Imiquimod
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A 50-year-old woman was referred to a dermatology department for assessment of a lesion on her nose that had been present for 1 year. A biopsy confirmed it was a superficial basal cell carcinoma. She was treated with imiquimod 5% cream applied 5 times per week for 6 weeks. After 2 weeks of treatment, she developed mild erythema, crusting, and burning sensation at the site.
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Imiquimod
ImiquimodDr. Peral www.dermaperal.com A 50-year-old woman was referred to a dermatologist for assessment of a lesion on her nose that had been present for 1 year. A biopsy confirmed it was a superficial basal cell carcinoma. She was treated with imiquimod 5% cream applied 5 times per week, which caused mild side effects after 2 weeks but cleared the lesion completely after 4 weeks of treatment.
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Cheek Advancement FlapDr. Peral www.dermaperal.com A 75-year-old woman had a basal cell carcinoma removed from her cheek, creating a large defect on her lateral nose and cheek. The defect was closed using a cheek advancement flap procedure. In this procedure, the skin of the cheek is elevated and pulled forward to close the wound. The closure is tested by pulling on the flap with hooks to ensure adequate closure.
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Nodule on the cheekDr. Peral www.dermaperal.com A 25-year-old woman was referred to a dermatologist for evaluation of a 1.2 x 1.5 cm firm nodule on her cheek that had been present for 3 months. Examination of the nodule and histopathological analysis showing epithelial hyperplasia and large intracytoplasmic inclusion bodies in many epidermal cells. The dermatologist is seeking input on the diagnosis which will be provided on their blog in the next post.
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Lichen Planus ActinicDr. Peral www.dermaperal.com A 17-year-old male presented with well-defined brownish erythematous annular plaques on his cheek that had been present for 4 months and exacerbated with sun exposure. A biopsy showed mild to moderate liquefaction and degeneration of the basal epidermal layer with moderate perivascular lymphocytic infiltration and pigmentary incontinence in the upper and mid dermis. The diagnosis will be provided next Thursday.
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Basal cell carcinoma. dermoscopyDr. Peral www.dermaperal.com A 75-year-old woman was referred for assessment of a facial lesion that had been present for 1 year. Dermoscopy of the lesion revealed an absence of pigment network, linear and branching red blood vessels, ulceration, and multiple blue-gray globules, which are features characteristic of basal cell carcinoma.
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Pretibial myxedema wiyh graves disease[1].Dr. Peral www.dermaperal.com A 30-year-old male presented with pretibial myxedema associated with Graves' disease. He had a 2-year history of Graves' disease and 1-year history of plaques on his lower legs. A biopsy showed mucin accumulation between collagen fibers consistent with pretibial myxedema. He was treated with topical corticosteroids at night under occlusion.
Superficial basal cell carcinomaon chronic radiodermatititis
Superficial basal cell carcinomaon chronic radiodermatititisDr. Peral www.dermaperal.com A 60-year-old woman presented with an annular lesion on her breast that was found to be a superficial basal cell carcinoma. She had a history of breast carcinoma treated with radiotherapy, resulting in chronic radiodermatitis. Dermoscopy of the lesion revealed leaf-like brown structures at the periphery, typical of superficial basal cell carcinoma. Chronic radiodermatitis can occur after prolonged exposure to ionizing radiation and increase the risk of developing skin neoplasms like basal cell carcinoma months to years later.
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A C N E 1hovanes3333 This document summarizes information about erysipelas, an acute bacterial skin infection caused mainly by group A streptococci. It presents as a raised, sharply demarcated red patch with a fiery red color and vesicles at the advancing border. Symptoms include pain, burning and tenderness. Treatment involves initial parenteral antibiotics such as penicillin or cefazolin, followed by oral antibiotics to prevent complications. Recurrence is common without long-term prophylactic antibiotics in susceptible individuals, which can lead to permanent skin thickening. The lower legs, face and ears are most commonly affected.
