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skin lesion

Practice targeted AMC-style multiple-choice questions on skin lesion.

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dermatology middle-aged man biopsy elderly patient oncology skin biopsy breast cancer general practice geriatrics rash

Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 45-year-old male presents to his GP with a lesion on his nose that has been slowly enlarging over the past six months. He reports no pain, itching, or bleeding. He has no significant past medical history and takes no regular medications. On examination, vital signs are stable. The image shows the appearance of the lesion. Given the clinical presentation and morphology, what is the most appropriate initial step in management?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 35-year-old male presents to his general practitioner complaining of a persistent, asymptomatic lesion on his nose that has been present for approximately 6 months. He denies any trauma to the area. He reports no other skin issues or systemic symptoms. Physical examination reveals the lesion shown. The patient is concerned about cosmetic appearance and potential for malignancy. What is the MOST appropriate initial management step?

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A 45-year-old woman presents with a 3-month history of an intensely itchy rash on her wrists and ankles. On examination, you note violaceous, flat-topped papules. What is the most likely diagnosis?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 35-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or recent illness. Examination reveals the image shown. What is the most appropriate initial management?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 68-year-old woman presents with a persistent, pruritic rash on her chest wall at the site of a previous mastectomy performed 8 years ago for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation. Examination reveals the area shown. What is the MOST appropriate next step in management?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 40-year-old man presents with a painless, slowly growing lesion on his nose for the past 8 months. He denies any trauma or previous skin conditions. Examination reveals the pictured lesion. What is the MOST appropriate next step in management?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 72-year-old woman presents with a 6-month history of a non-healing rash on her chest wall at the site of a previous mastectomy performed 10 years prior for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation. Examination reveals the findings shown. What is the MOST appropriate next step in management?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 70-year-old woman, post-mastectomy, presents with a chronic, pruritic lesion. What is the MOST likely underlying pathophysiology?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 68-year-old woman presents with a persistent rash on her chest wall at the site of a previous mastectomy performed 8 years ago. She denies pain or itching. What is the MOST appropriate next step in management?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 65-year-old woman presents with a chronic, non-healing lesion at the site of her mastectomy scar, performed 7 years ago. She denies pain but reports occasional itching. What is the MOST appropriate next investigation?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 68-year-old woman presents to her GP with a 3-month history of a persistent, mildly pruritic skin lesion on her left chest wall. She had a left simple mastectomy for invasive ductal carcinoma 10 years ago, followed by adjuvant therapy. She denies fever, weight loss, or other systemic symptoms. Physical examination reveals the appearance shown. What is the most appropriate initial diagnostic investigation?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 70-year-old woman presents with a lesion on her chest wall at the site of a mastectomy performed 10 years prior. She reports it started as a small area of redness and has slowly enlarged. What is the MOST likely diagnosis?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 40-year-old man presents with a solitary, asymptomatic nodule on his nose. Biopsy reveals perivascular eosinophilic infiltrate. What is the MOST likely diagnosis?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 35-year-old man presents with a painless lesion on his nose, present for 6 months. Examination reveals the image shown. What is the MOST likely diagnosis?

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A 65-year-old lady weighing 70 kg has an enlarging papule on her right neck, measuring 8 mm, raised with a keratotic horn. A keratinocytic tumor is suspected. What is the maximum safe dose of 1% lidocaine with adrenaline for local anesthesia in this patient?

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Right leg affected by warfarin necrosis

Image by Bakoyiannis C, Karaolanis G, Patelis N, Maskanakis A, Tsaples G, Klonaris C, Georgopoulos S, Liakakos T — CC BY 4.0 · Source

A 72-year-old female on warfarin for chronic atrial fibrillation presents with a 2-day history of increasing pain and a developing lesion on her right lower leg. She denies trauma. Her INR is therapeutic at 2.5. Vitals are stable. Considering the clinical presentation and the image provided, what is the most appropriate immediate management?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 55-year-old man presents to his GP with a lesion on his nose that he first noticed about 6 months ago. It has gradually increased in size but is not painful or itchy. He has no significant past medical history and takes no regular medications. On examination, vital signs are stable. The image shows the lesion. Based on the appearance of this lesion, what is the most appropriate next step in management?

