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I am intern doctor, please show list of all dermatology and venereology illnesses along with clinical pictures and also mention their classification, management, diagnosis, laboratory analysis and treatment

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Now I have extensive material from the textbooks and image library. Let me compile a comprehensive reference guide.

Dermatology & Venereology: Complete Clinical Reference for Intern Doctors

Sources: Dermatology 2-Volume Set 5e (Bolognia); Fitzpatrick's Dermatology 9e; Andrews' Diseases of the Skin

CLASSIFICATION FRAMEWORK

Dermatological diseases are organized along two major branches:
  1. Inflammatory (infectious / non-infectious)
  2. Neoplastic (benign / malignant)
A practical clinical axis further divides diseases by reaction pattern (eczematous, papulosquamous, vesicobullous, pustular, vascular, etc.).

PART I — INFLAMMATORY DERMATOSES (Non-infectious)

1. ECZEMA / ATOPIC DERMATITIS

Classification
  • Atopic dermatitis (endogenous)
  • Contact dermatitis: Allergic vs Irritant
  • Seborrhoeic dermatitis
  • Discoid (nummular) eczema
  • Dyshidrotic eczema (pompholyx)
  • Stasis/gravitational eczema
Clinical Features
  • Pruritus, erythema, papules, vesicles, lichenification
  • Distribution: flexural creases (antecubital, popliteal) in atopic; coin-shaped plaques in nummular; greasy scales on scalp/nasolabial folds in seborrhoeic
Inflammatory eczema — erythematous scaling plaques on forearm
Diagnosis
  • Clinical (Hanifin-Rajka criteria for atopic dermatitis)
  • Patch testing for allergic contact dermatitis
Lab Analysis
  • Serum IgE elevated (atopic)
  • Eosinophilia
  • RAST/specific IgE for allergens
  • KOH prep to exclude tinea (especially in hand eczema)
Management & Treatment
  • Trigger avoidance, emollients (cornerstone)
  • Topical corticosteroids (mild-to-moderate: hydrocortisone 1%; moderate-to-potent: betamethasone valerate, mometasone)
  • Topical calcineurin inhibitors: tacrolimus 0.03–0.1%, pimecrolimus (steroid-sparing)
  • Antihistamines (sedating: chlorphenamine; non-sedating: cetirizine) for itch
  • Severe/refractory: dupilumab (anti-IL-4Rα), ciclosporin, methotrexate, azathioprine
  • Seborrhoeic: antifungal shampoos/creams (ketoconazole 2%), low-potency steroids

2. PSORIASIS

Classification
  • Plaque psoriasis (psoriasis vulgaris) — 80–90%
  • Guttate psoriasis
  • Pustular psoriasis (generalised/palmoplantar)
  • Erythrodermic psoriasis
  • Inverse (flexural) psoriasis
  • Nail psoriasis
  • Psoriatic arthritis
Clinical Features
  • Well-demarcated, salmon-pink plaques with silvery-white scale
  • Auspitz sign (pinpoint bleeding on scale removal)
  • Koebner phenomenon
  • Nail: pitting, onycholysis, oil-drop sign
Genital/flexural psoriasis — erythematous demarcated plaques
Diagnosis
  • Clinical; biopsy if uncertain
  • Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI)
Lab Analysis
  • Skin biopsy: parakeratosis, Munro microabscesses, acanthosis, elongated rete ridges
  • ASO titre (guttate — streptococcal trigger)
  • HLA-Cw6 association
  • Metabolic screen (psoriasis associates with metabolic syndrome, CVD)
Management & Treatment
SeverityTreatment
MildTopical corticosteroids, vitamin D analogues (calcipotriol), combination (Daivobet)
ModeratePhototherapy: NB-UVB, PUVA
SevereMethotrexate, ciclosporin, acitretin; Biologics: TNF-α inhibitors (etanercept, adalimumab, infliximab), IL-17 inhibitors (secukinumab, ixekizumab), IL-23 inhibitors (guselkumab, risankizumab)

3. ACNE VULGARIS

Classification
  • Comedonal (non-inflammatory)
  • Inflammatory: papulopustular
  • Nodulocystic/conglobate (severe)
  • Acne fulminans (most severe)
  • Acne rosacea (separate entity — see below)
Clinical Features
  • Comedones (open=blackheads, closed=whiteheads), papules, pustules, nodules, cysts
  • Face, chest, upper back
  • Post-inflammatory hyperpigmentation, scarring
Diagnosis
  • Clinical; grading by IGA (Investigator Global Assessment) or Leeds scale
Lab Analysis
  • Androgen profile (if features of PCOS/virilisation)
  • Bacterial culture if resistant (rule out Gram-negative folliculitis)
  • If on isotretinoin: LFTs, fasting lipids, FBC, urine pregnancy test
Management & Treatment
GradeTreatment
MildBenzoyl peroxide, topical retinoids (adapalene, tretinoin), topical antibiotics (clindamycin)
ModerateOral antibiotics: doxycycline 100 mg OD (first-line), lymecycline
SevereOral isotretinoin 0.5–1 mg/kg/day (highly teratogenic — contraception mandatory); spironolactone (females)
HormonalCombined OCP (e.g. co-cyprindiol/Dianette)