Assignment 3 Writing and Pronunciation—Dermatologic Disease or Cond.docx
Assignment 3 Writing and Pronunciation—Dermatologic Disease or Cond.docxdanielfoster65629 Assignment 3: Writing and Pronunciation—Dermatologic Disease or Condition Medical Report
NO COPY Paste----> Need quality
work
Making use of the following terms, write a fictitious medical report of about two paragraphs describing a dermatologic condition or disease. Focus the report on the onset, progression, location, and etiology of the condition or disease, and the treatment parameters.
All terms must be defined in this report.
Diaphoresis
Macule
Ulcer
Epidermis
Ecchymosis
Wheal
Keratosis
Abscess
Pediculosis
Biopsy
Papular
Cryosurgery
Pruritus
Dermabrasion
Petechia
Erythema
Decubitus ulcer
Incision
Antifungal
Antihistamines
Keratolytics
Parasiticides
Sample
work is here..
22 year old female presents to a dermatology office with complaints of a rash on her upper back and legs. There is severe pruritus (itching) present. Patient also complains off diaphoresis at night. These symptoms have been going on for 4 weeks and have gotten progressively worse. Patient has tried using over-the-counter anti-fungal cream (Lamisil) and Ammonium Lactate lotion.
Patient's past medical history includes facial acne which is controlled with regular dermabrasion and history of pediculosis in childhood which was successfully treated with complete shaving of the head.
Patient's surgical history is significant for a Pilonidal Abscess which was treated by incision and drainage.
Patient's family history includes seborrheic keratosis in her father which are routinely treated with cryotherapy, history of long-standing diabetes in her mother resulting in peripheral neuropathy and below knee amputation due to non-healing ulcer, and multiple sclerosis in her maternal grandmother resulting in a decubitus ulcer secondary to immobility.
Patient's medications include Loratadine, Ortho-Tricycline, and Multivitamin.
On exam patient is in moderate distress. There is generalized erythematous maculo-papular rash involving the epidermal layer on her upper back and lower extremities. There are two areas of 4 cm wheals on the upper back as well. There is no evidence of ecchymosis, petechia or lymph node enlargement.
Assessment/Plan: Will perform shave biopsy of the rash. Continue anti-histamine (Loratadine). Add Triamcinolone cream twice daily. Stop Keratolytic. Will follow-up following results of the biopsy.
.
Dermoscopy. Lentigo maligna melanoma on the cheek.
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Dermoscopy. Lentigo Maligna Melanoma.
Dermoscopy. Lentigo Maligna Melanoma.Dr. Peral www.dermaperal.com A 60-year-old man was referred for assessment of a pigmented lesion on his cheek that had been present for 6 months. Dermoscopy of the lesion revealed a pseudo-pigmented network, slate gray dots arranging in annular-granular structures, and asymmetric pigmentation of the follicular openings and rhomboidal structures. A biopsy of the darkest area showing rhomboidal structures found lentigo maligna melanoma with a Breslow thickness of 0.5 mm.
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- Lesions include non-inflammatory comedones and inflammatory papules, pustules, and nodules. Variants include neonatal, infantile, nodulocystic, and hormonally-induced forms.
- Treatment involves topical and oral antibiotics, retinoids, and isotretinoin depending on severity. Hormonal therapies may be used for severe acne
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Acrokeratosis verruciformis 
Acrokeratosis verruciformis Dr. Peral www.dermaperal.com A 60-year-old woman was referred for assessment of lesions on her hands that had been present for 20 years. Skin biopsy showed mild acanthosis with slight papillomatosis and hyperkeratosis at the lesion edges. Acrokeratosis verruciformis of Hopf is an autosomal dominant genodermatosis characterized by multiple, symmetrical, skin-colored, wart-like lesions on the hands and feet that are usually present from birth.
Lesions on the hands
Lesions on the handsDr. Peral www.dermaperal.com A 60-year-old woman presented with lesions on her hands that had been present for 20 years. A skin biopsy showed mild thickening of the epidermis, thickening and scaling of the skin surface, and inflammatory cells in the dermis surrounding blood vessels. The diagnosis was seborrheic keratosis based on the histological examination findings.
