I’ve just discovered the on-line version of Pulse, complete with their regular picture quizzes. This fills an increasingly glaring DEN for me – I used to get various free educational journals with a section for picture revision, and looking at those few pictures of random skin lesions each week really added up over time in terms of keeping my dermatology knowledge up to date. Since no longer getting the journals (I’ve no idea why I don’t – I just seem to have dropped off their mailing lists at some point), I’ve definitely felt the difference, and, now that I’ve found the Pulse site, I’ll check their picture sections out regularly.
The problem is, of course, that I’m not sure how to record this for appraisal purposes, since those sections of the site don’t record visits and it’s hard to write notes on something that’s essentially jogging my visual memory. The best I can do is record a few particular learning points here that I want to remember.
Ecthyma: Like impetigo but deeper. Crusted sores over ulcers.
Erysipelas: Like cellulitis but more superficial, hence with a better-defined border. Typically associated with systemic upset.
Erythrasma: Pinkish-brown rash in the skin folds, caused by Corynebacterium minutissimum.
Histiocytoma: Another name for dermatofibroma. Firm nodule which may be yellowish-brown, pink, or dark, usually on legs or arms. Display skin dimpling when the skin on the sides of the lesion is squeezed, due to skin tethering. Benign overgrowth of histiocyte cells, often triggered by a minor skin injury such as an insect bite/thorn injury. Last for years but are quite harmless.
And finally – Don’t use topical antibiotics for infected eczema. The organisms form a biofilm on the surface of the eczema which won’t respond to antibiotics, but they can still induce resistance.