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Mixed diagnoses – 10 cases (1 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 2 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

Cheilitis i.e. sore, swollen, dry and cracked lips.

Retinoids, particularly isotretinoin, which is sebostatic, causing dry lips in every treated patient, even those taking small doses.

Advise the patient to apply lip balm frequently and to avoid lip licking. The dose of isotretinoin may need to be reduced, or it may be discontinued for a few days until the cheilitis has resolved. Swabs may culture Staphylococcus aureus, which may be treated with topical antiseptic for a few days e.g. hydrogen peroxide cream (Crystacide™). Oral antibiotic may be required for more severe infection.

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