Hidrocystoma apocrine
Hidrocystoma apocrineDr. Peral www.dermaperal.com A 35-year-old woman was referred for assessment of lesions on her face that had been present for 3 years. Apocrine hidrocystomas are benign cystic skin growths of apocrine gland origin that typically appear as solitary, translucent skin-colored or bluish nodules, commonly located on the face. Histological examination revealed cystic spaces in the dermis with papillary projections, characteristic of apocrine hidrocystomas.
Lesion on the face
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Seborrheic kertaosisDr. Peral www.dermaperal.com A 65-year-old man was referred for assessment of a 10-year-old lesion on his head. Dermoscopy showed a sharply demarcated lesion with a moth-eaten border and irregular crypts resembling a brain-like appearance with fissures and ridges. Within the lesion, networklike structures were seen that differed from a classic pigment network in melanocytic lesions by being larger with hyperpigmented lines that abruptly ended at the periphery.
Lesion on the head
Lesion on the headDr. Peral www.dermaperal.com A 65-year-old man was referred to a dermatologist for evaluation of a pigmented lesion on his head that had been present for 10 years. After examination with dermoscopy, the dermatologist diagnosed the lesion.
Lesion on the back 2012
Lesion on the back 2012Dr. Peral www.dermaperal.com A 65-year-old woman was referred to a dermatologist for evaluation of a pigmented lesion on her back that had been present for 6 years. The dermatologist examined the lesion and determined it was a congenital birthmark that had been on the woman's back since birth.
Spitz nevus
Spitz nevusDr. Peral www.dermaperal.com A 35-year-old woman was referred for assessment of a lesion on her right leg that had been present for 3 years. Dermoscopy revealed a vascular pattern with peripheral dot vessels. Pathology confirmed the lesion was a Spitz nevus. Spitz nevi can present as evolving lesions in various colors and patterns including globular, starburst, reticular, or homogeneous under dermoscopy. They may also display an atypical pattern or vascular pattern with dotted vessels, as was seen in this case.
Lesion on the leg.
Lesion on the leg.Dr. Peral www.dermaperal.com A 35-year-old woman was referred to a dermatologist for evaluation of a lesion on her right leg that had been present for 3 years. Based on the limited information provided, the dermatologist cannot make a definitive diagnosis about the lesion.
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chpter 1 psych 41
chpter 1 psych 41hovanes3333 This document summarizes information about erysipelas, an acute bacterial skin infection caused mainly by group A streptococci. It presents as a raised, sharply demarcated red patch with a fiery red color and vesicles at the advancing border. Symptoms include pain, burning and tenderness. Treatment involves initial parenteral antibiotics such as penicillin or cefazolin, followed by oral antibiotics to prevent complications. Recurrence is common without long-term prophylactic antibiotics in susceptible individuals, which can lead to permanent skin thickening. The lower legs, face and ears are most commonly affected.
A C N E 1
A C N E 1hovanes3333 This document summarizes information about erysipelas, an acute bacterial skin infection caused mainly by group A streptococci. It presents as a raised, sharply demarcated red patch with a fiery red color and vesicles at the advancing border. Symptoms include pain, burning and tenderness. Treatment involves initial parenteral antibiotics such as penicillin or cefazolin, followed by oral antibiotics to prevent complications. Recurrence is common without long-term prophylactic antibiotics in susceptible individuals, which can lead to permanent skin thickening. The lower legs, face and ears are most commonly affected.
Assignment 3 Writing and Pronunciation—Dermatologic Disease or Cond.docx
Assignment 3 Writing and Pronunciation—Dermatologic Disease or Cond.docxdanielfoster65629 Assignment 3: Writing and Pronunciation—Dermatologic Disease or Condition Medical Report
NO COPY Paste----> Need quality
work
Making use of the following terms, write a fictitious medical report of about two paragraphs describing a dermatologic condition or disease. Focus the report on the onset, progression, location, and etiology of the condition or disease, and the treatment parameters.
All terms must be defined in this report.
Diaphoresis
Macule
Ulcer
Epidermis
Ecchymosis
Wheal
Keratosis
Abscess
Pediculosis
Biopsy
Papular
Cryosurgery
Pruritus
Dermabrasion
Petechia
Erythema
Decubitus ulcer
Incision
Antifungal
Antihistamines
Keratolytics
Parasiticides
Sample
work is here..
