Case 1 Tonsillar hole

This young lady was rather alarmed on looking at her throat to see a large hole in the middle of her tonsil. She had not noticed this before and was otherwise well.

A What is the diagnosis?

B What symptoms can be associated with this condition?

Case 2 Crusted rash

This young girl developed a rash on her upper arm over the course of a few days. Initially there was a single central lesion, but this was followed by the development of new smaller lesions. A schoolfriend had had a similar rash a few days earlier.

A What is the diagnosis?

B What are the likely causative organisms?

Case 3 Lumpy thumb

A long history of tophaceous gout had led to the development of numerous gouty tophi on this man's fingers. The lesions were painless and were not causing any symptoms but the patient's daughter had become worried that the skin overlying some of them had broken down.

A What drugs can be associated with the development of gout?

B In gout, the formation of crystals in the joints leads to pain. What are these crystals made of?

Case 4 Speckled mole

During a routine examination an odd looking mole was noted on this lady's torso. She remembered it being present from her childhood days and had not noticed any recent changes. She had a strong family history of skin cancer with a first-degree relative having had a melanoma.

A What is the name of this type of lesion?

B How should it be managed?

Case 5 Growing umbilicus

At a routine six-week check a swelling on this baby's umbilicus was noticed. The swelling had a shiny surface and had bled once or twice. The mother was not concerned by it and the baby seemed otherwise well.

A What is the diagnosis?

B How can this condition be treated?

Case 6 White patch

Over a couple of years this lady had developed a large white area on the left side of her body. It was asymptomatic and the rest of her body was normal. She assumed it had occurred as the result of sunburn many years before.

A What is the diagnosis?

B Name two possible differential diagnoses.