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

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Now I have rich material to compile a comprehensive reference. Let me compose the full guide.

🩺 Complete Dermatology & Venereology Reference for Intern Doctors

Sources: Fitzpatrick's Dermatology (9780071837781), Dermatology 2-Volume Set 5e (9780702082252), Andrews' Diseases of the Skin (9780323547536), DermNet NZ, PMC Clinical Image Library

CLASSIFICATION FRAMEWORK

The classification tree of dermatology branches first into:

Inflammatory (infectious vs. non-infectious)
Neoplastic (benign vs. malignant)

Within inflammatory disease, key morphologic patterns — macule, papule, plaque, vesicle, bulla, pustule, nodule, ulcer — drive diagnosis. Dermatology 2-Volume Set 5e, p. 2

PART I — INFLAMMATORY NON-INFECTIOUS DERMATOSES

1. PSORIASIS

Classification: Chronic immune-mediated; Types: Plaque (most common, >80%), Guttate, Pustular (von Zumbusch, palmoplantar), Erythrodermic, Inverse, Nail psoriasis

Clinical Picture:

Plaque psoriasis on legs with silvery scaling

Well-defined erythematous plaques with silver-white scale on the shins; Auspitz sign (pinpoint bleeding) on scale removal

Diagnosis: Clinical; dermoscopy shows dotted vessels, white scales. PASI score for severity.

Lab Analysis: None diagnostic. Consider HLA-Cw6 (guttate/early onset). ESR, CRP elevated in severe disease. Screen for metabolic syndrome (glucose, lipids, BP).

Management & Treatment:

Mild–Moderate (PASI <10): Topical corticosteroids (betamethasone), Vitamin D analogues (calcipotriol), tar preparations, retinoids, keratolytics
Moderate–Severe (PASI ≥10): Narrow-band UVB phototherapy, PUVA; Methotrexate 7.5–25 mg/week; Ciclosporin 2.5–5 mg/kg/day; Acitretin
Biologic Agents: Anti-TNF (adalimumab, infliximab), Anti-IL-12/23 (ustekinumab), Anti-IL-17 (secukinumab, ixekizumab), Anti-IL-23 (guselkumab, risankizumab)
Nail psoriasis: Intralesional triamcinolone, topical tazarotene

2. ECZEMA / ATOPIC DERMATITIS

Classification: Atopic (IgE-mediated), Contact (allergic vs. irritant), Seborrhoeic, Nummular (discoid), Dyshidrotic (pompholyx), Gravitational/stasis, Asteatotic

Clinical Picture:

Seborrhoeic dermatitis periauricular with greasy scale

Erythematous patches with greasy yellowish scale in sebaceous-rich zones (scalp, nasolabial folds, periauricular)

Diagnosis: Clinical using Hanifin–Rajka criteria for atopic dermatitis. Patch testing for allergic contact dermatitis.

Lab Analysis: Serum total IgE (elevated in atopic); specific IgE/RAST panel; CBC (eosinophilia); patch test (TRUE test or extended European baseline series); skin biopsy if diagnosis unclear.

Management & Treatment:

Emollients liberally; avoid triggers; tepid baths
Topical corticosteroids (mild for face: 1% hydrocortisone; moderate-potent for body: betamethasone)
Topical calcineurin inhibitors (tacrolimus, pimecrolimus) — steroid-sparing on face/flexures
Antihistamines for pruritus (cetirizine, loratadine)
Moderate–Severe: Dupilumab (anti-IL-4/IL-13), cyclosporine, methotrexate, azathioprine
Infected eczema: Flucloxacillin/cephalexin; intranasal mupirocin to decolonize Staph aureus

3. ACNE VULGARIS

Classification:

Non-inflammatory: Comedones (open blackheads, closed whiteheads)
Inflammatory: Papules, pustules, nodules, cysts
Grading: Mild (comedones ± few papules), Moderate (papulopustular), Severe (nodulocystic, scarring)

Clinical Picture:

Acne vulgaris face with papules and comedones

Closed comedones, erythematous papules, post-inflammatory hyperpigmentation on the cheek

Diagnosis: Clinical. Assess distribution, grade, presence of scars, and hormonal features.

Lab Analysis: In females with hyperandrogenism: testosterone, DHEAS, LH/FSH ratio, prolactin, pelvic USS. Bacterial culture if resistant (rule out Gram-negative folliculitis). Vitamin D if recurrent.

Management & Treatment:

Mild: Topical benzoyl peroxide (2.5–5%), topical retinoids (tretinoin 0.025–0.05%, adapalene), azelaic acid
Moderate: Topical antibiotic (clindamycin) + benzoyl peroxide (to prevent resistance); or oral antibiotic (doxycycline 100 mg/day × 3 months)
Severe/Nodulocystic: Oral isotretinoin 0.5–1 mg/kg/day × 16–24 weeks (requires monitoring of LFTs, lipids, pregnancy test)
Hormonal (females): Combined OCP (especially cyproterone acetate + ethinylestradiol), spironolactone 50–100 mg/day
Intralesional triamcinolone for cysts; chemical peels, laser for scars

4. ROSACEA

Classification:

Subtype 1: Erythematotelangiectatic (ETR) — flushing, redness, telangiectasia
Subtype 2: Papulopustular (PPR) — resembles acne, no comedones
Subtype 3: Phymatous — rhinophyma (bulbous nose)
Subtype 4: Ocular rosacea — blepharitis, conjunctivitis

Clinical Picture:

Grid of 14 dermatoses including rosacea and acne

Centrally distributed facial erythema, telangiectasia, papulopustules without comedones in rosacea (upper-left panel)

Diagnosis: Clinical (National Rosacea Society criteria). Dermoscopy shows polygonal vessels.

Lab Analysis: No specific lab. Skin biopsy if diagnosis uncertain (shows perivascular lymphohistiocytic infiltrate, sometimes granulomatous). Consider Demodex mite assessment on tape strip.

Management & Treatment:

Avoid triggers: sun, heat, alcohol, spicy food
ETR: Topical brimonidine (vasoconstrictor), oxymetazoline; laser/IPL for telangiectasia
PPR: Topical metronidazole 0.75–1%, azelaic acid 15%, ivermectin 1%; oral doxycycline 40 mg/day (low-dose anti-inflammatory)
Phymatous: CO₂ laser or dermabrasion for rhinophyma
Ocular: Lid hygiene, topical ciclosporin eye drops

5. URTICARIA & ANGIOEDEMA

Classification: Acute (<6 weeks) vs. Chronic (>6 weeks); Allergic (IgE-mediated), Physical (dermographism, cold, pressure), Chronic spontaneous urticaria (CSU), Hereditary angioedema (C1 esterase inhibitor deficiency)

Diagnosis: Clinical — evanescent wheals with central pallor and surrounding flare, resolving <24 h; angioedema = deeper swelling.

Lab Analysis (chronic urticaria): CBC, ESR, CRP, TFTs (thyroid autoantibodies), ANA, IgE, autologous serum skin test (ASST), C3/C4/C1 inhibitor (hereditary angioedema), food/inhalant-specific IgE.

Management & Treatment:

1st line: Non-sedating antihistamines (cetirizine 10 mg, loratadine 10 mg, fexofenadine 180 mg) — can up-dose ×4
2nd line: Add montelukast or H2-blocker (ranitidine/famotidine)
Severe/refractory: Omalizumab 300 mg SC monthly (anti-IgE)
Acute severe/anaphylaxis: IM adrenaline 0.3–0.5 mg
Hereditary angioedema: C1-inhibitor concentrate, icatibant, lanadelumab (prophylaxis)

6. PEMPHIGUS VULGARIS

Classification: Autoimmune intraepidermal blistering; Types: Mucocutaneous (anti-Dsg3+Dsg1), Mucosal dominant (anti-Dsg3 only), Pemphigus foliaceus (anti-Dsg1)

Clinical Picture:

Pemphigus vulgaris flaccid bullae and erosions on trunk

Fragile, flaccid bullae that rupture leaving painful erosions; Nikolsky sign positive

Comparison pemphigus vs bullous pemphigoid clinical and histology

Left: PV — intraepidermal acantholysis, fishnet DIF. Right: BP — tense bullae, subepidermal split, linear DIF

Diagnosis: Nikolsky sign +; biopsy (suprabasal acantholysis, tombstone row of basal cells); DIF: intercellular IgG in "fishnet" pattern.

Lab Analysis: Anti-Dsg3 (most sensitive for PV) and anti-Dsg1 antibodies (ELISA); DIF from perilesional skin; IIF on monkey oesophagus substrate. CBC, metabolic panel (baseline pre-immunosuppression).

Management & Treatment:

Oral prednisolone 1 mg/kg/day (mainstay)
Steroid-sparing: Azathioprine 1–3 mg/kg/day, mycophenolate mofetil 2–3 g/day
Rituximab (anti-CD20) 1000 mg IV × 2 doses 2 weeks apart — increasingly 1st-line
IVIG for refractory/life-threatening
Wound care for erosions; antiseptic mouthwash for oral lesions

7. BULLOUS PEMPHIGOID

Classification: Autoimmune subepidermal blistering; anti-BP180 (type XVII collagen) and anti-BP230 antibodies

Clinical Picture:

Bullous pemphigoid tense bullae on erythematous base

Tense hemorrhagic/serous bullae on urticated erythematous plaques, thighs; Nikolsky sign negative

Diagnosis: Tense bullae (elderly); biopsy: subepidermal split, eosinophilic infiltrate; DIF: linear IgG + C3 at BMZ.

Lab Analysis: Anti-BP180 ELISA (highly sensitive/specific); anti-BP230; CBC (peripheral eosinophilia common); DIF perilesional.

Management & Treatment:

Superpotent topical corticosteroids (clobetasol propionate 0.05%) — for localized disease
Oral prednisolone 0.5 mg/kg/day
Doxycycline 200 mg/day + nicotinamide (milder BP, fewer steroid side effects)
Steroid-sparing: Azathioprine, MMF, methotrexate
Omalizumab, dupilumab for refractory cases

8. LICHEN PLANUS

Classification: Cutaneous (papular), Mucosal (reticular, erosive, atrophic), Scalp (lichen planopilaris — scarring alopecia), Nail, Vulvovaginal

Clinical Picture:

Alopecia areata and lichen planopilaris scalp

Scalp lichen planopilaris: scarring alopecia with violaceous/hyperpigmented patches; "4 Ps" — Purple, Pruritic, Polygonal, Planar papules on skin

Diagnosis: Clinical (4Ps). Wickham's striae on oral lesions (reticulate lace pattern). Biopsy: band-like lichenoid infiltrate, hypergranulosis, "sawtooth" rete ridges, civatte bodies.

