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Dermatology Quiz

Progressive facial slate-grey pigmentation

Fig 1. Slate-grey pigmentation
Figure 1. Slate-grey pigmentation on the patient’s forehead.

A 68-year-old man presented with asymptomatic progressive pigmentation, confined to the sun-exposed sites of his face and hands. Details of his drug history plus a skin biopsy with UV light microscopy revealed the diagnosis.

Itchy coin-shaped lesions

Fig 1. Crusted lesions
Figure 1. Crusted coin-shaped lesions with small peripheral vesicles on the patient’s limb.

A 43-year-old man presented with pruritic, round, crusted lesions on his limbs. The size of the lesions varied, and there was a vesicular border.

Intermittently itchy reddish-brown spots

Fig 1. Red-brown lesions
Figure 1. Reddish-brown lesions on the patient’s back and upper limbs.

A 32-year-old man presents with persistent and numerous reddish-brown spots on his limbs and trunk. The lesions are stable, but occasionally there is an urticarial reaction when they are rubbed. A skin biopsy confirmed the diagnosis.

A pearly nodule on the back

Fig 1. Pearly nodule
Figure 1. A pearly nodule on the patient’s upper back.

A 38-year-old man presents with a smooth, shiny and well demarcated pearly nodule on his upper back. The nodule is asymptomatic and of unknown duration.

Recurrent dusky skin lesions

Fig 1. Erythematous lesion
Figure 1. An erythematous lesion with dusky centre located on the patient’s trunk.

A 35-year-old woman presents with erythematous lesions on her upper limbs and trunk shortly after taking antibiotics for a urinary tract infection.

Progressive pigmented purpura

Fig 1. Pigmented patches
Figure 1. Irregular pigmented patches with purpura on the pretibial areas.

A 42-year-old woman presents with progressive yellow–brown pigmentation associated with nonpalpable purpura over her shins.

An acute pustulovesicular eruption

Fig 1. Pustular lesions
Figure 1. Arciform pustulovesicular lesions on the upper arm.

A middle-aged woman presents with a recent history of tender annular and bow-shaped pustular lesions on her face, neck, and upper limbs.

Scarring alopecia with tufted folliculitis

Fig 1. Scarring alopecia
Figure 1. An irregular area of scarring alopecia on the vertex of the scalp.

A 34-year-old woman presents with an 18-month history of progressive hair loss, associated with tenderness, on her scalp. Tufted follicles and scarring alopecia were the key to diagnosis.

Skin necrosis with vascular calcification

Fig 1. Skin necrosis
Figure 1. Irregular areas of skin necrosis with dark eschar over the lower leg.

A 59-year-old woman with chronic renal failure presents with a recent history of multiple progressive, painful ulcers over the lower limbs.

Itchy papules on the trunk and limbs

Fig 1. Itchy papules
Figure 1. Multiple pale pink papules at different stages. Note the hyperpigmented areolae, increased skin markings (lichenification), and focal dark crust.

A 47-year-old woman developed persistent itchy papules on the trunk and limbs over a two-year period.

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