Check Study Program

#Rosacea

#Rosacea

Malcolm, aged 59 years, is concerned about his red face and attends your clinic with his wife. Malcolm is a cattle farmer and though active and relatively fit, he is concerned he may be experiencing blood pressure issues (his father had a touch). His main reason for this self-diagnosis is his continuously flushed and red face. He does not drink. He explains that his face seems to fare better in the winter, when he experiences less irritation. He offers that he is not fond of wind as he finds it causes his skin to pain. He notes that attempts to use his wife’s face creams only seem to make his skin more painful and that sunscreen is the worst. He stopped applying sunscreen a number of years back and has not washed his facial skin with any soap or other cleanser due to the discomfort it causes. Shaving has become a painful daily chore. Of late his face feels red and irritated all the time. 1.On initial presentation, Malcolm gives an articulate description of his skin sensations. What particular part of his history and presentation would concern you the most? 2.Why is it important to ask about natural therapies and occupational exposure to chemicals (such as sheep drench)? 3.What other pathologies would concern you, given Malcolm’s presentation? 4.What occurs with the application of topical steroids to the facial skin? 5.Acne and rosacea both involve an inflammatory component in the disease process. Can they occur together? 6.Is photodynamic therapy a treatment option for rosacea? 7.Is Mohs surgery appropriate for lentigo maligna melanoma? 8.Could rosacea be considered an immune response? #Week20_Case2

#Melasma_Prognosis

#Melasma_Tx

#Melasma_DDX

#Melasma_Malar

#Melasma_Patterns

#Melasma_Examination

#Melasma

#Week20_Case1

Kim, aged 40 years, is of Southeast Asian origin and presents with dark brown patches on her face of more than six months’ duration without pruritus (Figure 1). Kim is a mother of three, whose youngest child is aged five years. She is a non-smoker and does not drink alcohol. On examination, Kim is systemically well. Slightly darkish-brown hyper- pigmented macules and patches are evident on her face, involving the bilateral cheeks, forehead with glabella, mandible and chin. 1.What further history would be helpful in determining the aetiology of Kim’s facial hyperpigmentation and what specifically would you look for on examination? 2.What conditions would you include in your differential diagnosis, and what is the most likely diagnosis based on Kim’s clinical information? 3.What is melasma and what is its epidemiology? 4.What investigations would you consider for Kim? 5.What is the aetiopathogenesis of melasma? 6.What treatment options can you offer Kim? 7.What are the complications and prognosis/course of melasma? #Week20_Case1