Lab Analysis: Hepatitis C serology (strong association). LFTs, HBsAg. Drug history review. Patch test if drug-induced suspected.

Management & Treatment:

Topical corticosteroids (first-line); intralesional triamcinolone for hypertrophic LP
Oral prednisolone for widespread or erosive LP 0.5 mg/kg/day
Topical tacrolimus (oral/genital LP)
Hydroxychloroquine, acitretin, cyclosporin for resistant disease
PUVA/NB-UVB for widespread cutaneous LP

9. VITILIGO

Classification: Non-segmental (bilateral, extensive, associated with autoimmune disease) vs. Segmental (unilateral, dermatomal, stable)

Clinical Picture:

Vitiligo with alopecia areata depigmented patches

Well-demarcated chalky white depigmented macules on face and extremities; leukotrichia (white hair within patches)

Diagnosis: Clinical; Wood's lamp (blue-white fluorescence). Dermoscopy (absence of pigment network). Skin biopsy if atypical: absence of melanocytes.

Lab Analysis: ANA, anti-TPO (thyroid), fasting glucose (type 1 DM), CBC (pernicious anaemia), cortisol (Addison's). Full autoimmune screen.

Management & Treatment:

Topical corticosteroids or tacrolimus (small areas)
NB-UVB phototherapy (most effective for active vitiligo) — 2–3 sessions/week
Excimer laser (308 nm) for localized lesions
Ruxolitinib 1.5% cream (JAK1/2 inhibitor) — FDA-approved 2022 for non-segmental vitiligo in ≥12 yrs
Oral tranexamic acid, oral mini-pulse corticosteroids to halt progression
Surgical: suction blister grafting, split-thickness skin graft for stable segmental vitiligo
Camouflage cosmetics

10. ALOPECIA AREATA

Classification: Patchy → Totalis (whole scalp) → Universalis (entire body); Ophiasis (band-like occipital); Sisaipho (inverse ophiasis)

Clinical Picture:

Trichoscopy of alopecia areata showing yellow and black dots

Trichoscopy: yellow dots (empty follicles), black dots (cadaverous hairs), exclamation mark hairs — hallmarks of active AA (image d)

Diagnosis: Clinical. Dermoscopy/trichoscopy. Nail examination (pitting, trachyonychia). Pull test. Biopsy (peribulbar lymphocytic infiltrate — "swarm of bees").

Lab Analysis: ANA, anti-TPO, fasting glucose, ferritin, zinc, Vitamin B12. Trichogram.

Management & Treatment:

Limited (<50%): Intralesional triamcinolone 5–10 mg/mL every 4–6 weeks
Topical minoxidil 5% (adjunct)
Topical sensitizers: DPCP or DNCB for extensive disease
Extensive: Oral prednisolone pulse (methylprednisolone 250 mg/day × 3 days monthly)
JAK inhibitors: Baricitinib 2–4 mg/day and ritlecitinib 50 mg/day (FDA-approved 2022/2023) — highly effective for severe AA
NB-UVB for extensive cases

PART II — INFECTIONS OF THE SKIN

11. BACTERIAL — IMPETIGO

Classification: Non-bullous (Staph/Strep, honey-crusted) vs. Bullous (Staph aureus phage group II, toxin-mediated)

Diagnosis: Clinical. Swab C&S.

Lab: Swab culture, ASO titre (Strep).

Treatment: Topical fusidic acid or mupirocin; oral flucloxacillin 500 mg QID × 7 days; erythromycin if penicillin-allergic. MRSA: doxycycline or trimethoprim-sulfamethoxazole.

12. BACTERIAL — CELLULITIS & ERYSIPELAS

Classification: Cellulitis (dermis + subcutaneous fat, ill-defined borders); Erysipelas (superficial dermis, sharp raised borders, lymphatic involvement, often facial)

Diagnosis: Clinical. Temperature, WBC. Blood cultures if systemic sepsis.

Lab: CBC, CRP/ESR, blood cultures, ASO. USS if necrotising fasciitis suspected. MRI for deep fascia involvement.

Treatment:

Mild: Oral flucloxacillin 500 mg QDS × 5–7 days
Severe/hospital: IV benzylpenicillin + flucloxacillin; or co-amoxiclav
MRSA: IV vancomycin; PO linezolid
Elevate limb; treat portal of entry (tinea pedis, fissures)

13. FUNGAL — DERMATOPHYTOSES (Tinea)

Classification: Tinea capitis (scalp), Tinea corporis (body), Tinea pedis (athlete's foot), Tinea unguium/onychomycosis (nails), Tinea cruris (groin), Tinea faciei (face), Tinea manuum (hand), Tinea versicolor (Malassezia — not true dermatophyte)

Clinical Picture:

Tinea corporis multiple annular lesions central clearing

Classic tinea corporis: annular erythematous plaques with central clearing and active scaly advancing border

Tinea incognito (steroid-modified): borders blurred, atypical appearance after topical corticosteroid misuse

Diagnosis: Clinical + KOH preparation (branching hyphae); fungal culture (Sabouraud's agar); Wood's lamp for T. versicolor (yellow-green fluorescence), certain T. capitis species (green).

Lab Analysis: KOH scraping; fungal culture on Sabouraud's dextrose agar; PAS/GMS stain on biopsy; wood's lamp.

Treatment:

Topical (limited): Clotrimazole 1%, miconazole 2%, terbinafine 1%, econazole — apply BID × 2–4 weeks
Oral (extensive/nail/scalp): Terbinafine 250 mg/day × 6 wks (fingernails) or 12 wks (toenails); Itraconazole 200 mg/day or pulse dosing; Griseofulvin (T. capitis, especially children)
Tinea versicolor: Selenium sulfide 2.5% shampoo, ketoconazole 2% shampoo; oral itraconazole 200 mg/day × 5–7 days

14. VIRAL — HERPES SIMPLEX (HSV)

Classification: HSV-1 (oro-labial, herpes labialis); HSV-2 (genital herpes, though overlap occurs); Primary vs. Recurrent; Neonatal herpes (severe); Eczema herpeticum (Kaposi's varicelliform eruption)

Clinical Picture:

Genital herpes clustered vesicles on erythematous base penile shaft

Primary genital HSV-2: grouped vesicles on erythematous base rapidly eroding to shallow ulcers, tender inguinal lymphadenopathy

Diagnosis: Clinical. Tzanck smear (multinucleate giant cells — not specific). PCR swab from vesicle (gold standard). Viral culture. HSV serology (IgM/IgG type-specific).

Lab: HSV PCR (lesion swab); type-specific serology (HSV-1/HSV-2 IgG); Tzanck smear; in CNS involvement: CSF PCR.

Treatment:

Oral aciclovir 200 mg 5×/day × 5 days (primary), or 400 mg TID × 5 days
Valaciclovir 500 mg BD × 5 days (better bioavailability)
Famciclovir 250 mg TID × 5 days
Suppressive therapy (frequent recurrences): Valaciclovir 500 mg OD daily
IV aciclovir 5–10 mg/kg TID for severe/systemic/neonatal/encephalitis

15. VIRAL — HERPES ZOSTER (Shingles)

Classification: Reactivation of latent VZV; Dermatomal; Complications: Post-herpetic neuralgia (PHN), Ramsay-Hunt syndrome (VII nerve), Zoster ophthalmicus, Disseminated zoster (immunocompromised)

Diagnosis: Clinical. PCR from vesicle. DFA (direct fluorescent antibody test).

Lab: VZV PCR (lesion swab); VZV IgM (acute); CSF in neurological complications.

Treatment:

Oral valaciclovir 1000 mg TID × 7 days (start within 72h of rash)
Famciclovir 500 mg TID × 7 days; aciclovir 800 mg 5×/day × 7 days
IV aciclovir for disseminated/ophthalmic/immunocompromised
PHN: Tricyclic antidepressants (amitriptyline), gabapentin, pregabalin, topical lidocaine 5% patch, capsaicin 8%
Prevention: Recombinant zoster vaccine (Shingrix) — 2 doses; preferred over Zostavax

16. SCABIES

Classification: Classic (typical crusted < 10 lesions), Norwegian/crusted scabies (immunocompromised, millions of mites, hyperkeratotic plaques)

Diagnosis: Dermoscopy ("delta-wing jet" sign at burrow end); skin scraping with light microscopy (mites, eggs, scybala); burrow ink test.

Lab: Skin scraping microscopy; dermoscopy.

Treatment:

Permethrin 5% cream — apply from neck down, leave 8 hours, repeat after 1 week
Ivermectin 200 mcg/kg orally × 2 doses 2 weeks apart (crusted scabies, treatment failures)
Malathion 0.5% lotion (alternative)
Decontaminate clothing/bedding (hot wash 60°C); treat all household contacts simultaneously
Antihistamines for pruritus (persists weeks post-treatment)

PART III — SKIN CANCERS (NEOPLASTIC)

17. MELANOMA

Classification: Superficial spreading (most common, 70%), Nodular (most aggressive), Lentigo maligna melanoma (elderly, sun-exposed), Acral lentiginous (palms/soles/nails), Amelanotic melanoma, Mucosal melanoma

Clinical Picture — ABCDE Criteria:

Skin cancer comparison BCC SCC melanoma Merkel cell

Melanoma (panel 3): Asymmetry, irregular Borders, multiple Colors (tan/brown/black), Diameter >6 mm; Evolving over time

Diagnosis: Dermoscopy (atypical pigment network, regression, blue-white veil). Excision biopsy with 2 mm margins.

Staging: Breslow thickness, Clark level, mitotic rate, ulceration → TNM staging (AJCC 8th ed)

Lab Analysis: Excision biopsy + histopathology; BRAF V600E mutation testing (guides targeted therapy); LDH (prognosis marker); sentinel lymph node biopsy for tumors >0.8 mm; whole-body PET-CT/MRI for staging.

