AKT – Dermatological presentations

Sophie Lambert, aged 32, presents with a 2-month history of an itchy, red rash on the flexor surfaces of her elbows and behind her knees. She reports a personal history of asthma and hay fever. The rash flares in dry weather and improves with moisturisers.

What is the MOST likely diagnosis?

Thomas McLean, aged 46, presents with a new dark lesion on his upper back noticed by his partner. It has grown over the last 6 months and occasionally bleeds. On examination, it is asymmetrical, 9 mm in diameter, with irregular borders and variable pigmentation.

What is the MOST appropriate next step?

Ava King, aged 26, presents with painful, pus-filled lesions in her axillae and groin. They have been recurrent for the past 2 years. She reports occasional scarring and foul-smelling discharge. She is a smoker and overweight.

What is the MOST likely diagnosis?

Jack O’Donnell, aged 69, presents with a rough scaly patch on his forehead that has not healed over 3 months. It feels gritty and occasionally stings in the sun. He works outdoors and has fair skin. On exam, there is a 1 cm erythematous, scaly plaque with no induration.

What is the MOST likely diagnosis?

Emily Fraser, aged 21, presents with a painful vesicular rash over her face. The rash began as tingling before becoming red and blistered. She is otherwise well.

What is the MOST appropriate treatment?

Isabel Nguyen, aged 17, presents with persistent acne affecting her face and upper back. She has numerous comedones, papules, and pustules. She has tried over-the-counter benzoyl peroxide with minimal improvement. She is not sexually active and prefers to avoid oral contraceptives.

What is the MOST appropriate next step in management?

Gavin Hill, aged 72, presents with a new lesion on his left cheek. It is a pearly nodule with visible surface telangiectasia and a rolled border. It has slowly grown over several months but is not painful. There is no bleeding.

What is the MOST likely diagnosis?

Laura Spencer, aged 35, presents with a well-demarcated red plaque with silvery scale on her elbow. She reports mild itch. She has a family history of a similar skin condition. Examination reveals several plaques on the scalp and knees.

What is the MOST likely diagnosis?

Peter Wallace, aged 28, presents with a pruritic rash between his toes. It is red, with maceration and scaling. He frequently wears damp runners while working in a warehouse.

What is the MOST appropriate management?

Ashleigh Young, aged 24, presents with sudden onset of target-shaped lesions on both hands and forearms. She had a recent episode of herpes labialis. The lesions are not itchy but look alarming to her.

What is the MOST likely diagnosis?

Olivia Sheridan, aged 42, presents with a butterfly-shaped rash across her cheeks and nose. She reports fatigue and joint pain. The rash worsens with sun exposure. There is no scaling or pustules.

What is the MOST likely diagnosis?

Ethan Williams, aged 5, is brought in with honey-coloured crusted lesions around his nose and mouth. He is otherwise well. No previous treatment has been given. A few children at his daycare have similar rashes.

What is the MOST appropriate treatment?

Daniela Russo, aged 33, presents with multiple dark, ‘stuck-on’ waxy lesions on her upper back and chest. They have increased in number over the last few years. She denies any bleeding or pain. Her father has similar lesions.

What is the MOST likely diagnosis?

Claire Matthews, aged 38, presents with flushing and persistent redness on her cheeks and nose. She also experiences a stinging sensation with skin products and has occasional papules. There are visible telangiectasias on her cheeks.

What is the MOST likely diagnosis?

Matthew Chan, aged 29, presents with intensely itchy vesicles on his fingers and palms. The rash is recurrent and often flares during stressful periods. Examination shows clear fluid-filled vesicles on the lateral aspects of his fingers.

What is the MOST likely diagnosis?

Harriet Bolton, aged 58, presents with a 2-month history of a non-healing ulcer on her lower leg. She has a history of chronic venous insufficiency and varicose veins. On examination, there is a shallow ulcer over the medial malleolus with surrounding hemosiderin staining and mild oedema.

