Quiz
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 5

The patient is a man of 68 who has had this pustular eruption on both feet for twenty-four years.

What is the diagnosis?

Palmoplantar pustulosis, often called "localized pustular psoriasis&quot

It is associated with what addictive habit?

Smoking. This skin disorder is rare in non-smokers. The reason for this is unknown, but probably relates to the effect of nicotine on neutrophils.

What other sites may be affected?

The palms are frequently affected as well or instead, with dry or fissured erythematous plaques, studded with tender pustules. Some patients have chronic plaque psoriasis affecting other sites.

What treatments are available?

Palmoplantar pustulosis is relatively resistant to all forms of treatment. Topical therapy that may help includes intermittent courses of clobetasol proprionate ointment, ointments containing crude coal tar, calcipotriol ointment, and simple emollients. Oral therapy, on the advice of a dermatologist, may include tetracycline antibiotics, photochemotherapy (PUVA), acitretin, colchicine, dapsone or methotrexate.

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Quiz Mixed diagnoses – 10 cases (9 of 11)

Case 5

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Quiz
Mixed diagnoses – 10 cases (9 of 11)