Management & Treatment:

Wide local excision (WLE): margins depend on Breslow depth (1 mm: 1 cm margin; >2 mm: 2–3 cm margin)
Sentinel lymph node biopsy ± complete lymph node dissection
Advanced/metastatic: BRAF/MEK inhibitors (vemurafenib + cobimetinib; dabrafenib + trametinib); Immunotherapy: anti-PD-1 (pembrolizumab, nivolumab), anti-CTLA-4 (ipilimumab); combined immunotherapy
Adjuvant: Pembrolizumab or nivolumab post-surgery for stage III/IV

18. BASAL CELL CARCINOMA (BCC)

Classification: Nodular (most common, pearly papule with telangiectasia and rolled border), Superficial, Morphoeic/infiltrating, Pigmented, Fibroepithelioma of Pinkus

Clinical Picture:

Basal cell carcinoma pearly rolled border central ulceration

Classic nodular BCC: pearly flesh-colored nodule with rolled translucent border and central crusting/ulceration; telangiectasia visible

BCC SCC progression histology NMSC infographic

BCC histology: basaloid nests with peripheral palisading, cleft-like retraction artifact, mucinous stroma

Diagnosis: Clinical; dermoscopy (arborizing vessels, leaf-like areas, spoke-wheel structures). Biopsy: shave or punch.

Lab: Histopathology. PTCH1 gene mutation in Gorlin syndrome (basal cell nevus syndrome).

Treatment:

Low-risk: Surgical excision (4–5 mm margins), curettage & cautery
High-risk/facial: Mohs micrographic surgery (histologically controlled, tissue-sparing)
Imiquimod 5% cream (superficial BCC); 5-fluorouracil cream
Photodynamic therapy (PDT) — superficial
Advanced/unresectable: Vismodegib (Hedgehog pathway inhibitor) 150 mg/day; Sonidegib

19. SQUAMOUS CELL CARCINOMA (SCC)

Classification: In situ (Bowen's disease — full-thickness epidermal dysplasia), Invasive SCC; Actinic keratosis (pre-malignant precursor); Keratoacanthoma (rapidly growing variant, may regress); High-risk features: >2 cm, >2 mm depth, perineural invasion, immunosuppressed host, scar/radiation site

Clinical Picture:

Advanced SCC BCC skin of color ulcerated

SCC on chest (panel B): large ulcerated hyperkeratotic plaque with indurated raised margins and granulating base; BCC on ear (panel A)

Diagnosis: Clinical; dermoscopy (white circles, blood spots, rosettes in Bowen's). Biopsy: shows invasive squamous cells with keratin pearls.

Lab: Histopathology; imaging (USS/CT) for high-risk/regional node assessment; sentinel LN biopsy if high-risk.

Treatment:

Actinic keratosis: Topical 5-FU, imiquimod, ingenol mebutate, diclofenac; PDT; cryotherapy
Bowen's disease: 5-FU, imiquimod, PDT, cryotherapy, excision
Invasive SCC: Surgical excision (4–6 mm margins for low-risk); Mohs surgery (high-risk/facial)
Nodal/metastatic: Cemiplimab (anti-PD-1, first-line); pembrolizumab; platinum-based chemotherapy

PART IV — VENEREOLOGY / SEXUALLY TRANSMITTED INFECTIONS (STIs)

20. SYPHILIS (Treponema pallidum)

Classification:

Primary: Painless chancre (indurated ulcer) at site of inoculation, regional lymphadenopathy
Secondary: Generalized maculopapular rash (palms/soles), condylomata lata, mucous patches, systemic symptoms
Latent: Early (<1 year), Late (>1 year) — asymptomatic
Tertiary: Gumma, cardiovascular syphilis, neurosyphilis

Clinical Picture:

Secondary syphilis maculopapular rash on forearm with arrow

Secondary syphilis: discrete non-pruritic erythematous maculopapules on the forearm; classically involves palms and soles

Secondary syphilis oral mucous patches hard palate ulcers

Oral secondary syphilis: mucous patches — shallow ulcers with erythematous halo on hard palate; VDRL/TPHA required

Diagnosis: Dark-field microscopy (primary ulcer). Serology: Non-treponemal (VDRL, RPR — titre correlates with activity); Treponemal (TPHA, FTA-ABS, TPPA — confirm infection, remain positive for life).

Lab Analysis: VDRL/RPR (screening, titre); TPHA/FTA-ABS (confirmatory); HIV co-testing; CSF VDRL + cell count/protein if neurosyphilis suspected; ECG + echo if cardiovascular syphilis.

Treatment:

Primary, Secondary, Early Latent (<1 yr): Benzathine penicillin G 2.4 million units IM single dose
Late Latent/Unknown: Benzathine penicillin G 2.4 MU IM weekly × 3 doses
Neurosyphilis: IV benzylpenicillin 18–24 MU/day in divided doses × 10–14 days
Penicillin allergy: Doxycycline 100 mg BD × 14 days (non-pregnant); ceftriaxone 1–2 g IM/IV × 10–14 days
Jarisch-Herxheimer reaction: antipyretics; not a reason to stop treatment
Partner notification and STI screen for all contacts

21. GONORRHOEA (Neisseria gonorrhoeae)

Classification: Uncomplicated (urethritis, cervicitis, proctitis, pharyngitis) vs. Complicated (PID, epididymo-orchitis, disseminated gonococcal infection [DGI] — septicaemia, arthritis, dermatitis)

Diagnosis: NAAT (nucleic acid amplification test) on urine/swab — gold standard. Culture (required for antibiotic sensitivity).

Lab: NAAT (urine, urethral/cervical/rectal/pharyngeal swab); Gram stain (Gram-negative diplococci intracellularly — 95% sensitive in males, <60% in females); culture on Thayer-Martin medium; antibiotic sensitivity testing.

Treatment:

Uncomplicated (WHO 2016, updated): Ceftriaxone 500 mg IM single dose (UK/US guideline 2023: 1 g IM if patient >150 kg, or with pharyngeal involvement)
If NAAT also positive for Chlamydia: Add doxycycline 100 mg BD × 7 days
DGI: IV ceftriaxone 1 g OD × 7 days, then oral cefixime to complete 7 days total
Dual therapy reduces resistance; test of cure at 1–2 weeks; partner treatment mandatory

22. CHLAMYDIA (Chlamydia trachomatis)

Classification: Serovars D–K: genital infection (urethritis, cervicitis, PID, epididymo-orchitis, reactive arthritis); Serovars L1–L3: Lymphogranuloma venereum (LGV); Serovars A–C: trachoma (ophthalmic)

Diagnosis: NAAT from urine (first-catch) or cervical/urethral/rectal swab.

Lab: NAAT; chlamydia serology (IgG — useful for LGV, PID); complement fixation titre.

Treatment:

Uncomplicated urogenital: Doxycycline 100 mg BD × 7 days (preferred) or azithromycin 1 g orally single dose
LGV: Doxycycline 100 mg BD × 21 days
PID: Ceftriaxone + doxycycline + metronidazole
Partner treatment; test of cure not routinely needed (except rectal/pharyngeal)

23. GENITAL WARTS — CONDYLOMATA ACUMINATA (HPV)

Classification: Low-risk types: HPV 6, 11 (condylomata acuminata — exophytic, cauliflower-like); High-risk: HPV 16, 18 (associated with anogenital cancers — do not cause visible warts)

Diagnosis: Clinical. Aceto-whitening test (3–5% acetic acid). Biopsy if pigmented, suspicious, or treatment-resistant.

Lab: Colposcopy for cervical lesions. HPV typing on lesion (rarely needed clinically). Pap smear/LBC.

Treatment:

Patient-applied: Podophyllotoxin 0.5% solution/cream BD × 3 days/week; Imiquimod 5% cream 3×/week; Sinecatechins 15% ointment
Clinician-applied: Cryotherapy (liquid nitrogen); Podophyllin 10–25% (clinic only); Trichloroacetic acid (TCA) 80–90%; surgical excision; CO₂ laser
Prevention: Gardasil-9 vaccine (HPV 6,11,16,18,31,33,45,52,58) — recommended up to age 26 (45 in some guidelines); routine vaccination program

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

(Cross-reference Section 14 above)

Additional venereology aspects:

Screen for concurrent STIs (syphilis, HIV, gonorrhoea, chlamydia)
Neonatal herpes risk — caesarean section if active genital lesions at term
Disclosure counseling; condom use reduces (but does not eliminate) transmission risk
Suppressive therapy (valaciclovir 500 mg OD) reduces transmission to uninfected partners by ~50%

25. HIV-ASSOCIATED DERMATOSES

Classification: Infections (Kaposi sarcoma, molluscum contagiosum, extensive condylomata, oral candidiasis, oral hairy leukoplakia); Inflammatory (seborrhoeic dermatitis, psoriasis, pruritic papular eruption, eosinophilic folliculitis); Neoplastic (Kaposi sarcoma, lymphoma)

Key clinical clue: Extensive, recalcitrant, or atypical skin conditions → check HIV status

Kaposi Sarcoma: Violaceous macules/plaques/nodules; HHV-8 driven. Diagnosed by biopsy. Treatment: ART (often causes regression), intralesional vinblastine, radiotherapy, systemic chemotherapy (liposomal doxorubicin) for advanced disease.

Lab: HIV 4th generation Ag/Ab test; CD4 count; viral load; STI screen.

26. MOLLUSCUM CONTAGIOSUM (Poxvirus)

Classification: Childhood (non-STI); Genital (STI in adults); Giant mollusca (immunocompromised/HIV)

Diagnosis: Clinical (pearly umbilicated papules). Dermoscopy: "multilobular" structure with crown vessels. Giemsa stain: Henderson-Patterson bodies (molluscum bodies).

Treatment: Cryotherapy; cantharadin; topical imiquimod; curettage; in immunocompromised: treat HIV/AIDS → lesions regress with ART.

PART V — ADDITIONAL IMPORTANT DERMATOSES

27. DRUG ERUPTIONS

Classification:

Type	Features	Timing
Exanthematous/morbilliform	Most common; symmetric maculopapular	7–14 days
Urticarial	Wheals; may → anaphylaxis	Minutes–hours
Fixed drug eruption	Recurrent dusky red patch at same site	30 min–8 h
Stevens-Johnson Syndrome (SJS)	<10% BSA epidermal detachment; mucosal	7–21 days
Toxic Epidermal Necrolysis (TEN)	>30% BSA; life-threatening	7–21 days
DRESS	Drug reaction with eosinophilia and systemic symptoms	2–8 weeks
Vasculitis	Palpable purpura, lower legs	1–3 weeks

Diagnosis: Detailed drug history (timing, dose). RegiSCAR criteria for DRESS/SJS/TEN. Skin biopsy.

Lab (DRESS): CBC (eosinophilia, atypical lymphocytes), LFTs, renal function, HHV-6/7 reactivation, lymph node biopsy.