4. ROSACEA

Classification (Subtypes)
  • I: Erythematotelangiectatic (ETR)
  • II: Papulopustular
  • III: Phymatous (rhinophyma — sebaceous hyperplasia)
  • IV: Ocular rosacea
Clinical Features
  • Central facial erythema, flushing, telangiectasias
  • Papules/pustules without comedones (distinguishes from acne)
  • Triggers: sun, heat, spicy food, alcohol, stress
Erythematotelangiectatic rosacea — centrofacial erythema
Papulopustular rosacea — papules and pustules on malar region
Diagnosis
  • Clinical (National Rosacea Society diagnostic criteria)
  • Demodex folliculorum overcolonisation may be relevant
Lab Analysis
  • Dermoscopy: branching telangiectasias, follicular plugging
  • Skin biopsy if uncertain
Management & Treatment
  • Sun protection (SPF 50+), avoid triggers
  • Topical: metronidazole 0.75%, azelaic acid 15–20%, ivermectin 1% cream (anti-Demodex)
  • Oral: doxycycline 40 mg modified-release (low-dose anti-inflammatory, not antibiotic dose)
  • Vascular lasers/IPL for telangiectasias
  • Rhinophyma: CO₂ laser, surgical debulking

5. URTICARIA (HIVES)

Classification
  • Acute (<6 weeks): usually allergic/infective
  • Chronic (>6 weeks): spontaneous (CSU) or inducible (dermographism, cold, cholinergic, solar, pressure)
  • Urticarial vasculitis
Clinical Features
  • Transient wheals (pruritic, oedematous, centrifugal spread) lasting <24 h
  • Angioedema: deep dermal/subcutaneous swelling
Diagnosis
  • Clinical; trigger identification
Lab Analysis
  • FBC, ESR, CRP, LFTs, TFTs, ANA, complement (C3/C4)
  • Chronic: autologous serum skin test (ASST), anti-FcεRI/anti-IgE antibodies
  • Inducible: cold stimulation test, dermographometer
Management & Treatment
  • Acute: antihistamines (cetirizine, loratadine); severe/anaphylaxis: IM adrenaline 0.5 mg (1:1000)
  • Chronic spontaneous urticaria:
    • Step 1: Non-sedating H1-antihistamine (cetirizine 10 mg OD)
    • Step 2: Up to 4× licensed dose
    • Step 3: Add omalizumab (anti-IgE, 300 mg SC every 4 weeks) — highly effective
    • Step 4: Ciclosporin

PART II — BULLOUS (BLISTERING) DISEASES

6. PEMPHIGUS VULGARIS

Classification
  • Pemphigus vulgaris (most common, life-threatening)
  • Pemphigus foliaceus
  • Paraneoplastic pemphigus
  • IgA pemphigus
Clinical Features
  • Fragile, flaccid blisters → painful erosions
  • Oral mucosa often first affected (50–70%)
  • Nikolsky sign positive (skin slips with lateral pressure)
  • Asboe-Hansen sign positive
Pemphigus vulgaris — flaccid bullae, erosions, crusting on scalp
Diagnosis
  • Skin biopsy: intraepidermal acantholysis (suprabasal split)
  • Direct immunofluorescence (DIF): intercellular IgG/C3 "chicken-wire" pattern
  • Indirect IF: anti-desmoglein (Dsg3 > Dsg1) antibodies
  • ELISA: anti-Dsg3, anti-Dsg1
Lab Analysis
  • Anti-Dsg3 ELISA (mucosal disease), anti-Dsg1 (skin disease)
  • Baseline FBC, LFTs, U&E, glucose (before immunosuppression)
Treatment
  • High-dose systemic prednisolone 1 mg/kg/day initially
  • Steroid-sparing agents: azathioprine, mycophenolate mofetil
  • Rituximab (anti-CD20): now first-line in moderate-to-severe disease
  • Wound care for erosions; IVIG in refractory cases

7. BULLOUS PEMPHIGOID

Classification
  • Bullous pemphigoid (most common autoimmune blistering disease in elderly)
  • Mucous membrane pemphigoid
  • Pemphigoid gestationis (pregnancy)
  • Lichen planus pemphigoides
Clinical Features
  • Tense bullae on urticarial/erythematous base
  • Elderly patients (>70 years); trunk, flexures
  • Pruritus often precedes blistering
  • Nikolsky sign negative
Diagnosis
  • Biopsy: subepidermal blister, eosinophil-rich infiltrate
  • DIF: linear IgG/C3 at dermoepidermal junction (DEJ)
  • Anti-BP180 (BPAG2), anti-BP230 antibodies by ELISA
Treatment
  • Potent topical corticosteroids (clobetasol propionate 0.05%) — preferred over systemic
  • Oral prednisolone (0.5 mg/kg/day) for extensive disease
  • Doxycycline + niacinamide (milder disease)
  • Azathioprine, methotrexate, mycophenolate as steroid-sparing