What is the MOST likely diagnosis?

Alice White, aged 22, presents with grouped vesicles on an erythematous base on her labia. She describes a burning sensation and dysuria. This is her first episode. She has recently started a new sexual relationship.

What is the MOST likely diagnosis?

Noah Ferguson, aged 36, presents with annular scaly lesions with central clearing on his trunk. The rash is slowly expanding and mildly itchy. He has recently returned from a tropical holiday. No systemic symptoms are present.

What is the MOST appropriate management?

Sophie Tan, aged 6, is brought in with small, skin-coloured papules with central umbilication on her trunk and arms. She is otherwise well. The rash has slowly spread over several weeks. There is no itching or pain.

What is the MOST likely diagnosis?

William Browne, aged 41, presents with thickened, yellow toenails on both feet. He has no pain, but is concerned about the cosmetic appearance. There is scaling between the toes and he wears work boots all day.

What is the MOST appropriate next step?

Ruby Jensen, aged 45, presents with intense itch and excoriated papules on her wrists, web spaces, waistline, and groin. Her partner and 3-year-old child also have similar symptoms. The itch is worse at night.

What is the MOST likely diagnosis?

Tyler Nguyen, aged 30, presents with sudden widespread urticarial wheals after eating prawns. He is mildly short of breath but has no tongue swelling or hypotension. He has no prior allergy history.

What is the MOST appropriate immediate management?

Sandra Black, aged 62, presents with a solitary, firm, dome-shaped nodule with central keratin plug on her forearm. It appeared rapidly over the last 2 weeks and is mildly tender. She has extensive sun exposure history.

What is the MOST likely diagnosis?

Leah Watson, aged 8, presents with a red, itchy scalp and visible white nits attached to hair shafts. Several children at school have similar complaints. There is no fever or lymphadenopathy.

What is the MOST appropriate treatment?

David Holt, aged 50, presents with a 3-week history of painful erosions on his oral mucosa and flaccid bullae on his trunk. The bullae rupture easily, leaving erosions. Nikolsky sign is positive. He takes no new medications.

What is the MOST likely diagnosis?

Annabelle Rowe, aged 11, is brought in with a rash that started on her trunk and spread to the limbs. She has a herald patch on her chest and a fine scaly rash following the lines of her ribs. She is otherwise well.

What is the MOST likely diagnosis?

Jacob Franks, aged 65, presents with a non-healing, ulcerated lesion on his lower lip. It has grown slowly and bleeds occasionally. He has significant sun exposure history. On examination, the lesion is indurated with an irregular border.

What is the MOST likely diagnosis?

Ella Kumar, aged 4, presents with well-demarcated red, scaly plaques with thick scale on her scalp. Her mother reports mild hair thinning in the area. A Wood’s lamp shows green fluorescence.

What is the MOST likely diagnosis?

Lucas Everett, aged 34, presents with painful nodules and ulcers on his lower legs. The lesions began as small pustules and rapidly ulcerated. He has a history of ulcerative colitis. Examination shows deep ulcers with violaceous borders.

What is the MOST likely diagnosis?

Zara Bishop, aged 29, presents with an itchy, weepy rash under both breasts. She reports increased sweating due to recent warm weather. On examination, there is macerated erythema in the inframammary folds with some satellite lesions.

What is the MOST likely diagnosis?

Isobel Hunter, aged 36, presents with a sudden rash on her face and upper chest after starting a new blood pressure medication. She describes a burning sensation and photosensitivity. Examination reveals erythema in a photodistribution without vesicles.

What is the MOST likely diagnosis?

Hamza Ali, aged 43, presents with thick silvery plaques on the scalp and behind the ears. He has similar lesions on his elbows. The lesions are itchy but not painful. His father has a similar condition.

What is the MOST likely diagnosis?

Matthew Li, aged 22, presents with a painful red lesion on his upper back that has increased in size over 3 days. On examination, there is a fluctuant, erythematous nodule with central pointing. He has no fever.