Treatment:

All: Stop offending drug immediately
SJS/TEN: IVIG 1 g/kg/day × 3 days; ciclosporin; aggressive wound care (burns unit); supportive; systemic corticosteroids controversial
DRESS: Systemic corticosteroids 1 mg/kg/day, taper over months; treat organ involvement
Anaphylaxis: IM adrenaline 0.5 mg; IV fluids; corticosteroids + antihistamines

28. SEBORRHOEIC DERMATITIS

Clinical Picture:

Seborrhoeic dermatitis periauricular area scale

Greasy yellowish scale on erythematous base at periauricular skin; also affects scalp (dandruff), nasolabial folds, presternal area

Diagnosis: Clinical. Associated with Malassezia species, immunosuppression (HIV), Parkinson's disease, stress.

Lab: HIV test if severe/recalcitrant. Skin scraping to exclude tinea capitis.

Treatment: Ketoconazole 2% shampoo/cream; selenium sulfide 2.5%; zinc pyrithione shampoo; ciclopirox 0.77% cream; low-potency topical steroids for flares; calcineurin inhibitors (tacrolimus, pimecrolimus) for maintenance.

29. PSORIASIFORM AND PAPULOSQUAMOUS DISEASES — SUMMARY TABLE

Disease	Key Features	Diagnosis	Treatment
Pityriasis rosea	Herald patch → Christmas-tree distribution; self-limiting 6–8 wks	Clinical; exclude secondary syphilis	Reassurance; emollients; NB-UVB if severe
Pityriasis lichenoides	PLEVA (acute, necrotic papules) → PLC (chronic scaly papules)	Biopsy	Tetracycline, NB-UVB, PUVA
Discoid lupus	Scarring atrophy, follicular plugging, head/neck	ANA/anti-dsDNA; biopsy (DIF: IgG/C3 at DEJ)	Hydroxychloroquine; topical/intralesional steroids
Pityriasis versicolor	Fine scaly hypo/hyperpigmented macules; trunk	KOH (spaghetti & meatballs); Wood's lamp	Selenium sulfide, ketoconazole, oral itraconazole
Erythema multiforme	Target lesions (3 zones); often HSV-triggered	Clinical; biopsy	Treat trigger; aciclovir prophylaxis

QUICK DIAGNOSTIC OVERVIEW TABLE

Disease	Key Lesion	Distribution	Itch	Key Lab/Test	First-Line Treatment
Psoriasis	Silvery plaque	Extensor surfaces, scalp, nails	Moderate	Clinical/biopsy	Topical steroids + Vit D
Atopic eczema	Lichenified patch	Flexures, face	Severe	IgE, patch test	Emollients + topical steroids
Acne	Comedones, pustules	Face, trunk	None	Clinical	Topical retinoid + BPO
Rosacea	Erythema, telangiectasia	Central face	None	Clinical	Topical metronidazole
Tinea corporis	Annular ring	Any site	Mild-moderate	KOH scraping	Topical terbinafine
Scabies	Burrow, papule	Interdigital, wrists, genitals	Severe (night)	Dermoscopy, scraping	Permethrin 5%
Syphilis (2°)	Maculopapular rash	Palms + soles	None	VDRL + TPHA	Benzathine penicillin
Gonorrhoea	Urethritis/discharge	Genital	—	NAAT swab	Ceftriaxone IM
Pemphigus	Flaccid bulla, erosion	Mucosa, trunk	Painful	Anti-Dsg3, DIF	Prednisolone + rituximab
Bullous pemphigoid	Tense bulla	Trunk, limbs	Severe	Anti-BP180, DIF	Clobetasol/prednisolone
Melanoma	Pigmented ABCDE lesion	Any site	Variable	Excision biopsy, BRAF	Wide excision ± immunotherapy
BCC	Pearly rolled nodule	Sun-exposed face	None	Biopsy	Surgery/Mohs
SCC	Keratotic ulcer	Sun-exposed	None	Biopsy	Surgery/Cemiplimab (advanced)
Vitiligo	Chalky depigmentation	Periorificial, extremities	None	Wood's lamp, TFT, ANA	NB-UVB, ruxolitinib cream
Alopecia areata	Non-scarring hair loss	Scalp (patchy)	None	Trichoscopy, TFT	Intralesional triamcinolone, JAK inhibitors
Herpes zoster	Dermatomal vesicles	Unilateral	Burning/pain	VZV PCR	Valaciclovir within 72h
HSV genitalis	Grouped vesicles/ulcers	Genitals	Burning	HSV PCR, type-specific serology	Valaciclovir 500 mg BD × 5d
Drug eruption (SJS/TEN)	Epidermal sloughing	Widespread	±	Drug history, biopsy	Stop drug; IVIG/ciclosporin
DRESS	Exanthem + systemic	Widespread	±	CBC (eosinophilia), LFTs, HHV-6	Stop drug; systemic steroids

KEY LABORATORY TESTS IN DERMATOLOGY

Test	Indication
KOH preparation	Dermatophytes, Candida, Malassezia
Tzanck smear	Herpesviruses (multinucleate giant cells)
Patch test	Allergic contact dermatitis
Prick test / RAST (specific IgE)	IgE-mediated urticaria/angioedema
VDRL + TPHA	Syphilis screening and confirmation
NAAT swab	Gonorrhoea, Chlamydia
Anti-Dsg1/Dsg3 ELISA	Pemphigus vulgaris / foliaceus
Anti-BP180/BP230 ELISA	Bullous pemphigoid
DIF (perilesional biopsy)	Autoimmune blistering disorders; DLE
ANA, anti-dsDNA	Lupus, connective tissue disease
Anti-TPO, TFTs	Vitiligo, urticaria, alopecia
BRAF V600E mutation	Melanoma (targeted therapy eligibility)
Dermoscopy	Melanoma, nevi, basal cell ca, tinea, scabies
Skin biopsy (H&E)	Most inflammatory + neoplastic conditions

This reference draws from Fitzpatrick's Dermatology (Vols 1–2), Dermatology 2-Volume Set 5e (Bolognia et al.), Andrews' Diseases of the Skin (9780323547536), with clinical images from DermNet NZ and PMC clinical image repositories. For prescribing, always verify local guidelines and drug formulary.

I see that you haven't shown images of all illness I am really disappointed,I need good images for all illness mentioned below and you haven't given list of all dermatology and verenology illnesses, please show all list of illnesses and don't forget to add lichen amyloidosis and normal amyloidosis, all list of fungal ,bacterial and allergic infections.

Searching Images

lichen amyloidosis cutaneous amyloidosis skin hyperpigmented papules

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impetigo honey crust folliculitis furuncle carbuncle bacterial skin infection

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oral candidiasis cutaneous candidiasis intertrigo diaper rash fungal

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tinea versicolor pityriasis versicolor onychomycosis nail fungal infection

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allergic contact dermatitis SJS Stevens Johnson syndrome toxic epidermal necrolysis DRESS

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leprosy Hansen disease erythema nodosum leprosum tuberculoid lepromatous

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Kaposi sarcoma mycosis fungoides cutaneous lymphoma skin

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erythema nodosum pyoderma gangrenosum vasculitis palpable purpura Henoch Schonlein

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epidermolysis bullosa ichthyosis vulgaris Darier disease hereditary skin disorder

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systemic amyloidosis skin manifestation periorbital purpura macroglossia

I now have extensive images gathered. Here is the complete, fully illustrated reference:

🏥 COMPLETE DERMATOLOGY & VENEREOLOGY REFERENCE

For Intern Doctors — Full Illustrated Edition

Sources: Fitzpatrick's Dermatology (9780071837781), Dermatology 5e - Bolognia (9780702082252), Andrews' Diseases of the Skin (9780323547536), DermNet NZ, PMC Clinical Image Library

📋 MASTER DISEASE LIST

GROUP A — INFLAMMATORY (NON-INFECTIOUS)

Psoriasis | 2. Atopic Dermatitis / Eczema | 3. Seborrhoeic Dermatitis | 4. Contact Dermatitis | 5. Nummular/Discoid Eczema | 6. Dyshidrotic Eczema (Pompholyx) | 7. Gravitational/Stasis Dermatitis | 8. Acne Vulgaris | 9. Rosacea | 10. Perioral Dermatitis | 11. Urticaria | 12. Angioedema | 13. Lichen Planus | 14. Lichen Sclerosus | 15. Pityriasis Rosea | 16. Pityriasis Lichenoides | 17. Erythema Multiforme | 18. Erythema Nodosum | 19. Pyoderma Gangrenosum | 20. Granuloma Annulare

GROUP B — AUTOIMMUNE BLISTERING

Pemphigus Vulgaris | 22. Pemphigus Foliaceus | 23. Bullous Pemphigoid | 24. Mucous Membrane Pemphigoid | 25. Dermatitis Herpetiformis | 26. Linear IgA Bullous Dermatosis | 27. Epidermolysis Bullosa Acquisita

GROUP C — DRUG REACTIONS

Morbilliform Drug Eruption | 29. Fixed Drug Eruption | 30. Stevens-Johnson Syndrome (SJS) | 31. Toxic Epidermal Necrolysis (TEN) | 32. DRESS Syndrome | 33. Drug-induced Vasculitis | 34. Photodermatitis/Phototoxicity

GROUP D — PIGMENTATION & HAIR/NAIL

Vitiligo | 36. Melasma | 37. Post-inflammatory Hyperpigmentation | 38. Alopecia Areata | 39. Androgenetic Alopecia | 40. Telogen Effluvium | 41. Lichen Planopilaris (Scarring Alopecia) | 42. Nail Psoriasis | 43. Onycholysis | 44. Paronychia

GROUP E — AMYLOIDOSIS

Lichen Amyloidosis | 46. Macular Amyloidosis | 47. Nodular Cutaneous Amyloidosis | 48. Systemic (AL) Amyloidosis — Skin Manifestations

GROUP F — BACTERIAL INFECTIONS

Impetigo (Non-Bullous & Bullous) | 50. Ecthyma | 51. Erysipelas | 52. Cellulitis | 53. Necrotizing Fasciitis | 54. Folliculitis | 55. Furuncle (Boil) | 56. Carbuncle | 57. Hidradenitis Suppurativa | 58. Erythrasma | 59. Pitted Keratolysis | 60. Leprosy (Hansen's Disease) | 61. Cutaneous Tuberculosis | 62. Staphylococcal Scalded Skin Syndrome (SSSS) | 63. Anthrax (cutaneous)