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Right leg affected by warfarin necrosis

Image by Bakoyiannis C, Karaolanis G, Patelis N, Maskanakis A, Tsaples G, Klonaris C, Georgopoulos S, Liakakos T — CC BY 4.0 · Source

A 65-year-old patient recently started on warfarin for deep vein thrombosis presents with a painful, expanding skin lesion on their leg. They report the lesion appeared suddenly and has worsened over the past 24 hours. INR is 2.8. Considering the clinical presentation and the appearance of the lesion, what is the most appropriate immediate management step?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 55-year-old man presents to his GP with a persistent lesion on his nose that has been present for several months and has not changed significantly in size or appearance. He reports it is occasionally itchy but otherwise asymptomatic. His medical history is unremarkable, and vital signs are within normal limits. On examination, you observe the lesion shown in the image. Considering the appearance of this lesion, what is the most appropriate initial step in the management of this patient?

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Right leg affected by warfarin necrosis

Image by Bakoyiannis C, Karaolanis G, Patelis N, Maskanakis A, Tsaples G, Klonaris C, Georgopoulos S, Liakakos T — CC BY 4.0 · Source

A 68-year-old woman recently started on warfarin for a pulmonary embolism presents with a painful, rapidly expanding purpuric lesion on her thigh, which developed two days ago. Her INR is 2.5. She has no history of trauma to the area. Considering the clinical presentation and the appearance of the lesion, what is the most likely underlying pathophysiological process?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 65-year-old woman presents with a several-month history of a slowly enlarging, mildly pruritic skin lesion on her left chest wall. She underwent a simple mastectomy on the left side for invasive ductal carcinoma 8 years ago. She denies systemic symptoms. Physical examination reveals the appearance shown. What is the most appropriate next step in management?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 62-year-old man presents with a painless lesion on his nose, present for 8 months. He denies trauma or fever. Examination reveals the image shown. Histopathology is MOST likely to show which of the following?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 35-year-old man presents with a painless lesion on his nose that has been present for several months. He denies any trauma or recent illness. Examination reveals the image shown. What is the most appropriate initial management?

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Inguinal hernia right view. Adult male with an inguinal hernia, showing bulging in the groin area.

Image by IkeTheSloth — CC0 1.0 · Source

A 45-year-old man presents with the finding shown. He denies pain but is concerned about its appearance. What is the MOST appropriate initial step?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 50-year-old man presents with a slowly growing, asymptomatic nasal lesion. He reports no trauma or fever. Examination reveals the image shown. What is the MOST likely long-term outcome if left untreated?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 40-year-old patient presents with a persistent, slightly raised lesion on their nose that has been present for several months. It is asymptomatic except for occasional mild itching. There is no history of trauma or recent changes in size or colour. The patient is otherwise healthy. Considering the appearance of the lesion shown and the clinical presentation, which of the following represents the most appropriate initial approach?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 55-year-old man presents to his GP with a lesion on his nose that has been slowly enlarging over the past 4 months. He reports no associated pain, itching, or bleeding. He is otherwise well, with no significant past medical history. On examination, vital signs are within normal limits. The lesion is as shown in the image. Considering the clinical presentation and the appearance of the lesion, what is the most appropriate initial step in the management of this patient?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 50-year-old man presents with a slowly growing nasal lesion. Examination reveals the image shown. What is the MOST appropriate initial management?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 35-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or previous skin conditions. Examination reveals the image shown. What is the MOST appropriate initial management step?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 45-year-old male presents with a painless lesion on his nose that has been present for 6 months. He denies any trauma or previous skin conditions. Examination reveals the lesion seen in the image. What is the MOST appropriate next step in management?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 72-year-old woman presents with a persistent, slowly expanding skin lesion on her right chest wall, present for several months. She underwent a right mastectomy for invasive ductal carcinoma 12 years ago. She denies pain, discharge, or systemic symptoms. Physical examination reveals the appearance shown. Considering the patient's history and the clinical finding, which of the following investigations is most appropriate to assess for potential underlying malignancy or systemic involvement?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 45-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or recent illness. Examination reveals the image shown. What is the MOST appropriate initial management?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 68-year-old woman presents with a persistent, pruritic rash on her chest wall at the site of a previous mastectomy performed 8 years ago for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation at that time. Examination reveals the area shown. What is the MOST appropriate next step in management?