PART III — PAPULOSQUAMOUS DISORDERS

8. LICHEN PLANUS

Classification
  • Cutaneous LP
  • Oral LP (reticular, erosive, bullous)
  • Genital LP
  • Lichen planopilaris (scarring alopecia)
  • Nail LP
  • LP pigmentosus
Clinical Features
  • 4 P's: Pruritic, Purple, Polygonal, Papules
  • Wickham's striae (lacy white lines on surface)
  • Koebner phenomenon
  • Wrists, forearms, ankles, mucous membranes
Diagnosis
  • Clinical; biopsy if uncertain
Lab Analysis
  • Skin biopsy: band-like lichenoid infiltrate at DEJ, basal cell damage, colloid bodies (Civatte bodies)
  • Hepatitis C serology (associated in some populations)
  • Oral LP: exclude lichenoid drug reaction (check medication history)
Treatment
  • Topical corticosteroids (moderate to potent)
  • Oral: prednisolone for severe/widespread; acitretin
  • Topical tacrolimus (oral LP)
  • Phototherapy (NB-UVB, PUVA)

9. PITYRIASIS ROSEA

Clinical Features
  • Herald patch (2–5 cm oval scaly plaque) → generalized eruption 1–2 weeks later
  • "Christmas tree" distribution on trunk
  • Self-limiting (6–8 weeks)
  • HHV-6/7 association
Treatment
  • Reassurance; topical emollients
  • Antihistamines for itch
  • Aciclovir (early use may shorten duration)
  • NB-UVB (second line)

PART IV — INFECTIOUS DERMATOSES

10. FUNGAL INFECTIONS (DERMATOPHYTOSES)

Classification by Site
  • Tinea capitis (scalp)
  • Tinea corporis (body/ringworm)
  • Tinea cruris (groin — "jock itch")
  • Tinea pedis (foot — "athlete's foot")
  • Tinea unguium/Onychomycosis (nails)
  • Tinea versicolor/pityriasis versicolor (Malassezia — not a dermatophyte)
  • Cutaneous candidiasis
Clinical Features
  • Annular, scaly plaques with active advancing edge and central clearing
  • Tinea pedis: interdigital maceration, scaling, fissuring
  • Onychomycosis: nail thickening, yellowing, subungual debris
Tinea corporis, tinea cruris, tinea pedis — composite
Tinea pedis — plantar scaling and fissuring
Diagnosis
  • KOH microscopy: septate hyphae (dermatophytes), pseudohyphae (Candida), spaghetti and meatballs (Malassezia)
  • Wood's lamp: Microsporum → green fluorescence; Pityrosporum → yellow-green
  • Fungal culture on Sabouraud's dextrose agar
Lab Analysis
  • Skin scrapings, nail clippings, or hair stubs for KOH/culture
  • PCR (increasingly used for species identification)
Treatment
  • Tinea corporis/cruris/pedis: topical terbinafine 1%, clotrimazole 1% (4 weeks)
  • Tinea capitis (requires oral): griseofulvin 10–20 mg/kg/day × 6–8 wk; terbinafine 125–250 mg/day × 4 wk
  • Onychomycosis: oral terbinafine 250 mg/day × 12 wk (fingernails 6 wk) or itraconazole pulse
  • Pityriasis versicolor: selenium sulphide shampoo, topical azoles; oral itraconazole/fluconazole for extensive disease

11. BACTERIAL SKIN INFECTIONS

Classification
  • Impetigo (Staph. aureus / Group A Strep)
  • Ecthyma (deep impetigo)
  • Erysipelas (Group A Strep, dermis/superficial)
  • Cellulitis (deep dermis/subcutaneous)
  • Folliculitis, furuncle (boil), carbuncle
  • Hidradenitis suppurativa (apocrine)
  • Erythrasma (Corynebacterium minutissimum)
Clinical Features
  • Impetigo: golden-crusted lesions, honey-coloured exudate, perioral/nasal
  • Erysipelas: bright red, sharply demarcated, raised plaque; fever/systemic upset
  • Cellulitis: poorly defined erythema, warmth, tenderness, fever
Diagnosis
  • Swabs for MCS; blood cultures if systemic sepsis
  • Erythrasma: coral-red fluorescence under Wood's lamp
Lab Analysis
  • FBC (neutrophilia), CRP/ESR, blood cultures
  • ASO titre (streptococcal)
  • MRSA swab if risk factors
Treatment
  • Impetigo: topical mupirocin 2% or fusidic acid; oral flucloxacillin/cefalexin if widespread
  • Erysipelas/cellulitis: IV benzylpenicillin + flucloxacillin (or IV co-amoxiclav); MRSA — vancomycin/daptomycin
  • Folliculitis: topical antiseptics; recurrent — oral antibiotics, decolonisation
  • Hidradenitis suppurativa:
    • Hurley I: topical clindamycin, antiseptics
    • Hurley II-III: oral tetracyclines, rifampicin + clindamycin
    • Biologic: adalimumab (only licensed biologic for HS), secukinumab
    • Surgery: wide local excision
Hidradenitis suppurativa — nodules, abscesses, sinus tracts in groin