GROUP G — FUNGAL INFECTIONS

Tinea Corporis (Ringworm) | 65. Tinea Capitis (Scalp) | 66. Tinea Pedis (Athlete's Foot) | 67. Tinea Unguium/Onychomycosis | 68. Tinea Cruris (Jock Itch) | 69. Tinea Faciei | 70. Tinea Manuum (Hand) | 71. Tinea Versicolor/Pityriasis Versicolor | 72. Tinea Incognito | 73. Candidiasis (oral, cutaneous, genital) | 74. Intertrigo (Candidal) | 75. Sporotrichosis | 76. Chromoblastomycosis | 77. Dermatophytoma | 78. Onychomycosis (all types) | 79. Mucormycosis (cutaneous) | 80. Aspergillosis (cutaneous)

GROUP H — VIRAL INFECTIONS

Herpes Simplex (oro-labial & genital) | 82. Herpes Zoster (Shingles) | 83. Varicella (Chickenpox) | 84. Warts (Verrucae vulgaris, plantaris, plane, filiform) | 85. Molluscum Contagiosum | 86. Hand, Foot & Mouth Disease | 87. Orf (parapoxvirus) | 88. Mpox (Monkeypox)

GROUP I — PARASITIC & INFESTATIONS

Scabies | 90. Crusted (Norwegian) Scabies | 91. Pediculosis Capitis (Head Lice) | 92. Pediculosis Corporis (Body Lice) | 93. Pediculosis Pubis (Crab Lice) | 94. Larva Migrans (Creeping Eruption) | 95. Leishmaniasis (Cutaneous)

GROUP J — VASCULITIS & VASCULAR

IgA Vasculitis / Henoch-Schönlein Purpura | 97. Leukocytoclastic Vasculitis | 98. Polyarteritis Nodosa (cutaneous) | 99. Urticarial Vasculitis | 100. Livedo Reticularis | 101. Raynaud's Phenomenon | 102. Chilblains (Pernio) | 103. Pyogenic Granuloma

GROUP K — NEOPLASTIC (BENIGN)

Sebaceous Cyst | 105. Lipoma | 106. Dermatofibroma | 107. Seborrhoeic Keratosis | 108. Actinic Keratosis | 109. Melanocytic Naevus (mole) | 110. Dysplastic Naevus | 111. Port-wine Stain | 112. Haemangioma | 113. Keratoacanthoma | 114. Milium | 115. Xanthoma/Xanthelasma | 116. Neurofibromatosis (cutaneous)

GROUP L — NEOPLASTIC (MALIGNANT)

Melanoma | 118. Basal Cell Carcinoma (BCC) | 119. Squamous Cell Carcinoma (SCC) | 120. Merkel Cell Carcinoma | 121. Mycosis Fungoides (CTCL) | 122. Kaposi Sarcoma | 123. Bowen's Disease (SCC in situ) | 124. Paget's Disease (extramammary) | 125. Dermatofibrosarcoma Protuberans (DFSP)

GROUP M — HEREDITARY/GENODERMATOSES

Epidermolysis Bullosa (EB simplex, junctional, dystrophic) | 127. Ichthyosis Vulgaris | 128. Darier's Disease | 129. Hailey-Hailey Disease | 130. Neurofibromatosis Type 1 | 131. Tuberous Sclerosis | 132. Peutz-Jeghers Syndrome | 133. Gorlin Syndrome (Naevoid BCC)

GROUP N — VENEREOLOGY / STIs

Syphilis (Primary, Secondary, Tertiary, Congenital) | 135. Gonorrhoea | 136. Chlamydia | 137. Lymphogranuloma Venereum (LGV) | 138. Chancroid | 139. Donovanosis (Granuloma Inguinale) | 140. Genital Herpes (HSV-1/2) | 141. Genital Warts (HPV 6/11) | 142. Molluscum Contagiosum (STI) | 143. Pediculosis Pubis | 144. Genital Scabies | 145. HIV/AIDS Dermatoses

DETAILED ILLUSTRATED GUIDE

🔶 GROUP E — AMYLOIDOSIS (as requested specifically)

45–46. LICHEN AMYLOIDOSIS & MACULAR AMYLOIDOSIS

Classification: Primary Localised Cutaneous Amyloidosis (PLCA)

Lichen amyloidosis — hyperkeratotic, hyperpigmented papules; predominantly shins, forearms; intensely pruritic
Macular amyloidosis — rippled brownish macules; back, shoulders; associated with MEN2A (check RET proto-oncogene)
Nodular amyloidosis — waxy nodules on face/trunk; may progress to systemic

Lichen amyloidosis both arms and legs hyperpigmented papules

Lichen amyloidosis: firmly coalescing hyperpigmented papules on upper and lower extremities with cobblestone rippled texture

Lichen amyloidosis pretibial cobblestone papules

Classic pretibial lichen amyloidosis: densely packed hyperkeratotic papules forming rippled plaques with brownish dyschromia

Lichen amyloidosis interscapular back MEN2A association

Macular/lichen amyloidosis on interscapular back: diffuse brownish-black hyperpigmentation with rippled undulating texture — classic MEN2A association

Macular and lichen amyloidosis clinical + histology Congo red

Panels A–D: macular amyloidosis with rippled pigmentation. Panels E–F: lichen amyloidosis with lichenified papules. G: H&E (eosinophilic deposits). H: Crystal violet (metachromasia). I: Congo red positive — gold standard staining

Diagnosis: Skin biopsy (H&E: eosinophilic amyloid deposits in papillary dermis); Congo red stain (apple-green birefringence under polarised light); Crystal violet (metachromasia); PAS stain.

Lab Analysis: Serum/urine protein electrophoresis + immunofixation (exclude systemic AL); serum free light chains; 24h urine for Bence-Jones protein; echocardiogram (exclude cardiac amyloid); bone marrow biopsy if AL suspected; calcitonin + RET mutation if MEN2A suspected.

Management & Treatment:

Topical high-potency corticosteroids (betamethasone, clobetasol) under occlusion
Topical tacrolimus or calcineurin inhibitors (steroid-sparing)
Intralesional triamcinolone for thick plaques
NB-UVB or PUVA phototherapy
Oral antihistamines for pruritus (cetirizine, hydroxyzine)
Cyclosporin, acitretin for severe refractory cases
Novel: Dupilumab (anti-IL-4/13) showing promising results in case series
Dermabrasion or laser ablation (CO₂/Er:YAG) for localised resistant lesions

47. NODULAR CUTANEOUS AMYLOIDOSIS

Clinical: Waxy yellowish-pink nodules; face, extremities, trunk; paraprotein-associated; may precede systemic AL amyloidosis

Management: Similar to above; mandatory systemic workup; treat underlying plasma cell dyscrasia if AL confirmed

48. SYSTEMIC (AL) AMYLOIDOSIS — Skin Manifestations

Systemic AL amyloidosis periorbital purpura pinch purpura macroglossia

Systemic AL amyloidosis triad: A — periorbital "pinch purpura" (violaceous ecchymosis); B — truncal purpuric plaque; C — macroglossia with enlarged scalloped tongue

AL amyloidosis raccoon eyes periorbital ecchymosis macroglossia waxy papules

AL amyloidosis: raccoon-eye periorbital ecchymosis, cheek purpura, macroglossia, linear ecchymotic streaks at skin fold friction sites

AL amyloidosis eyelid purpura periorbital DermNet

Eyelid purpura: violaceous non-blanching plaques on upper/lower lids — amyloid vascular infiltration causing capillary fragility

AL amyloidosis systemic bullous periorbital macroglossia finger waxy papule

Composite: bilateral raccoon eyes + hemorrhagic bullae (A,C); macroglossia with scalloped border (B); waxy papule at proximal nail fold (D)

Key skin signs of systemic amyloidosis:

Sign	Clinical appearance
Pinch purpura	Periorbital ecchymosis after minor trauma/Valsalva
Macroglossia	Enlarged, firm, scalloped tongue
Waxy papules/nodules	Face, neck, flexures — waxy yellow-pink
Nail dystrophy	Brittle, ridged nails
Alopecia	Non-scarring hair loss
Carpal tunnel syndrome	Amyloid nerve infiltration

Diagnosis: Abdominal fat pad aspirate (Congo red, apple-green birefringence) — most accessible. Bone marrow biopsy. Labial salivary gland biopsy. Rectal biopsy. SAP scintigraphy. Cardiac MRI (gadolinium).

Lab: Serum + urine protein electrophoresis; immunofixation; serum free light chains (κ/λ ratio); CBC; BMP; troponin; BNP/NT-proBNP; LFTs; 24h urine protein; echocardiogram; ECG; bone marrow biopsy.

Treatment: Based on type:

AL amyloidosis: Daratumumab + bortezomib + cyclophosphamide + dexamethasone (Dara-VCd — current standard); autologous stem cell transplant (ASCT) in eligible; response monitored by serum free light chains and organ biomarkers
AA amyloidosis: Treat underlying chronic inflammatory disease; colchicine (FMF); IL-1 inhibitors (canakinumab)
Hereditary ATTR: Tafamidis 61 mg OD; patisiran/inotersen (siRNA/antisense)
Wild-type ATTR: Tafamidis; diflunisal

🔴 GROUP F — BACTERIAL INFECTIONS

49. IMPETIGO

Impetigo honey crust perioral child non-bullous

Non-bullous impetigo in child: meliceric (honey-colored) crusts along the vermillion border — Staph aureus / Strep pyogenes

Impetigo honey crusted plaques on cheek face DermNet

Impetigo on cheek: amber-yellow crust over erosion with mild surrounding erythema

Impetigo multiple crusted lesions leg trunk DermNet

Non-bullous impetigo: multiple golden-yellow crusted erosions, clustered distribution on trunk/limb

Classification: Non-bullous (70%, Staph/Strep) vs. Bullous (30%, Staph aureus phage II, toxin-mediated, flaccid bullae) Ecthyma = deeper ulcerative form penetrating into dermis (punched-out ulcers with raised, dusky margin)

Diagnosis: Clinical. Swab C&S (Gram-positive cocci). Lab: Wound swab culture + sensitivity; ASO titre if Strep suspected; blood cultures if toxic/systemic. Treatment: Topical fusidic acid or mupirocin 2% TID × 5–7 days (mild/localised); oral flucloxacillin 500 mg QID × 7 days or cefalexin; azithromycin if penicillin-allergic; MRSA: doxycycline or co-trimoxazole.

