SKIN LECTURE PART TWO

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SKIN LECTUREPART TWO

• DR ANDREW HERD
• GPWSI DERMATOLOGY
• COVENTRY PCT

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MELANOMA CLASSIFICATION

• Or
• A to E
• Rule

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ASYMMETRY
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BORDER
5
COLOURMore than 2
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Diametergt6mm
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Elevation/ Evolution

• Change to lesion in weeks/months
• Itch
• Bleed
• Growth

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Innocent?

• Both are melanomas
• Top is melanoma
• Bottom is melanoma

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Everyday skin problemsseen as Doctor
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WartsWhat is the correct common treatment?

• Freezing
• Painting on agent
• Go to BQ for help
• None
• Nail varnish
• Find a frog/toad

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Neck problemWhat do you do?

• Love bite will heal
• Avoid wearing scarves
• Dont bother me with this, it will go itself
• Fungal infection needing topical Rx

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Happy boy!What should we do?

• Report parent for abuse?
• Give antibiotic?
• Reassure mum it will settle by itself?

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Fifth Disease

• Viral infection also known as
• SLAP FACE DISEASE
• Will settle with no antibiotic cover.

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Unhappy boy!What to tell parents?

• It will settle by itself?
• Tell son to stop picking nose?
• Give treatment and advice

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IMPETIGO

• Bacterial infection
• Very infectious can be spread by touch
• Needs topical and or oral antibiotic depending on
  severity
• Parents given hygiene advise

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Nail Problems

• Both nails need no treatment?
• Both nails need treatment?
• Only right nail needs treatment
• Only left nail needs treatment

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Nail results

• Top nail has a fungal infection( need nail
  scrapping/clippings)
• Bottom nail is due to biting nails since nine
  years old!!

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LumpsUsing Classification

• This needs urgent referral for removal?
• This can be left alone?
• This can be removed by a GP?

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Not melanoma

• Pigmented Seborrhoeic wart/ keratosis
• Gives impression of being stuck on skin
• ( Like a barnacle on a boat)
• Mostly found on elderly

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What to do??
This lump has taken years to develop and scabs
then reappears as thisgtgtgtgtgtgtgtgtgtgtgt

• Reassure no treatment needed?
• Refer for removal for cosmetic reasons?
• Refer urgently for removal

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Basal cell carcinoma

• Most common of all skin cancers
• Mostly due to UVR exposure.
• Local spread only but can become worse if left
  alone
• Needs removal by secondary care/GPWSI.

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THANK YOU FOR NOT SLEEPING IN THE LAST 3 HOURS

• Doctor R Allan Doctor
  A M Herd
• WISH YOU ALL THE BEST IN YOUR FUTURE STUDIES!!