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Facial eosinophilic granuloma. Red-brown nodule on the nose. Clearly visible follicular structures ("peau d'orange").

Image by Sand, Michael, et al. — CC BY 2.0 · Source

A 45-year-old man presents to his GP with a lesion on his nose that he first noticed about 6 months ago. It has slowly increased in size but is not painful or itchy. He has no significant past medical history and takes no regular medications. On examination, vital signs are stable. The image shows the appearance of the lesion. Considering the clinical presentation and the appearance of the lesion shown, what is the most appropriate initial management step?

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Right leg affected by warfarin necrosis

Image by Bakoyiannis C, Karaolanis G, Patelis N, Maskanakis A, Tsaples G, Klonaris C, Georgopoulos S, Liakakos T — CC BY 4.0 · Source

A 68-year-old patient on warfarin for a recent DVT presents with a painful, rapidly expanding skin lesion on their leg that started 48 hours ago. Their INR is 2.9. Given the clinical context and the appearance of the lesion, what is the most appropriate immediate management step?

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Clinical aspects of mammary Paget's disease occurred on the thoracic wall where simple mastectomy was performed some years before.

Image by Monica Giovannini, Carmelo D'Atri, Quirino Piubello, Annamaria Molino — CC BY-SA 2.0 · Source

A 72-year-old woman presents with a 6-month history of a non-healing rash on her chest wall at the site of a previous mastectomy performed 10 years prior for invasive ductal carcinoma. She has completed adjuvant chemotherapy and radiation. Examination reveals the findings shown. What is the MOST appropriate next step in management?

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Right leg affected by warfarin necrosis

Image by Bakoyiannis C, Karaolanis G, Patelis N, Maskanakis A, Tsaples G, Klonaris C, Georgopoulos S, Liakakos T — CC BY 4.0 · Source

A 72-year-old woman on warfarin for chronic atrial fibrillation presents with a painful, rapidly expanding lesion on her right lower leg that began two days ago, shortly after her warfarin dose was increased. Her vital signs are stable, and her INR is within the therapeutic range. Considering the clinical presentation and the appearance of the lesion shown, what is the most appropriate immediate management?

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Right leg affected by warfarin necrosis

Image by Bakoyiannis C, Karaolanis G, Patelis N, Maskanakis A, Tsaples G, Klonaris C, Georgopoulos S, Liakakos T — CC BY 4.0 · Source

An 82-year-old woman with a history of paroxysmal atrial fibrillation and a recent hospitalisation for pneumonia was discharged 5 days ago on warfarin 5mg daily. She presents to the emergency department complaining of increasing pain and a rapidly evolving lesion on her right lower leg over the past 48 hours. She denies trauma. Her vital signs are stable: BP 130/80 mmHg, HR 78 bpm, RR 16/min, Temp 36.8°C. Physical examination reveals the appearance shown in the image on her right anterior lower leg. Her INR today is 4.5. She has no known history of protein C or S deficiency. Considering the patient's history, current medication, laboratory result, and the clinical appearance depicted, which of the following represents the most appropriate immediate management strategy?

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Synchronous multiple small bowel intussusceptions in an adult with blue rubber bleb naevus syndrome. CT scan of abdomen showing i) multiple intussusceptions demonstrating doughnut signs (white arrows), intussusceptiens [A], intussusceptum [B], distended loop of small

bowel [C] and ii) haemangioma of right quadratus lumborum muscle (dark arrow).

Image by Lee C, Debnath D, Whitburn T, Farrugia M, Gonzalez F — CC BY 2.0 · Source

A 50-year-old man with multiple cutaneous lesions presents with recurrent episodes of abdominal pain and iron deficiency anemia. The provided image was obtained. What is the MOST appropriate next step in management?

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