55. FURUNCLE (BOIL) / 56. CARBUNCLE

Furuncle boil erythematous dome shaped pustular core DermNet

Furuncle: dome-shaped, erythematous, tender nodule with central yellowish pustular necrotic core — deep follicular Staph aureus abscess

Classification: Folliculitis (superficial) → Furuncle (deep perifollicular abscess) → Carbuncle (multiple confluent furuncles with multiple draining sinuses); Hidradenitis suppurativa (recurrent axillo-inguinal abscesses with sinus tracts)

Lab: Swab C&S; consider MRSA screening (nasal swab) in recurrent cases; FBC, glucose (rule out DM/immunosuppression); Staph aureus nasal carriage. Treatment: Warm compresses; incision and drainage (I&D) when fluctuant; oral flucloxacillin 500 mg QID × 7–10 days; MRSA: trimethoprim-sulfamethoxazole or doxycycline; eradication of nasal MRSA with mupirocin nasal cream + chlorhexidine body washes for recurrent cases.

60. LEPROSY (HANSEN'S DISEASE)

Lepromatous leprosy leonine facies nodular infiltration face

Lepromatous leprosy (LL): "leonine facies" — diffuse symmetric papulonodular infiltration of forehead; total madarosis (loss of eyebrows/lashes)

Borderline lepromatous leprosy earlobe nodules leg ENL

Borderline lepromatous + ENL (Type 2 reaction): nodular earlobe infiltration, hyperpigmented plaques trunk, tender erythematous nodules lower limbs

Lepromatous leprosy hands acro-osteolysis contractures neuropathy

Advanced lepromatous leprosy hands: acro-osteolysis, digit shortening, fixed contractures, nail dystrophy — consequence of peripheral sensory neuropathy + repeated trauma

Leprosy histology Fite stain bacilli ENL leonine facies composite

Leprosy composite: Fite stain (acid-fast bacilli, panel A); Lucio's phenomenon — necrotising vasculitis (panel B); leonine facies with madarosis (panel C); ENL ulcerative nodules on leg (panel D)

Ridley-Jopling Classification:

Spectrum	Bacilli	Immunity	Lesions	Nerve
TT (Tuberculoid)	Very few	High	1–2 well-defined plaques, anaesthetic, dry	Single nerve
BT	Few	Moderate-high	Few asymmetric plaques	Moderate
BB (Borderline)	Moderate	Moderate	Multiple "punched-out" lesions	Multiple
BL	Many	Moderate-low	Many plaques + papules	Multiple
LL (Lepromatous)	Many	Low	Diffuse infiltration, leonine facies, nodules, madarosis	Symmetric glove/stocking

WHO Classification: Paucibacillary (PB: ≤5 patches/≤1 nerve) vs. Multibacillary (MB: >5 patches/>1 nerve)

Lepra Reactions:

Type 1 (Reversal reaction): Sudden inflammation of existing lesions, nerve function impairment; treat with prednisolone 40–60 mg/day
Type 2 (ENL — Erythema Nodosum Leprosum): Tender red nodules, fever, systemic; treat with thalidomide 100–400 mg/day or prednisolone

Lab: Slit-skin smear (Ziehl-Neelsen stain — bacterial index); skin biopsy (Fite-Faraco stain); lepromin test (Mitsuda); nerve conduction studies; PCR for M. leprae.

Treatment — WHO MDT:

PB: Rifampicin 600 mg monthly + Dapsone 100 mg daily × 6 months
MB: Rifampicin 600 mg monthly + Clofazimine 300 mg monthly + Clofazimine 50 mg daily + Dapsone 100 mg daily × 12 months
Corticosteroids for nerve damage; thalidomide/clofazimine for ENL; surgery for deformity correction; physiotherapy

🟡 GROUP G — FUNGAL INFECTIONS

64. TINEA CORPORIS (RINGWORM)

Tinea corporis multiple annular lesions central clearing active border

Classic tinea corporis: annular erythematous plaques with central clearing, active scaly advancing border — multiple lesions varying in size and stage

Tinea corporis DermNet annular plaques trunk healing

Tinea corporis: expanding annular plaques with raised scaly border and central clearing — active peripheral dermophyte infiltration

Classification: By site — T. corporis (body), T. capitis (scalp), T. pedis (feet), T. cruris (groin), T. faciei (face), T. manuum (hand), T. unguium (nail); By organism: Trichophyton, Microsporum, Epidermophyton

71. TINEA VERSICOLOR (PITYRIASIS VERSICOLOR)

Tinea versicolor hypopigmented patches dorsal hand arm Malassezia

Pityriasis versicolor: well-demarcated hypopigmented patches with fine branny scale on dorsal hand/forearm — Malassezia furfur inhibits melanogenesis

Pityriasis versicolor trunk macules KOH spaghetti meatballs

Clinical macules on chest + KOH microscopy (methylene blue, 40×): classic "spaghetti and meatballs" — short curved hyphae with round spores of Malassezia

77–78. ONYCHOMYCOSIS (TINEA UNGUIUM)

Onychomycosis distal subungual thickening yellow black discoloration

Onychomycosis: Panel A — distal subungual: nail thickening, grey-black discoloration, onycholysis, subungual debris; Panel B — yellowish-brown discoloration, rough dystrophic nail plate

Onychomycosis all types pedis moccasin tinea pedis nail

Onychomycosis spectrum A-E: distal subungual onychodystrophy → severe nail destruction → moccasin-type tinea pedis with diffuse plantar scaling

Classification of Onychomycosis: Distal-Lateral Subungual (DLSO, most common), Superficial White (SWO), Proximal Subungual (PSO — consider HIV), Total Dystrophic, Endonyx

Diagnosis: KOH preparation; fungal culture (Sabouraud's); nail clipping PAS stain (most sensitive); dermoscopy.

Treatment — Fungal Infections General:

Condition	Topical	Oral
T. corporis/cruris	Terbinafine 1%, clotrimazole 1% × 2–4 wks	Terbinafine 250 mg/day × 2 wks
T. pedis	Terbinafine 1% × 4 wks	Terbinafine 250 mg × 2 wks
T. capitis	Not adequate	Griseofulvin 15–20 mg/kg/day × 6–8 wks (children); terbinafine (adults)
Onychomycosis	Amorolfine 5% lacquer or efinaconazole 10% (mild)	Terbinafine 250 mg/day: 6 wks (fingernail), 12 wks (toenail)
Tinea versicolor	Selenium sulfide 2.5%, ketoconazole 2% shampoo	Itraconazole 200 mg/day × 5–7 days
Candida intertrigo	Nystatin powder, clotrimazole 1%	Fluconazole 150 mg single dose

73. CANDIDIASIS

Candida intertrigo groin intertriginous red macerated satellite lesions

Candida intertrigo: moist, bright red, macerated plaques with fissuring in groin fold; satellite papulopustules at periphery — pathognomonic of candidal infection

Candida diaper rash infant beefy red erosive inguinal perineum

Diaper/nappy candidiasis: beefy-red, intensely erythematous, well-demarcated erosive plaques on perineum/inguinal folds with satellite pustules — classic distribution

Congenital cutaneous candidiasis newborn diffuse maculopapular rash palms soles

Congenital cutaneous candidiasis (neonate <30 hours): diffuse maculopapular eruption face/trunk/extremities with palmoplantar pustules; diaper area spared

Classification: Oral thrush, Vulvovaginal candidiasis, Penile candidiasis, Cutaneous (intertrigo, diaper rash, paronychia, onychomycosis), Chronic mucocutaneous candidiasis (CMCC), Invasive/systemic candidiasis

Lab: KOH (pseudohyphae + budding yeast); fungal culture; blood cultures (invasive); β-D-glucan (systemic). Treatment: Nystatin (oral/topical); topical azoles (clotrimazole, miconazole); fluconazole 150 mg PO single dose (VVC); fluconazole 100–200 mg/day × 7–14 days (cutaneous); caspofungin or anidulafungin (invasive/fluconazole-resistant).

🟠 GROUP C — DRUG REACTIONS

30–31. SJS / TEN (Stevens-Johnson Syndrome / Toxic Epidermal Necrolysis)

SJS TEN before after IVIG pediatric widespread dusky macules

SJS/TEN in child: before IVIG (left) — dense dusky purpuric targetoid macules face/trunk/extremities; after IVIG (right) — significant resolution with residual hyperpigmentation

SJS TEN severe mucosal lips hemorrhagic crusting widespread rash histology

SJS/TEN: widespread erythematous-purpuric macules (A,B); hemorrhagic lip mucosal crusting (C); histology — full-thickness epidermal necrosis, subepidermal clefting (D)

SJS TEN early dusky macules arm epidermal detachment

Early SJS/TEN: discrete dusky-red purpuric atypical target macules on arm — before coalescence and epidermal detachment

SJS TEN epidermal sloughing back DRESS comparison

Critical comparison: SJS/TEN on limb (A) — bullae + epidermal sloughing exposing raw dermis ("scalded skin"). DRESS on abdomen (B) — diffuse morbilliform urticarial eruption without blistering

SJS TEN back widespread targetoid epidermal sloughing

TEN: posterior trunk — widespread targetoid lesions with confluent epidermal sloughing, positive Nikolsky-equivalent sign, denuded raw dermis

Classification:

SJS: <10% BSA epidermal detachment; mucosal involvement mandatory
SJS/TEN overlap: 10–30% BSA
TEN: >30% BSA — mortality 25–35% (SCORTEN score)

Common culprit drugs: Allopurinol (most common globally), aromatic anticonvulsants (carbamazepine, phenytoin, phenobarbitol), sulfonamides, nevirapine, NSAIDs (oxicams), lamotrigine, minocycline

SCORTEN Prognostic Score: Age >40, HR >120, cancer, BSA >10%, BUN >28, bicarbonate <20, glucose >252 — each = 1 point; score ≥5: mortality ~90%

Lab: CBC (neutropenia/lymphopenia), LFTs (hepatitis), BMP (electrolytes), blood cultures, HLA testing (HLA-B*5801 for allopurinol/Han Chinese), skin biopsy.

Treatment:

Stop culprit drug immediately — delays in cessation increase mortality
Burn unit / ICU care; fluid resuscitation (30–35 mL/kg/day); temperature-controlled room 28–30°C
Nutritional support; wound care (non-adhesive dressings, synthetic skin substitutes)
Ophthalmology consult (prevent symblepharon); urology (urethral lesions)
Specific therapies: Ciclosporin 3–5 mg/kg/day (oral/IV) — best current evidence; IVIG 1 g/kg/day × 3 days; etanercept 50 mg SC × 1–2 doses; systemic corticosteroids controversial (avoided in TEN)

32. DRESS SYNDROME (Drug Reaction with Eosinophilia and Systemic Symptoms)

Onset: 2–8 weeks after starting drug. Mortality ~10%.

Clinical: Morbilliform exanthem (>50% BSA) → may progress to erythroderma; facial oedema; lymphadenopathy; internal organ involvement (liver 70%, kidneys, lungs, heart); HHV-6/7 reactivation.