22 year old female presents to a dermatology office with complaints of a rash on her upper back and legs. There is severe pruritus (itching) present. Patient also complains off diaphoresis at night. These symptoms have been going on for 4 weeks and have gotten progressively worse. Patient has tried using over-the-counter anti-fungal cream (Lamisil) and Ammonium Lactate lotion.
Patient's past medical history includes facial acne which is controlled with regular dermabrasion and history of pediculosis in childhood which was successfully treated with complete shaving of the head.
Patient's surgical history is significant for a Pilonidal Abscess which was treated by incision and drainage.
Patient's family history includes seborrheic keratosis in her father which are routinely treated with cryotherapy, history of long-standing diabetes in her mother resulting in peripheral neuropathy and below knee amputation due to non-healing ulcer, and multiple sclerosis in her maternal grandmother resulting in a decubitus ulcer secondary to immobility.
Patient's medications include Loratadine, Ortho-Tricycline, and Multivitamin.
On exam patient is in moderate distress. There is generalized erythematous maculo-papular rash involving the epidermal layer on her upper back and lower extremities. There are two areas of 4 cm wheals on the upper back as well. There is no evidence of ecchymosis, petechia or lymph node enlargement.
Assessment/Plan: Will perform shave biopsy of the rash. Continue anti-histamine (Loratadine). Add Triamcinolone cream twice daily. Stop Keratolytic. Will follow-up following results of the biopsy.
.
Dermoscopy. Lentigo maligna melanoma on the cheek.
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Dermoscopy. Lentigo Maligna Melanoma.Dr. Peral www.dermaperal.com A 60-year-old man was referred for assessment of a pigmented lesion on his cheek that had been present for 6 months. Dermoscopy of the lesion revealed a pseudo-pigmented network, slate gray dots arranging in annular-granular structures, and asymmetric pigmentation of the follicular openings and rhomboidal structures. A biopsy of the darkest area showing rhomboidal structures found lentigo maligna melanoma with a Breslow thickness of 0.5 mm.
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Intraepidermal Carcinoma.pptx in the children
Intraepidermal Carcinoma.pptx in the childrenDinu85 1) Squamous cell carcinoma in situ (SCCIS) is a non-invasive form of skin cancer where cancerous cells are located in the epidermis.
2) SCCIS is most commonly caused by long-term exposure to ultraviolet radiation from sunlight, which damages skin cell DNA and leads to abnormal cell growth.
3) SCCIS typically appears as red, scaly patches or plaques on sun-exposed skin like the head and neck. If left untreated it could develop into invasive skin cancer.
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- Acne is caused by abnormalities in sebum production, desquamation, P. acnes proliferation and inflammation within pilosebaceous units. It commonly affects adolescents.
- Lesions include non-inflammatory comedones and inflammatory papules, pustules, and nodules. Variants include neonatal, infantile, nodulocystic, and hormonally-induced forms.
- Treatment involves topical and oral antibiotics, retinoids, and isotretinoin depending on severity. Hormonal therapies may be used for severe acne
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Controlling the GLP Inspection Process
Regulatory authorities conduct inspections to verify GLP compliance. Laboratories must prepare for inspections by:
• Maintaining up-to-date documentation.
• Conducting internal audits.
• Ensuring personnel training and awareness.
• Implementing corrective actions for non-compliance.
Regulatory inspections typically assess laboratory infrastructure, personnel competence, study documentation, and adherence to protocols. Laboratories must demonstrate transparency and proactive quality control measures.
Documentation in GLP
Accurate and comprehensive documentation is crucial in GLP compliance. Key documentation elements include:
• Study protocols
• Standard operating procedures (SOPs)
• Raw data records
• Analytical reports
• Audit reports
• Equipment calibration records
• Archiving and retention policies
Proper documentation ensures traceability, accountability, and reliability in laboratory research.
