Scales and Nails
I know, I know, there has been a rash (pun intended) of articles regarding, well, er….rashes, this week.
For example, SBSD featured a guy with exfoliative lesions all over his body. And Exam Bloopers 11 also featured a patient who has joint deformities, some kind of rash and nail changes.
Yesterday I was fortunate enough to have my Canon camera ready when I briefly sat in with this patient during the Long OSCE exam. He has chronic liver disease but what interested me more were these findings as shown below:
A lesion on his shin.
And his knees.
Check out his nails!!!
Let me say that the SBSD and Exam Bloopers 11 entries are related to this one. So, can anyone give me a final diagnosis?
Fri, 240807 @ 0730; am so anxious…will there be borderline exam today or not?
PS: This blog was hit 1685 times over the last 24 hours. Fui-yoh!!!! Do you think it’s time to place ads and hand in my resignation letter?
No la, just a lowly Ixus 40
Hmm EOS 400D?
Wow! I’ve got internet after all! Anyway, since I am connected, might as well settle the issue of diagnosis of the 3 articles.
For SBSD and Exam Bloopers 11’s answers, please refer to the articles.
The diagnosis for this one is Plaque Psoriasis and the nail changes are onycholysis and pitting. Remember this for life ya, because a lot of students said things like koilonychia, onychomycosis, lumpy nails, spoon shaped nails and even clubbing! Some said things like Beau’s lines or Mee’s lines.
So take a good look and imprint it into your mind. It won’t be the last time u see this.
The finger nail pictures in Exam Bloopers 11 also showed the same thing but it wasn’t clear as I didn’t have my Canon camera with me then.
Tell u all the answers when I get back from an ID workshop over the weekend. The darn hotel I stay in has NO internet. I am having withdrawal symptoms already.
plague psoriasis+nail psoriasis+psoriatic arthritis….shiu, they are all grouped under psoriasis la..aih…
Psoriasis with nail dystrophy?
No really sure about the answer because the previous 2 I answered Plague Psoriasis and Psoriasis Athropathy.
This one is very suggestive of plaque psoriasis.
Wala, an epidemic of psoriasis attack…
don resign la, consider blogging as part time job, worth it!.. haha…
Jonzz reminded me that if I resign, I will have no blog fodder to write about. I mean, I can only write about sun rise and sun set if I become a beach bum right? Sigh…. No win situation.
Classic pics Jimbo. Yalah can resign and provide online CME!
I regret not having taken any pics all those years back when I was in the Skin Clinic (of course that was way before digital cameras were invented!)
I still remember diagnosing a classic case of Borderline Hansen’s with “inverted saucer” lesions in a teenager. I don’t think you see such cases nowadays (thankfully I might add)
Sorry, i mean SBSD, not exam bloopers 11
argh..*depressed* For exam blooper 11’s, i would say it is erythrodermic psoriasis.. but for this patient it’s Plaque psoriasis with arthropathy and nail involvement yay? kekekeke.. lucky i didn’t get jimbo for my exit viva =P
wah, tambah gula, tambah garam.
Whops typo typo. PLAQUE psoriasis i meant.. Hmmm.. can I say generalized plaque psoriasis with arthropathy?? hahaha
You do mean plaque and not plague right, ctps? Almost there
Plague psoriasis with arthropathy ahem ahem