12. VIRAL SKIN INFECTIONS

A. Varicella (Chickenpox) — Primary VZV infection
  • Pruritic vesicular exanthem in crops ("dewdrop on a rose petal")
  • Centripetal distribution; lesions at different stages simultaneously
  • Fever, malaise
Varicella — vesicular eruption at multiple stages, facial distribution
Diagnosis: Clinical; PCR of vesicle fluid (gold standard); DFA, serology (VZV IgM) Treatment: Oral aciclovir 800 mg 5× daily × 7 days (adults, immunocompetent); IV aciclovir 10 mg/kg TDS in immunocompromised; varicella vaccination (prevention)
B. Herpes Zoster (Shingles) — VZV reactivation
  • Dermatomal pain/burning → unilateral vesicular eruption
  • Thoracic > trigeminal distribution
  • Ramsay Hunt syndrome (geniculate ganglion: ear vesicles + facial palsy + hearing loss)
  • Post-herpetic neuralgia (PHN) — major complication
Diagnosis: Clinical; PCR swab; DFA Lab: Tzanck smear (multinucleated giant cells — not specific) Treatment: Valaciclovir 1000 mg TDS × 7 days; famciclovir; IV aciclovir (ophthalmic/disseminated); pregabalin/gabapentin, amitriptyline for PHN; shingles vaccine (Shingrix — recombinant zoster vaccine)
C. Herpes Simplex (HSV-1/HSV-2)
  • Grouped vesicles on erythematous base; lips (orolabial) or genitalia
  • Primary vs recurrent
  • Eczema herpeticum (Kaposi's varicelliform eruption) in atopic patients
Diagnosis: PCR swab; viral culture; Tzanck smear Treatment: Aciclovir 400 mg TDS × 5 days (topical aciclovir for orolabial); IV aciclovir for severe/encephalitis; suppressive therapy: aciclovir 400 mg BD for recurrent genital herpes
D. Molluscum Contagiosum (Poxvirus)
  • Skin-coloured, umbilicated dome-shaped papules 2–5 mm
  • Children (trunk), adults (genital area in sexually active)
  • Self-limiting; HIV: extensive/giant lesions
Molluscum contagiosum — umbilicated papules on trunk
Treatment: Curettage, cryotherapy, potassium hydroxide 5–10% solution, cantharidin (topical); imiquimod for extensive disease
E. Warts (HPV)
  • Common warts (verruca vulgaris): rough, papillomatous, any site
  • Plantar warts (verruca plantaris): endophytic, painful
  • Flat warts (verruca plana): flat-topped papules, face/limbs
  • Genital warts (condylomata acuminata): HPV 6, 11
Treatment: Salicylic acid (first-line), cryotherapy (liquid nitrogen); electrosurgery; imiquimod/podophyllin (genital warts); HPV vaccine (prevention)

13. PARASITIC INFESTATIONS

A. Scabies (Sarcoptes scabiei)
Classification: Classical, crusted (Norwegian) scabies (immunocompromised — hyperinfestation)
Clinical Features
  • Intense nocturnal pruritus
  • Burrows (pathognomonic) in finger webs, wrists, genitalia
  • Widespread papular eruption; secondary eczematisation
  • Crusted scabies: thick hyperkeratotic plaques, mild itch but highly contagious
Diagnosis
  • Clinical + dermoscopy ("delta-wing jet with contrail" sign of mite)
  • Skin scraping + microscopy (mites, eggs, faecal pellets)
Treatment
  • Permethrin 5% cream: whole body (neck down), leave 8–12 h, repeat 1 week
  • Alternative: malathion 0.5%, benzyl benzoate 25%
  • Oral ivermectin 200 µg/kg × 2 doses (crusted scabies — first-line; classical — second-line)
  • Treat all household contacts simultaneously; wash clothing/bedding at 60°C
  • Antihistamines + topical steroids for post-scabetic itch
B. Pediculosis (Lice)
  • Pediculus humanus capitis (head lice): nits (egg cases) on hair shafts, pruritic scalp
  • Pediculus humanus corporis (body lice): vector for typhus, trench fever, relapsing fever
  • Phthirus pubis (pubic/crab lice): STI
Treatment: Permethrin 1% lotion, malathion 0.5%, wet combing; oral ivermectin for resistant cases

PART V — PIGMENTARY DISORDERS

14. VITILIGO

Classification
  • Segmental (unilateral, dermatomal)
  • Non-segmental/generalised: vitiligo vulgaris, acrofacial, universal
Clinical Features
  • Well-demarcated depigmented macules/patches
  • Wood's lamp: chalk-white fluorescence
  • Association with autoimmune conditions (thyroid disease, T1DM, Addison's, pernicious anaemia)
Vitiligo and alopecia areata — depigmented patches, hair loss
Diagnosis
  • Clinical; Wood's lamp examination
  • Autoantibody screen: anti-thyroid, anti-nuclear, ANA
Lab Analysis
  • TFTs + anti-TPO, anti-thyroglobulin antibodies
  • Fasting glucose/HbA1c
  • FBC (pernicious anaemia screen)
Treatment
  • Topical corticosteroids (class III), topical calcineurin inhibitors
  • NB-UVB phototherapy (best evidence for repigmentation)
  • Excimer laser
  • Oral/topical ruxolitinib (JAK 1/2 inhibitor — approved 2022)
  • Surgical (melanocyte transfer, split-thickness skin grafts) for stable segmental vitiligo
  • Sunscreen to protect depigmented areas

