Mixed diagnoses – 10 cases (5 of 11)

For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.

Each case should take approximately five minutes to complete. There is a list of suggested further reading material at the end of the quiz.

When you finish the quiz, you can download a certificate.

Case 1

A 68-year-old retired farmer presents with a non-healing lesion on the right temple.

The lesion is a 'rodent ulcer' i.e. an ulcerated nodular basal cell carcinoma.

The lesion should be fully excised by an experienced skin surgeon with a margin of several millimetres. Although primary closure may be possible in this patient, reconstruction may require a flap or skin graft.

The patient's skin should be fully examined, as there is a high chance he will have more than one significant skin lesion. He may have other basal cell carcinomas, solar keratoses, squamous cell carcinomas or perhaps a melanoma. The patient should be advised regarding sun protection, self skin examination and the need to return to his medical practitioner should he develop any further skin lumps or sores.

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