What is the MOST appropriate initial management?

Jasmine Clarke, aged 10, presents with a widespread itchy rash. She recently had antibiotics for a chest infection. Examination reveals a symmetrical, erythematous, maculopapular rash across her trunk and limbs. There is no mucosal involvement.

What is the MOST likely diagnosis?

Naomi Bishop, aged 48, presents with yellowish papules on both eyelids. She has no itch or discomfort. Medical history includes hypertension and hyperlipidaemia. The lesions have slowly increased over 6 months.

What is the MOST likely diagnosis?

Frederick Cole, aged 60, presents with multiple rough, scaly patches on his bald scalp. They are poorly defined, pink, and feel like sandpaper. He has a history of outdoor work and no systemic symptoms.

What is the MOST likely diagnosis?

Chloe Nguyen, aged 31, presents with a red, scaly rash around her mouth. The rash spares the area immediately around the lips. She has been using topical corticosteroids for a few weeks with no improvement.

What is the MOST likely diagnosis?

Declan Smith, aged 26, presents with hyperpigmented velvety plaques in both axillae. He is obese and has a family history of diabetes. The skin changes have developed gradually over the last year.

What is the MOST likely diagnosis?

Lily Baxter, aged 3, presents with small red spots on her face that developed after vomiting from a viral illness. The rash is non-blanching and limited to the periorbital area. She is afebrile and well.

What is the MOST likely diagnosis?

Alexander O’Connor, aged 48, presents with a solitary red nodule on his upper arm. It bleeds easily when touched. The lesion developed over a few weeks and is dome-shaped, red, and friable.

What is the MOST likely diagnosis?

Emily Dunne, aged 29, presents with well-demarcated hypopigmented patches on her upper back and shoulders. The patches are mildly scaly and more noticeable after sun exposure. She is otherwise well and has no itch.

What is the MOST likely diagnosis?

Luke Fitzgerald, aged 52, presents with a persistent sore on his scalp that bleeds and forms a crust. He has a history of significant sun exposure. On examination, there is a non-healing lesion with an indurated base and crusting.

What is the MOST likely diagnosis?

Alicia Thomas, aged 24, presents with linear red streaks on her forearms and torso after hiking through bushland. The rash is intensely itchy and developed within hours of exposure. There are no systemic symptoms.

What is the MOST likely diagnosis?

Daniel Brooks, aged 39, presents with white, lacy lesions on the inside of his cheeks. He is asymptomatic but worried it could be cancer. There are no ulcers or bleeding. He has a history of psoriasis.

What is the MOST likely diagnosis?

Toby Shaw, aged 7, presents with a single annular lesion on his forearm that is red, scaly, and has a central clearing. It has slowly enlarged over a week. He recently got a new pet kitten.

What is the MOST likely diagnosis?

Natasha Peters, aged 19, presents with a widespread maculopapular rash and oral mucosal ulcers. She recently started taking trimethoprim for a UTI. She is febrile and unwell. Examination reveals dusky erythematous patches, blisters, and mucosal involvement.

What is the MOST likely diagnosis?

Oliver Bennett, aged 45, presents with itchy, violaceous, flat-topped papules on his wrists and forearms. He has white lacy patterns on his buccal mucosa. He is not on any regular medications.

What is the MOST likely diagnosis?

Clara Finch, aged 6 months, presents with a weepy, red rash on both cheeks. Her mother reports it flares with wool clothing and dry weather. She has a family history of asthma and hay fever.

What is the MOST likely diagnosis?

Mark O’Leary, aged 61, presents with a solitary black lesion on his upper back. It is asymmetric, 11 mm in diameter, with irregular borders and colour variation. It has changed significantly in the last year.

What is the MOST likely diagnosis?

Sophia Green, aged 28, presents with grouped vesicles on an erythematous base on her right lateral finger. The lesion is painful and has recurred in the same location several times over the past year.

What is the MOST likely diagnosis?