15. MELASMA

Clinical Features: Symmetric brown hyperpigmentation, cheeks/upper lip/forehead; females predominantly; triggered by UV, pregnancy, OCP
Diagnosis: Clinical; Wood's lamp (epidermal = enhanced; dermal = not enhanced)
Treatment: Sun protection (UVF 50+); triple therapy: hydroquinone 4% + tretinoin 0.05% + mild corticosteroid; azelaic acid 15–20%; kojic acid; chemical peels; tranexamic acid (oral/topical — newer evidence); laser (risk of PIH)

PART VI — HAIR & NAIL DISORDERS

16. ALOPECIA

Classification
TypeCauseScarring?
Androgenetic alopeciaDHT-mediated, geneticNo
Alopecia areata (AA)AutoimmuneNo
Tinea capitisDermatophyteNo (kerion can scar)
Lichen planopilarisLichen planusYes
Discoid lupusAutoimmuneYes
Traction/traumaticPhysicalNo (can become scarring)
Alopecia areata — smooth patches; tinea capitis; kerion; seborrhoeic scalp disorders
Alopecia areata — ophiasis pattern
Alopecia Areata Diagnosis
  • Clinical (smooth, non-scarring patches; exclamation mark hairs at periphery)
  • Dermoscopy: yellow dots, black dots, broken hairs
  • Scalp biopsy if uncertain (peribulbar lymphocytic infiltrate — "swarm of bees")
  • TFTs, FBC, ferritin, serum zinc
Treatment (AA)
  • Intralesional triamcinolone acetonide 5–10 mg/mL (patches)
  • Topical minoxidil 5%, topical DPCP immunotherapy
  • Oral JAK inhibitors: baricitinib, ritlecitinib (approved for severe AA)
  • Systemic steroids for rapidly progressive disease
Androgenetic Alopecia Treatment
  • Topical minoxidil 2–5% (men and women)
  • Oral finasteride 1 mg/day (men only — blocks 5α-reductase); dutasteride
  • Hair transplant (FUE/FUT)

PART VII — SKIN TUMOURS & NEOPLASMS

17. MELANOMA

Classification (Subtypes)
  • Superficial spreading melanoma (SSM) — most common, 70%
  • Nodular melanoma (most aggressive)
  • Lentigo maligna melanoma (sun-damaged skin, elderly)
  • Acral lentiginous melanoma (palms, soles, nails — commonest in darker skin)
  • Amelanotic melanoma
Clinical Features — ABCDE Rule
  • Asymmetry
  • Border irregularity
  • Colour variegation (tan, brown, black, red, white, blue)
  • Diameter >6 mm
  • Evolution (change over time)
Melanoma, BCC, SCC, Merkel cell — comparative clinical chart
Diagnosis
  • Dermoscopy (increase diagnostic accuracy by 30%)
  • Excision biopsy (do not incise or shave)
  • Sentinel lymph node biopsy for Breslow >0.8 mm or ulceration
Lab Analysis
  • Histopathology with Breslow thickness (depth in mm), Clark level, ulceration, mitotic rate
  • BRAF V600E mutation testing (present in ~50% — guides targeted therapy)
  • Staging CT (chest, abdomen, pelvis), MRI brain
  • LDH (elevated in metastatic disease — poor prognosis)
Treatment
  • Wide local excision (margins determined by Breslow thickness: 0–1 mm → 1 cm margin; 1–2 mm → 1–2 cm; >2 mm → 2 cm)
  • Immunotherapy: pembrolizumab, nivolumab (anti-PD-1)
  • Targeted therapy: BRAF inhibitors (vemurafenib, dabrafenib) + MEK inhibitors (trametinib, cobimetinib)
  • Radiation for unresectable/metastatic

18. BASAL CELL CARCINOMA (BCC)

Classification
  • Nodular (most common): pearly papule/nodule with rolled border and telangiectasias
  • Superficial: erythematous scaly plaque (multiple lesions)
  • Morphoeic/infiltrative: scar-like, ill-defined (most aggressive local growth)
  • Pigmented BCC
  • Basosquamous
Clinical Features: Pearly or translucent papule/nodule; telangiectasias; rolled border; central ulceration; sun-exposed areas (head, neck)
Diagnosis
  • Clinical + dermoscopy (arborising telangiectasias, blue-grey ovoid nests)
  • Punch/shave biopsy
Lab Analysis
  • Histopathology: basaloid nests with peripheral palisading and retraction artefact
Treatment
  • Surgical excision (gold standard): 3–5 mm margins
  • Mohs micrographic surgery: highest cure rates for high-risk/facial BCC
  • Cryotherapy (superficial, small)
  • Topical imiquimod 5%/PDT (superficial BCC)
  • Curettage and cautery
  • Advanced/inoperable: vismodegib (Hedgehog pathway inhibitor), sonidegib