Audit in GLP Compliance
Auditing is a critical component of GLP, ensuring adherence to established regulations and identifying areas for improvement. Audits can be internal (self-audit) or external (regulatory or third-party audits).
Goals of Laboratory Quality Audit
• Ensure compliance with GLP regulations.
• Identify gaps and areas for improvement.
• Validate data integrity and accuracy.
• Enhance operational efficiency.
• Prevent regulatory penalties and study disqualification.
Audit Tools in GLP
Laboratories use various audit tools to assess compliance, including:
• Checklists and self-assessments
• Internal quality audits
• Electronic data tracking systems
• Third-party inspections
• Root cause analysis
• Corrective and preventive action (CAPA) plans
Future of GLP Regulations
ELDERLY PRIMI GRAVIDA & GRAND MULTI PARApptx
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Is Malaria really spread by mosquitos.pptx
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Like most residents of western Europe I thought little about Malaria until I had opportunity to travel to Africa. My destination in Southern Botswana was not on the malaria map. However, parts of the North of the country to which I intended to travel were. People told me I needed to get malaria tablets that had to be taken for a week or two in advance, then daily or weekly and for some time after leaving malaria areas. There were a few different medications and combination tablets available and I investigated which would be the lesser evil. None seemed particularly effective so I decided to check the evidence of the mosquito cause of malaria and how these tablets were supposed to act. I soon became suspicious of the complicated malaria transmission story.
I have written a book 'Malaria is Spread by Mosquitos?'.
This presentation is a short introduction to the topic. see https://usmalaria.com/
Adverse Drug Reactions (ADR). .
Adverse Drug Reactions (ADR). .Department of Pharmaceutical science, Gurugram University Adverse Drug Reactions are
unintended and harmful responses resulting from the
administration of medication; these may range
from mild side effects to life threatening conditions,
reflecting the complexity of
individual pharmacological
responses presented by Sant Kumar from Department of Pharmaceutical science, Gurugram University
PARKINSON’S USMLE style question by dr ankush goyal
PARKINSON’S USMLE style question by dr ankush goyalDr Ankush goyal Parkinsonism refers to a clinical syndrome characterized by a combination of motor and non-motor symptoms that resemble Parkinson’s disease (PD). It results from dysfunction in the basal ganglia, particularly due to dopamine deficiency in the substantia nigra.
Key Features of Parkinsonism:
1. Bradykinesia – Slowness of movement with difficulty in initiating and executing voluntary movements.
2. Rigidity – Increased muscle tone, presenting as either:
Lead-pipe rigidity (uniform resistance)
Cogwheel rigidity (intermittent resistance with a ratchet-like quality)
3. Tremor – Resting tremor, typically "pill-rolling" (4-6 Hz), that improves with movement.
4. Postural Instability – Impaired balance leading to a higher risk of falls.
Causes of Parkinsonism:
1. Idiopathic Parkinson’s Disease (PD) – The most common cause, due to progressive degeneration of dopaminergic neurons in the substantia nigra.
2. Drug-Induced Parkinsonism – Caused by dopamine-blocking agents (e.g., antipsychotics, metoclopramide, reserpine).
3. Atypical Parkinsonian Syndromes (Parkinson-plus syndromes) – Progressive conditions with additional features beyond classic Parkinsonism, such as:
Multiple System Atrophy (MSA)
Progressive Supranuclear Palsy (PSP)
Corticobasal Degeneration (CBD)
Dementia with Lewy Bodies (DLB)
4. Vascular Parkinsonism – Due to multiple small strokes affecting the basal ganglia.
5. Toxic or Metabolic Causes – Includes manganese poisoning, carbon monoxide exposure, Wilson’s disease.
6. Post-Encephalitic Parkinsonism – Rare, seen in survivors of encephalitis lethargica.
Diagnosis:
Clinical Evaluation – Based on cardinal motor symptoms.
Response to Levodopa – Helps differentiate PD from other causes.
Neuroimaging (MRI, DaTscan) – Useful in atypical cases.
