184 Acne vulgaris Instruction Look at this patient. Salient features History • Steroid ingestion • Isoniazid ingestion • Occupational exposure to oils (oil-induced acne). Examination • Comedones or blackheads (Fig….

169 Lupus pernio Instruction Look at this patient’s face. Salient features History • Shortness of breath, cough, chest discomfort • Fatigue, weight loss, malaise, anorexia • History of therapy with…

168 Lipoatrophy Instruction Look at this patient. Look here (examiner pointing at the patient’s thighs). Salient features History • Ask whether the patient is taking insulin for diabetes. • Is…

158 Herpes zoster syndrome (shingles) Instruction Look at this patient. Salient features History • Pain, particularly in the ophthalmic branch of the trigeminal nerve (Fig. 158.1), and in the lower…

118 Wilson’s disease Instruction Look at this patient’s eyes. Salient features History • History of consanguinity • In young adult or child: hepatitis, haemolytic anaemia, portal hypertension or neuropsychiatric abnormalities…

230 Parotid enlargement Instruction Look at this patient’s face. Salient features History • Ask the patient whether the parotids are painful and dry mouth • Ask the patient about dry…

221 Anaemia Patient 1 Instruction Would you like to ask this anaemic patient a few questions? Salient features History • Ask about the following: • Blood loss such as bleeding…

162 Systemic lupus erythematosus Instruction Examine this patient’s face (usually a young woman). Salient features History • Fatiguability and tiredness: suggests anaemia • Joint symptoms: particularly small joints (90% of…

149 Scleroderma Instruction Look at these hands. Salient features History • Tight skin over face and joints • Raynaud’s phenomenon (Case 161, p. 587) • Puffy hands and feet •…

216 Swollen leg I Deep vein thrombosis Instruction Look at this patient’s leg. Salient features History • Recent history of immoblization including recent surgery, stroke, myocardial infarction • Whether onset…