19. SQUAMOUS CELL CARCINOMA (SCC)

Classification
  • In situ (Bowen's disease — full-thickness epidermal dysplasia)
  • Invasive SCC
  • Verrucous carcinoma
  • Keratoacanthoma (controversial — may be variant)
Clinical Features
  • Hyperkeratotic, indurated nodule with ulceration
  • Actinic keratosis (AK) → SCC in situ (Bowen's) → invasive SCC (progression)
  • High risk: immunosuppressed patients (organ transplant recipients)
Lab Analysis
  • Histopathology: keratin pearls, disordered epidermal proliferation, dermal invasion
Treatment
  • Excision with 4–6 mm margins (standard); Mohs for high-risk sites
  • Radiotherapy (adjuvant or inoperable)
  • Cemiplimab (anti-PD-1) for advanced/metastatic SCC
  • Actinic keratoses: topical 5-FU 5%, imiquimod 5%, diclofenac 3%, PDT, cryotherapy
SCC on chest and ear in skin of colour

20. OTHER BENIGN TUMOURS

LesionFeaturesTreatment
Seborrhoeic keratosis"Stuck-on" waxy papule; older adultsCryotherapy, curettage
DermatofibromaFirm, tan/brown papule; legs; dimple signExcision if symptomatic
Epidermoid cystPunctum, cheesy contentsExcision
LipomaSoft, mobile, subcutaneousExcision
Pyogenic granulomaRapidly growing red papule; bleeds easilyCurettage, excision
HaemangiomaBright red vascular papuleOften involutes; propranolol for infantile
Keloid/hypertrophic scarExcess collagen; extends beyond wound (keloid)Intralesional triamcinolone, silicone, CO₂ laser

PART VIII — AUTOIMMUNE/CONNECTIVE TISSUE DISEASES

21. LUPUS ERYTHEMATOSUS (Cutaneous)

Classification
  • Discoid LE (DLE): chronic, scarring
  • Subacute cutaneous LE (SCLE)
  • Acute cutaneous LE (malar "butterfly" rash = SLE)
  • Neonatal LE
Diagnosis
  • ANA, anti-dsDNA (SLE), anti-Ro/SSA, anti-La/SSB (SCLE)
  • DIF (biopsy): lupus band (IgG, IgM, C3 at DEJ)
Treatment
  • Sunscreen (critical)
  • Topical/intralesional steroids; hydroxychloroquine (mainstay for cutaneous LE, 200–400 mg/day)
  • Severe SLE: systemic immunosuppression (azathioprine, mycophenolate, belimumab)

22. SYSTEMIC SCLEROSIS (SCLERODERMA)

Clinical Features (Skin)
  • Skin thickening (sclerosis): fingers → hands → trunk
  • Raynaud's phenomenon (often first sign)
  • Telangiectasias, calcinosis, fingertip ulcers
  • CREST syndrome: Calcinosis, Raynaud's, oEsophageal dysmotility, Sclerodactyly, Telangiectasias
Diagnosis
  • Anti-centromere antibody (limited), anti-topoisomerase I (anti-Scl-70) (diffuse)

PART IX — VENEREOLOGY (SEXUALLY TRANSMITTED INFECTIONS)

23. SYPHILIS (Treponema pallidum)

Classification (Stages)
StageFeatures
PrimaryPainless, indurated genital ulcer (chancre); painless inguinal lymphadenopathy; heals spontaneously in 3–6 wk
Secondary4–8 wk after chancre: systemic illness, maculopapular rash (palms and soles — pathognomonic), condylomata lata, mucous patches, generalised lymphadenopathy, alopecia
LatentEarly (<1 yr) vs late (>1 yr): asymptomatic
TertiaryGummas (granulomatous), neurosyphilis, cardiovascular (aortitis)
CongenitalEarly/late; Hutchinson's triad: interstitial keratitis, notched incisors, SNHL
Secondary syphilis — palmar rash with Biett's collarette
Secondary syphilis — palmar and cutaneous maculopapular rash with HIV coinfection
Secondary syphilis — oral mucous patches on hard palate
Diagnosis
  • Dark-field microscopy (primary chancre — gold standard for primary)
  • Non-treponemal tests: VDRL, RPR (titre reflects disease activity; becomes negative with treatment)
  • Treponemal tests: TPHA, FTA-ABS, TPPA, CLIA (remain positive for life — confirm diagnosis, cannot monitor treatment)
  • PCR (chancre swab, CSF)
Treatment
  • Primary, secondary, early latent (<1 yr): Benzathine penicillin G 2.4 MU IM stat (single dose)
  • Late latent/tertiary: Benzathine penicillin G 2.4 MU IM weekly × 3 doses
  • Neurosyphilis: IV benzylpenicillin G 18–24 MU/day × 10–14 days
  • Penicillin allergy: doxycycline 100 mg BD × 14 days (not congenital/neurosyphilis — desensitise)
  • Jarisch-Herxheimer reaction: fever/chills/headache 2–8 h post-treatment; manage with paracetamol