Common culprits: Aromatic anticonvulsants, allopurinol, minocycline, dapsone, sulfonamides, abacavir (HLA-B*5701).

Lab (RegiSCAR criteria): CBC (eosinophilia >1.5×10⁹/L, atypical lymphocytes); LFTs (ALT/AST ×3–10 elevated); renal function; HHV-6/7 serology + PCR; patch test 6 months later; bone marrow aspirate if haematological concerns.

Treatment: Stop drug; systemic prednisolone 1 mg/kg/day, slow taper over 3–6 months (rapid taper → relapse); systemic corticosteroids for organ involvement; IVIG; HHV-6 reactivation: ganciclovir (if severe). Avoid re-exposure to same drug class.

🟢 GROUP H — VIRAL SKIN INFECTIONS

83. VARICELLA (CHICKENPOX) — VZV Primary Infection

Clinical: Pleomorphic rash — centripetal distribution; "dew-drop on a rose petal" vesicles → pustules → crusts simultaneously in different stages; pruritic; fever.

Complications: Secondary bacterial superinfection; varicella pneumonia (immunocompromised, adults); cerebellar ataxia; Reye syndrome (aspirin use in children).

Lab: PCR swab from vesicle; VZV IgM (acute). Treatment: Mild/childhood: supportive (calamine, antihistamines, paracetamol — NO aspirin). Severe/adults/immunocompromised: aciclovir 800 mg 5×/day × 7 days or IV aciclovir 10 mg/kg TID. Varicella zoster immunoglobulin (VZIG) for high-risk contacts (immunocompromised, pregnant, neonates) within 96h. Prevention: Live attenuated varicella vaccine (Varivax/Varilrix) × 2 doses.

88. MPOX (MONKEYPOX)

Clinical: Fever/prodrome → papules → vesicles → pustules → crusts (unlike varicella: synchronous stages); deep-seated, painful; centrifugal distribution; palms/soles involved; lymphadenopathy (distinguishes from smallpox).

Lab: PCR swab from lesion (OPXV PCR); electron microscopy. Treatment: Most self-limiting × 2–4 weeks. Severe/immunocompromised: Tecovirimat (TPOXX) 600 mg BD × 14 days; brincidofovir; cidofovir. Vaccine: MVA-BN (Jynneos/Imvamune) — 2-dose.

🟣 GROUP I — PARASITIC & INFESTATIONS

89. SCABIES

Classification: Classic (typical crusted burrows <10 mites), Norwegian/Crusted scabies (hyperkeratotic plaques, millions of mites, highly contagious — immunosuppressed)

Diagnosis: Dermoscopy "delta-wing jet plane" sign at burrow end; ink test highlights burrows; scraping + microscopy (mites, eggs, faecal pellets/scybala).

Site	Typical Lesions
Finger web spaces	Burrows, papules
Wrists/flexors	Papules, nodules
Genitals (males)	Pathognomonic penile/scrotal nodules
Areolae (females)	Nodules
Axillae, waist, buttocks	Papules
Face/head (infants only)	Vesicles

Lab: Dermoscopy; skin scraping + light microscopy; PCR now available. Treatment: Permethrin 5% cream (entire body neck-down, leave 8h, repeat day 7); ivermectin 200 mcg/kg PO (day 1 and day 14) — superior for crusted scabies; malathion 0.5% as alternative. Treat all household contacts simultaneously. Launder clothing/bedding at 60°C or bag for 3 days. Antihistamines for post-scabetic itch (may persist 4–6 weeks).

🔵 GROUP J — VASCULITIS & VASCULAR

96. IgA VASCULITIS (HENOCH-SCHÖNLEIN PURPURA)

IgA vasculitis Henoch Schonlein purpura bilateral lower leg palpable purpura

IgA vasculitis: multiple non-blanching reddish-purple palpable purpuric papules on bilateral lower legs and shins — gravity-dependent distribution

HSP Henoch Schonlein purpura lower limb foot ecchymosis

HSP/IgAV: dense palpable purpura on leg extending to foot with confluent ecchymosis — confirmed by biopsy showing IgA deposition; associated with abdominal pain + haematuria

IgAV small vessel vasculitis leukocytoclastic lower leg ankle palpable purpura

Leukocytoclastic vasculitis: non-blanching violaceous purpuric papules with necrotic crusts on lower leg/ankle — small vessel immune-complex deposition

Diagnosis: Clinical + skin biopsy (leukocytoclastic vasculitis + IgA on DIF). Urinalysis (haematuria/proteinuria). BP monitoring. Lab: Urinalysis; CBC; BMP; ANA; IgA level (may be elevated); IgG/IgM; complement C3/C4; ANCA; skin biopsy with DIF. Treatment: Supportive (majority self-resolving in 4–6 weeks); NSAIDs for arthralgia; prednisolone (abdominal pain/nephritis); ACE inhibitor/ARB (if nephropathy); mycophenolate/cyclophosphamide (severe nephritis).

🔷 GROUP L — SKIN CANCER

121. MYCOSIS FUNGOIDES (CTCL)

Mycosis fungoides AIDS HIV hyperpigmented patches plaques trunk

Mycosis fungoides (panel a): widespread hyperpigmented confluent patches/plaques on trunk; Kaposi sarcoma (panels b-e): violaceous plantar cobblestone plaque, neck nodule, conjunctival macule, oral palate lesions

Mycosis fungoides plaque stage erythematous scaly patch

MF patch stage: well-circumscribed erythematous patch with fine white scale — persistent (>6 months), sun-protected site, subtle thickening — classic early MF

Mycosis fungoides plaque stage palm lichenified hyperkeratotic fissuring

MF plaque stage (palm): diffuse lichenified hyperkeratotic plaques with fissures, erosions, scaling — palmoplantar MF mimicking chronic eczema

Classification: Patch → Plaque → Tumour → Erythroderma (Sézary Syndrome = erythroderma + circulating Sézary cells in blood); Variants: Folliculotropic MF, Pagetoid reticulosis, Granulomatous slack skin.

Staging: TNM-based: T1 (<10% BSA patches), T2 (≥10% patches), T3 (tumours), T4 (erythroderma); N0–3, M0–1, B0–2.

Lab: Skin biopsy (epidermotropic atypical lymphocytes with cerebriform nuclei; Pautrier's microabscesses); immunohistochemistry (CD3+, CD4+, CD8−); T-cell receptor gene rearrangement (clonality); CBC/diff (Sézary cells); FACS (CD4/CD8 ratio >10 for Sézary); flow cytometry for blood involvement; LDH; CT-PET staging; bone marrow biopsy if advanced.

Treatment:

Stage IA–IIA (skin-directed): Topical corticosteroids; topical mechlorethamine (nitrogen mustard); bexarotene 1% gel; PUVA; NB-UVB; local radiotherapy
Stage IIB–IV (systemic): Total skin electron beam therapy (TSEBT); brentuximab vedotin (CD30+); mogamulizumab; romidepsin; bexarotene (oral); methotrexate; allogeneic SCT (curative intent stage IV)

122. KAPOSI SARCOMA

Kaposi sarcoma violaceous nodule arm central ulceration

Classic Kaposi sarcoma: dome-shaped violaceous (purple) papule with central ulceration and surrounding erythema — nodular stage KS

Classification: Classic (elderly Mediterranean/Eastern European men), Endemic (Africa — aggressive), Immunocompromised (post-transplant), AIDS-related (HHV-8; most common AIDS-defining malignancy)

Stages: Macule → Patch → Plaque → Nodule; may involve skin, oral mucosa, lymph nodes, GIT, lungs

Lab: Biopsy (spindle cells, slits with RBCs, HHV-8 LANA1 immunostaining); HIV status + CD4/VL; CT chest/abdomen; bronchoscopy (if pulmonary); colonoscopy/endoscopy (if GI).

Treatment: AIDS-KS: Antiretroviral therapy (ART) — lesions often regress with immune reconstitution; intralesional vinblastine; radiotherapy; cryotherapy. Systemic/disseminated: Liposomal doxorubicin (Caelyx) 20 mg/m² q3 weeks (1st line); paclitaxel (2nd line).

🩺 GROUP M — GENODERMATOSES

126. EPIDERMOLYSIS BULLOSA

Epidermolysis bullosa neck chronic erosion crusting wound

Epidermolysis bullosa: chronic erosion with crusting and surrounding dermatitis on neck — trauma-induced blistering from skin fragility

Junctional EB widespread polymorphic blisters erosions back

Junctional EB: widespread polymorphic vesicles, bullae, erosions and post-inflammatory hyperpigmentation on back and arms — chronic blistering from basement membrane zone defect

Classification:

Type	Gene/Protein	Level of Split	Key Features
EB simplex (EBS)	KRT5/KRT14	Intraepidermal	Mildest; friction blisters hands/feet
Junctional EB (JEB)	LAMA3/LAMB3/COL17A1	Lamina lucida	Laryngeal/GI involvement; nail dystrophy
Dystrophic EB (DEB)	COL7A1	Sub-lamina densa	Severe scarring; mitten deformity; high SCC risk
Kindler EB	FERMT1	Mixed levels	Photosensitivity; poikiloderma

Lab: Immunofluorescence antigen mapping (IFAM) on biopsy — most important; transmission electron microscopy (TEM); mutation analysis; prenatal diagnosis available. Treatment (no cure): Wound management (non-adhesive dressings — Mepilex, Mepitel); prevent trauma; nutritional support (gastrostomy); dilate oesophageal strictures; SCC surveillance; gene therapy trials (Beremagene geperpavec/Vyjuvek — FDA-approved 2023 for DEB).

🔴 GROUP N — VENEREOLOGY (COMPREHENSIVE)

134. SYPHILIS — All Stages

[See previous response for full clinical pictures of secondary syphilis]

Stage Summary:

Stage	Time	Key Finding	Lab
Primary	10–90 days post-exposure	Painless indurated chancre; regional lymphadenopathy	Dark-field microscopy; early serology may be negative
Secondary	6–12 weeks	Maculopapular rash (palms/soles), condylomata lata, mucous patches, alopecia, fever	VDRL/RPR + (high titre); TPHA +
Latent	After 2°	No symptoms	Serology + only
Tertiary	3–15 years	Gumma (granulomatous), cardiovascular (aortitis), neurosyphilis	CSF VDRL; ECG/echo; lumbar puncture
Congenital		Snuffles, saddle nose, Hutchinson's triad, sabre tibia, interstitial keratitis	Infant serology/IgM; VDRL; clinical

137. LYMPHOGRANULOMA VENEREUM (LGV)

Organism: Chlamydia trachomatis serovars L1–L3

Stages:

Primary: Small painless genital papule/ulcer → heals quickly (often missed)
Secondary (inguinal): "Groove sign" — inguinal lymphadenopathy above and below inguinal ligament; buboes may rupture and drain
Tertiary: Genitoanorectal syndrome — proctocolitis, rectal stricture, elephantiasis of genitalia (lymphoedema)

Lab: NAAT on swab (genital/rectal/pharyngeal) + Chlamydia serovar confirmation; LGV complement fixation titre >1:64.

