Mixed diagnoses – 10 cases (9 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

This teenager is embarrassed by her rough red cheeks. Moisturizers and anti-acne preparations have not helped.

This is facial keratosis pilaris, which is given various names depending on the appearance and subsequent atrophy. These include keratosis pilaris atrophicans faciei, ulerythema oophyrogenes (when eyebrows are affected), and atrophoderma vermiculata (when honeycomb scarring arises).

The upper arms and thighs are the most common sites to be affected by keratosis pilaris. Horny keratinous plugs surround vellous hairs in these areas. There may be surrounding erythema.

There appears to be no very successful treatment. Various keratolytic regimes have been recommended but are generally disappointing. Topical tretinoin or oral isotretinoin are occasionally helpful but may also aggravate keratosis pilaris.

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