24. GONORRHOEA (Neisseria gonorrhoeae)

Clinical Features
  • Males: urethral discharge (yellow-green, purulent), dysuria
  • Females: often asymptomatic; cervicitis, pelvic inflammatory disease (PID)
  • Pharyngeal, anorectal, ocular (neonatal ophthalmia)
  • Disseminated gonococcal infection (DGI): arthritis-dermatitis syndrome — migratory polyarthralgia, tenosynovitis, pustular/haemorrhagic skin lesions
Diagnosis
  • NAAT (nucleic acid amplification test) — gold standard (urine, urethral/cervical/rectal/pharyngeal swab)
  • Culture + sensitivity (essential before treatment if resistance suspected)
  • Gram stain: intracellular Gram-negative diplococci (good sensitivity in males; poor in females)
Treatment
  • Uncomplicated: ceftriaxone 1 g IM single dose (IM is preferred; oral cefixime 400 mg no longer recommended due to resistance in many regions)
  • Pharyngeal gonorrhoea: ceftriaxone 1 g IM (oral agents unreliable)
  • PID: ceftriaxone + doxycycline + metronidazole
  • Penicillinase-producing strains (PPNG): ceftriaxone remains effective; spectinomycin (alternate)
  • Partner notification mandatory; test for concurrent STIs

25. CHLAMYDIA (Chlamydia trachomatis)

Classification
  • Genital chlamydia (serovars D–K): most common bacterial STI
  • Lymphogranuloma venereum (LGV, serovars L1–L3): invasive
  • Trachoma (serovars A–C): eye disease (not STI in usual sense)
Clinical Features
  • Often asymptomatic; urethritis, mucopurulent cervicitis
  • LGV: transient painless genital ulcer → painful inguinal buboes → ano-rectal syndrome (proctitis, strictures in MSM)
LGV — genital ulcerative lesion
Diagnosis
  • NAAT (urine, self-taken vulvovaginal swab — most sensitive)
  • LGV: NAAT with genotyping; serology (complement fixation titre >1:64)
Treatment
  • Uncomplicated genital chlamydia: doxycycline 100 mg BD × 7 days (first-line) or azithromycin 1 g stat
  • LGV: doxycycline 100 mg BD × 21 days
  • Pregnancy: azithromycin 1 g stat or amoxicillin 500 mg TDS × 7 days

26. GENITAL HERPES (HSV-1/HSV-2)

Clinical Features
  • Primary episode: painful grouped vesicles/ulcers on genitalia, perianal area; fever, inguinal lymphadenopathy, dysuria; more severe than recurrences
  • Recurrences: shorter, less severe; prodrome of tingling/burning
  • Neonatal herpes: vertical transmission (peripartum contact)
Diagnosis
  • PCR swab from lesion (gold standard)
  • Viral culture; type-specific serology (HSV-2 IgG seroprevalence)
Treatment
  • First episode: aciclovir 400 mg TDS × 5 days or valaciclovir 1000 mg BD × 5 days
  • Recurrent: aciclovir 800 mg TDS × 2 days or valaciclovir 500 mg BD × 3 days
  • Suppressive therapy: aciclovir 400 mg BD (reduces recurrences and transmission)

27. HUMAN PAPILLOMAVIRUS (HPV) — ANOGENITAL WARTS

Classification
  • Condylomata acuminata (soft, fleshy warts): HPV 6, 11 (low risk)
  • Flat/papular warts: HPV 16, 18, 31, 33 (high-risk — associated with cervical/anal cancer)
  • Bowenoid papulosis, Buschke-Löwenstein tumour (giant condyloma)
Clinical Features
  • Soft, flesh-coloured cauliflower-like papules in anogenital region
  • Often asymptomatic; may itch or bleed
Diagnosis
  • Clinical; biopsy if uncertain or atypical
  • Acetic acid 5% test (acetowhitening — not specific)
  • Cervical cytology, colposcopy, anal cytology (high-risk patients)
Treatment
  • Patient-applied: imiquimod 5% cream × 16 wk; podophyllotoxin 0.5% solution/gel × 4 cycles
  • Clinician-applied: cryotherapy, trichloroacetic acid 80–90% (TCA), electrosurgery, CO₂ laser
  • HPV vaccination (Gardasil-9 — 9 strains): primary prevention (boys and girls 11–13 years)

28. TRICHOMONAS VAGINALIS

Clinical Features
  • Women: frothy yellow-green vaginal discharge, "strawberry cervix," pruritus vulvae, dysuria
  • Men: often asymptomatic; urethritis
Diagnosis
  • NAAT (most sensitive)
  • Wet mount microscopy: motile trichomonads (immediate; 60–70% sensitivity)
  • Culture on Diamond's medium
Treatment
  • Metronidazole 2 g oral stat (or 400 mg BD × 5–7 days)
  • Treat partners simultaneously; avoid alcohol during/48 h after metronidazole

