He attends regular optician checkups and has not needed to change his glasses in years.</span></p></p> <ul> <li>a. Basal cell carcinoma.</li> <li>b. Acanthoma fissuratum.</li> <li>c. Pyogenic granuloma.</li> <li>d. Squamous cell carcinoma.</li> </ul> </section> <p></p>Photo: Dermnet NZ

Author

Author: Dr Paul Muthiah is a GP and a former medical co-editor of Australian Doctor.

References on request from kate.kelso@adg.com.au