Quiz
Mixed diagnoses – 10 cases (11 of 11)

For each of the ten cases, study the image 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 4

This patient has developed an itchy rash under her watchstrap.

What is the diagnosis?

Contact allergic dermatitis to nickel

What else should you look for?

Dermatitis at other contact sites with metal items e.g. jewellery (particularly earrings), glasses, pockets, and hands

What further tests are necessary (if any)?

Patch tests to confirm diagnosis (refer to a dermatologist). Not all reactions to watch straps are due to contact allergy to nickel. Sometimes there are other contact allergies, particularly to cobalt. Other causes include irritation from rubbing, sweat, detergents etc. Perform diethyl glyoxime/ammonium hydroxide test on metal contactants to determine whether their use is suitable for the patient.

What is the treatment?

Remove the items completely from contact with the skin. Allergy is lifelong, so watch strap and jewellery which does not contain nickel must be obtained.

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Quiz Mixed diagnoses – 10 cases (11 of 11)

Case 4

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Quiz
Mixed diagnoses – 10 cases (11 of 11)