29. CHANCROID (Haemophilus ducreyi)

Clinical Features
  • Painful genital ulcer (contrast with painless syphilis chancre)
  • Ragged undermined edges; dirty grey/yellow necrotic base
  • Tender inguinal lymphadenopathy (bubo) — may suppurate
Diagnosis
  • Clinical; culture on selective medium (low sensitivity)
  • Exclusion of syphilis and herpes
  • PCR (when available)
Treatment
  • Azithromycin 1 g stat, or ceftriaxone 250 mg IM stat
  • Fluctuant buboes: aspiration or incision (prevent rupture)

30. HIV-RELATED DERMATOSES

Classification: HIV causes a wide spectrum of skin manifestations that vary with CD4 count.
CD4 CountCommon Skin Manifestations
AnySeborrhoeic dermatitis (severe), oral candidiasis, hairy leukoplakia
<200Kaposi's sarcoma, molluscum contagiosum (extensive/giant), herpes zoster (multidermatomal), chronic herpes simplex
<50Disseminated MAC, CMV retinitis (periorbital skin changes), bacillary angiomatosis
Kaposi's Sarcoma (KS): Violaceous macules/plaques/nodules; HHV-8; treatment: ART, chemotherapy (liposomal doxorubicin), radiotherapy
Molluscum contagiosum with secondary syphilis coinfection in HIV — umbilicated papules + targetoid plaques
Diagnosis: HIV serology (4th-generation Ag/Ab test), CD4 count, viral load

SUMMARY: KEY LABORATORY INVESTIGATIONS IN DERMATOLOGY & VENEREOLOGY

TestIndication
KOH microscopyFungal infection
Tzanck smearHSV/VZV (not specific)
Wood's lampTinea, erythrasma, vitiligo, pityriasis versicolor
Patch testAllergic contact dermatitis
Prick test/RASTUrticaria, atopic dermatitis
Skin biopsy + H&EBullous diseases, tumours, inflammatory dermatoses
DIFPemphigus, bullous pemphigoid, DLE
Anti-Dsg1/3 ELISAPemphigus
Anti-BP180/BP230Bullous pemphigoid
ANA, anti-dsDNALupus
RPR/VDRL + TPHASyphilis
NAATGonorrhoea, chlamydia, herpes, trichomonas
Dark-field microscopyPrimary syphilis chancre
Wet mountTrichomonas, Candida
FBC, CRPCellulitis, systemic infection
CD4 count/HIV VLHIV-related dermatoses
BRAF mutationMelanoma (targeted therapy selection)

SUMMARY: COMMONLY USED DRUGS IN DERMATOLOGY

Drug ClassExamplesKey Use
Topical corticosteroidsHydrocortisone (mild), betamethasone, clobetasol (potent)Eczema, psoriasis, lichen planus
Topical calcineurin inhibitorsTacrolimus, pimecrolimusEczema (face), oral LP
Topical retinoidsTretinoin, adapaleneAcne, photo-ageing
Systemic retinoidsIsotretinoin, acitretinSevere acne, psoriasis
AntifungalsTerbinafine, itraconazole, fluconazoleDermatophytoses
AntiviralsAciclovir, valaciclovir, famciclovirHSV, VZV
BiologicsDupilumab (IL-4Rα), secukinumab (IL-17), adalimumab (TNF-α), omalizumab (IgE)Severe eczema, psoriasis, urticaria, HS
JAK inhibitorsBaricitinib, ruxolitinib, ritlecitinibAlopecia areata, vitiligo, atopic dermatitis
PenicillinBenzathine pen GSyphilis
CeftriaxoneCeftriaxone 1 g IMGonorrhoea
Doxycycline100 mg BD × 7 dChlamydia, LGV, rosacea
Metronidazole2 g statTrichomonas; topical for rosacea
IvermectinOral 200 µg/kgScabies (crusted/systemic); topical 1% for rosacea
Sources: Dermatology 2-Volume Set 5e (Bolognia et al.); Fitzpatrick's Dermatology 9e (Kang et al.); Andrews' Diseases of the Skin Clinical Dermatology 13e; DermNet NZ clinical image library.

I am disappointed as you haven't shown all list dermatology/ venereology illnesses

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I am intern doctor, please show list of all dermatology and venereology illnesses along with clinical pictures and also mention their clinical classification, management, diagnosis, laboratory analysis and treatment

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acne vulgaris comedones papules pustules nodules face

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psoriasis plaque silvery scales erythematous Auspitz sign elbows knees

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eczema atopic dermatitis flexural lichenification itching child adult

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herpes zoster shingles dermatomal vesicular rash unilateral

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urticaria wheals angioedema hives skin swelling

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scabies burrows interdigital web spaces prurigo nodularis

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melanoma ABCDE asymmetry border color diameter evolution pigmented lesion

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contact dermatitis allergic patch test erythema vesicles

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vitiligo depigmented patches well-demarcated white macules

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