Management:
Pharmacological Treatment:
Levodopa (with carbidopa)
Dopamine agonists (pramipexole, ropinirole)
MAO-B inhibitors (selegiline, rasagiline)
COMT inhibitors (entacapone)
Anticholinergics (for tremors)
Non-Pharmacological Treatment:
Physiotherapy, speech therapy
Deep Brain Stimulation (DBS) in selected cases
TRAGEDIES IN PHASE 1 CLINICAL TRIAL Dr ankush goyal
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Phase 1 clinical trials are the first stage of testing a new drug or treatment in humans. These trials primarily assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of the investigational drug. Conducted on a small group of healthy volunteers (typically 20–100) or, in certain cases, patients with the target disease, Phase 1 trials aim to determine:
1. Safety and Tolerability – Identifying potential side effects and the maximum tolerated dose.
2. Pharmacokinetics (PK) – Studying drug absorption, distribution, metabolism, and excretion (ADME).
3. Pharmacodynamics (PD) – Understanding the drug’s biological effects and mechanism of action.
4. Dose Escalation and Determination – Establishing the optimal dosage for further trials.
These trials are usually open-label (no placebo control) and can be conducted in different designs, such as single ascending dose (SAD), multiple ascending dose (MAD), and food effect studies. While most drugs fail in this phase due to safety concerns, successful candidates proceed to Phase 2 trials, where efficacy is further evaluated.
FEB 2025 ONCOLOGY CARTOONS BY DR KANHU CHARAN PATRO
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Structure of skin and problem associated with prickly heat
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DEFIBRILLATORS.pptx created by KIRAN KARETHA
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Defibrillator is an electronic apparatus used to counteract atrial or ventricular fibrillation by application of a brief electric shock to the heart.
What is an Entity Code in Medical Billing.pptx
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bitewing rad.pptx, definition, techniques
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Introduction to the Clinical Laboratory.pdf
Introduction to the Clinical Laboratory.pdfShafqat Hussain Introduction to Laboratory
Introduction to diagnostic laboratory
What is lab
Learning Objectives
• What is a Laboratory
• Different types of Laboratory
• Understand the role of the clinical laboratory in healthcare.
• Identify the different types of laboratory departments.
• Clinical Lab Instruments
What is a Laboratory?
•A laboratory is a controlled environment where scientific experiments, tests, and analyses are
conducted.
•It is equipped with specialized instruments, tools, and reagents to perform specific tasks.
•Laboratories play a critical role in advancing science, medicine, and technology.
What is a Clinical Laboratory?
•A facility where tests are performed on clinical
specimens to diagnose, monitor, and treat diseases.
•Provides critical information for patient care.
TARGET DELINEATION IN CERVIX CANCER BY DR KANHU
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Improving the Patient Experience in Geographic Atrophy: Are You Putting the L...
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Pharmacology of Narcotic Analgesics.pptx
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Improving the Patient Experience in Geographic Atrophy: Are You Putting the L...
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Imiquimod
- 1. Treatment of facial superficial basal cell carcinoma with imiquimod 5% cream www.dermatoblog.com F. Peral Rubio, M.D. Department of Dermatology Hospital Universitario Virgen Macarena. Sevilla. Spain.
- 2. Treatment of facial superficial basal cell carcinoma with imiquimod 5% cream A 50-year-old woman The patient was referred to us for the assessment of a lesion on the nose 1 year previously.
- 3. A clinical diagnosis of superficial basal cell carcinoma was made
- 4. Treatment of facial superficial basal cell carcinoma with imiquimod 5% cream Biopsy from the edge of the lesion showed multiple nests of basaloid cells with peripheral palisading in the papillary dermis in continuity with the overlying epithelium
- 5. Treatment of facial superficial basal cell carcinoma with imiquimod 5% cream Imiquimod 5% cream to be applied five times a week during six weeks.
- 6. Treatment of facial superficial basal cell carcinoma with imiquimod 5% cream After two weeks of application, the patient developed mild erythema, crusting with burning sensation over the area.
- 9. Treatment of facial superficial basal cell carcinoma with imiquimod 5% cream www.dermatoblog.com F. Peral Rubio, M.D. Department of Dermatology Hospital Universitario Virgen Macarena. Sevilla. Spain.