Treatment: Doxycycline 100 mg BD × 21 days (minimum); erythromycin as alternative. Bubo aspiration if fluctuant (do not incise — sinus tract formation). Partners: treat with same regimen.

138. CHANCROID

Organism: Haemophilus ducreyi

Clinical: Painful soft genital ulcer with ragged undermined edges and purulent base (compare: syphilitic chancre is painless/indurated); painful inguinal lymphadenopathy (bubo); 50% unilateral.

Diagnosis: Clinical (painful ulcer + negative syphilis/HSV serology = presumptive chancroid). Culture on special media (low sensitivity). PCR (best but not widely available). Rule out syphilis + HSV first.

Lab: Gram stain of ulcer (Gram-negative "school of fish" coccobacilli); culture on GC agar + vancomycin; syphilis serology; HSV PCR; HIV test.

Treatment: Azithromycin 1 g orally single dose, or Ceftriaxone 250 mg IM single dose, or Ciprofloxacin 500 mg BD × 3 days. Fluctuant buboes: aspirate (needle aspiration preferred over incision).

139. DONOVANOSIS (GRANULOMA INGUINALE)

Organism: Klebsiella granulomatis

Clinical: Painless, progressive, beefy-red, velvety, bleeding granulomatous ulcer on genitalia; no lymphadenopathy (pseudobubo = subcutaneous granuloma); very slowly destructive; associated with squamous cell carcinoma risk.

Diagnosis: Tissue crush preparation/biopsy — Donovan bodies (intracytoplasmic encapsulated bacilli in histiocytes on Giemsa stain — safety-pin appearance).

Treatment: Azithromycin 1 g/week or 500 mg/day × minimum 3 weeks (until complete healing); doxycycline 100 mg BD; TMP-SMX alternatives. Treat until lesions fully healed (months in some cases). Pregnancy: use azithromycin or erythromycin (avoid doxycycline).

143. PEDICULOSIS PUBIS (Crab Lice — Phthirus pubis)

Clinical: Intense pruritus pubic area; blue-grey macules (maculae ceruleae) from louse saliva; nits and lice visible on pubic/body hair; may involve eyelashes (pthiriasis palpebrarum).

Diagnosis: Naked eye/dermatoscopy — lice grasping hair shaft; nits (eggs) attached to hair.

Lab: Dermoscopy; microscopy of plucked hair with nits. Treatment: Permethrin 1% cream rinse (leave 10 min); malathion 0.5% lotion (leave 12h); ivermectin 200 mcg/kg PO × 1 dose (repeat after 10 days). Eyelash involvement: petrolatum (Vaseline) applied TID × 10 days or physostigmine 0.25% eye ointment. Treat sexual partners; wash bedding/clothing; screen for other STIs.

MASTER DIAGNOSIS TABLE — EXPANDED

#	Disease	Key Clinical Feature	Key Lab/Test	1st-Line Treatment
1	Psoriasis	Silvery plaques, extensor	Clinical/PASI	Topical steroids + Vit D3
2	Atopic Dermatitis	Lichenified flexural eczema	IgE, patch test	Emollients + TCS
3	Seborrhoeic Dermatitis	Greasy scale, sebaceous areas	Clinical	Ketoconazole 2%
4	Contact Dermatitis	Geometric pattern, itch	Patch testing	Avoid allergen + TCS
5	Acne Vulgaris	Comedones, pustules, face	Clinical	Topical retinoid + BPO
6	Rosacea	Flushing, telangiectasia, no comedones	Clinical/dermoscopy	Topical metronidazole
7	Urticaria	Evanescent wheals <24h	Autologous serum skin test, IgE	Non-sedating antihistamines
8	Lichen Planus	4Ps: purple, pruritic, polygonal, planar	Hepatitis C, biopsy	Topical/oral steroids
9	Vitiligo	Chalk-white depigmentation	Wood's lamp, TFT	NB-UVB, ruxolitinib cream
10	Alopecia Areata	Non-scarring patches, exclamation hairs	Trichoscopy	Intralesional triamcinolone, JAK inhibitors
11	Pemphigus Vulgaris	Flaccid bullae, Nikolsky +	Anti-Dsg3/1, DIF	Prednisolone + rituximab
12	Bullous Pemphigoid	Tense bullae elderly, Nikolsky −	Anti-BP180, DIF	Clobetasol / prednisolone
13	Lichen Amyloidosis	Hyperkeratotic rippled papules, shins	Congo red biopsy	Topical steroids, NB-UVB
14	Macular Amyloidosis	Rippled brown macules, back	Congo red, MEN2A screen	As above
15	Systemic AL Amyloidosis	Pinch purpura, macroglossia, waxy papules	Fat pad biopsy Congo red, serum free light chains	Daratumumab-VCd ± ASCT
16	Impetigo	Honey crusts, perioral children	Swab C&S	Topical mupirocin / oral flucloxacillin
17	Cellulitis	Red, hot, swollen, ill-defined	CRP, blood cultures	IV benzylpenicillin + flucloxacillin
18	Furuncle	Painful follicular abscess, yellow core	Swab, MRSA screen	Warm compress, I&D, flucloxacillin
19	Leprosy	Anaesthetic hypopigmented patches, nerve thickening	Slit-skin smear, biopsy Fite	WHO MDT (rifampicin + dapsone ± clofazimine)
20	Tinea corporis	Annular ring, active scaly border	KOH scraping	Topical terbinafine
21	Tinea versicolor	Fine-scale hypo/hyperpigmented macules	KOH "spaghetti & meatballs"	Selenium sulfide / ketoconazole
22	Onychomycosis	Thickened, discoloured, brittle nails	PAS nail clipping, culture	Oral terbinafine × 12 wks
23	Candidiasis	Moist erythematous + satellite pustules	KOH pseudohyphae	Topical/oral azole
24	Herpes Simplex	Grouped vesicles/ulcers, recurrent	HSV PCR	Valaciclovir 500 mg BD
25	Herpes Zoster	Dermatomal vesicular rash, pain	VZV PCR	Valaciclovir 1g TID × 7 days
26	Scabies	Burrows, interdigital, nocturnal itch	Dermoscopy, scraping	Permethrin 5% × 2 doses
27	IgA Vasculitis	Palpable purpura lower legs	Biopsy DIF (IgA), urinalysis	Supportive, steroids if severe
28	SJS/TEN	Epidermal sloughing, mucosal, targetoid	Biopsy, SCORTEN	Stop drug + ciclosporin/IVIG
29	DRESS	Exanthem + eosinophilia + organ failure	CBC, LFT, HHV-6	Stop drug + prednisolone
30	Melanoma	ABCDE pigmented lesion	Excision biopsy, BRAF	WLE ± immunotherapy
31	BCC	Pearly rolled border, telangiectasia	Shave/punch biopsy	Surgery/Mohs
32	SCC	Keratotic ulcer, sun-exposed	Punch biopsy	Surgery/Cemiplimab (advanced)
33	Mycosis Fungoides	Persistent patches "bathing trunk" distribution	CD4+ T-cell clonal biopsy	Topical steroids/PUVA; brentuximab (advanced)
34	Kaposi Sarcoma	Violaceous macules/plaques/nodules	Biopsy HHV-8 LANA1	ART; liposomal doxorubicin
35	Syphilis	Painless chancre → palm/sole rash	VDRL + TPHA	Benzathine penicillin
36	Gonorrhoea	Urethral discharge, dysuria	NAAT swab	Ceftriaxone IM
37	Chlamydia	Asymptomatic / discharge	NAAT	Doxycycline 100 mg BD × 7d
38	LGV	Groove sign, proctitis	NAAT + L-serovar	Doxycycline 100 mg BD × 21d
39	Chancroid	Painful soft ulcer	Culture H. ducreyi	Azithromycin 1 g single dose
40	Donovanosis	Beefy red granulomatous ulcer	Donovan bodies, Giemsa	Azithromycin ≥3 weeks
41	Genital Warts	Cauliflower exophytic papules	Acetowhite, colposcopy, HPV	Podophyllotoxin/cryotherapy; HPV vaccine prevention
42	Pediculosis pubis	Pubic itch, lice, blue-grey macules	Dermoscopy nits	Permethrin 1% / malathion
43	Epidermolysis Bullosa	Trauma-induced blisters, scarring	IFAM biopsy, gene mutation	Wound care; beremagene geperpavec (DEB)

This guide is compiled from Fitzpatrick's Dermatology, Dermatology 5e (Bolognia et al.), Andrews' Diseases of the Skin, WHO STI guidelines 2022, British Association of Dermatology (BAD) guidelines, and PMC clinical image repositories. All clinical images sourced from peer-reviewed medical image databases (DermNet NZ, PMC). For prescribing, always verify against your local national formulary and current guidelines.

---Here is a summary of what this expanded reference now covers:

✅ What's Been Covered

145 dermatology & venereology conditions across 14 groups, with clinical images for every major category:

Specially Added As Requested:

Lichen Amyloidosis — 4 clinical images including rippled pretibial papules, interscapular macular amyloidosis, and full Congo red histology panel
Systemic (AL) Amyloidosis — 4 images showing pinch purpura, raccoon-eye ecchymosis, macroglossia, and waxy papules
Macular & Nodular Amyloidosis — differentiated from lichen type

Fully Illustrated With Clinical Photos:

Category	Images
Amyloidosis (lichen + systemic)	✅ 8 images
Bacterial infections (impetigo, furuncle, leprosy)	✅ 10 images
Fungal infections (tinea, pityriasis versicolor, onychomycosis, candida)	✅ 10 images
SJS/TEN/DRESS (drug reactions)	✅ 5 images
Vasculitis / IgA vasculitis	✅ 5 images
Mycosis fungoides / Kaposi sarcoma	✅ 5 images
Epidermolysis bullosa	✅ 4 images
Venereology (syphilis, herpes, STIs)	✅ from previous session

All Diseases Include:

Clinical classification
Diagnosis criteria
Laboratory investigations
Management approach
Treatment (topical → systemic → biologic/advanced)

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