Medical dermatology

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Unit 620

March 2025

Medical dermatology

The purpose of this activity is to provide an understanding of the assessment and treatment of patients with both acute and chronic skin issues.

Dermatology concerns represent approximately 17% of all general practice presentations. General practitioners require a wide range of knowledge and skills to assess and treat patients with both acute and chronic skin issues. Despite this, undergraduate dermatology education is commonly underrepresented, and many general practitioners lack the confidence to effectively diagnose and manage dermatological complaints. This contributes to a high prevalence of referrals to dermatologists, whose workforce is in substantial shortage and geographically favours urban areas, leading to long wait times and significant expense.

Learning outcomes

At the end of this activity, participants will be able to:
  • outline the assessment of a patient presenting with symptoms suggestive of hidradenitis suppurativa
  • describe the approach to managing a patient with Mycobacterium ulcerans, including any public health considerations 
  • discuss the differential diagnoses considered when a patient presents with vulval pain and the investigations that can help differentiate between these conditions 
  • outline the treatment of polymorphic eruption of pregnancy and commonly associated post-inflammatory pigmentation
  • discuss the prognosis and management of bullous pemphigoid, including any comorbidities that are important to consider.

Case studies

Below is a list of the case studies found in this month's unit of check. To see how these case studies unfold and gain valuable insights into this month's topic, log into gplearning to complete the course. 

Jess, a woman aged 24 years, attends your surgery complaining of recurrent, painful lumps in her groin near her genitals. She says she has had this problem since she was a teenager but is worried that things are getting worse. Some of the lesions have been there for a long time and intermittently become painful and inflamed. Sometimes they release purulent discharge and Jess has to wear sanitary pads to protect her clothes; occasionally she even stays home from work. She is worried about scarring in the area, and it is affecting her relationship with her partner.

Una, a woman aged 38 years, presents with a 15-mm ulcerated lesion on her left lateral thigh. The lesion initially presented two months prior as a small erythematous papule. It has gradually enlarged since then, eventually becoming ulcerated. Una describes the ulcer as mildly itchy at times but otherwise asymptomatic. Initially, she thought it was an insect bite and trialled over-the-counter topical corticosteroid cream, but this did not provide any significant improvement.

Carla, a woman aged 60 years, presents with a history of vulval pain for the past nine months. She also describes dyspareunia, which has been affecting her relationship with her partner. To cope with this stress, she has started smoking cigarettes again.

Lidia, a woman aged 26 years and pregnant with her first child, is an existing patient of your practice in a metropolitan suburb. She has had an uncomplicated pregnancy. However, at 32 weeks’ gestation, she noticed itchy, raised and red lesions on her abdomen. The lesions are intensely itchy and have been interfering with her sleep. You notice that there are erythematous papules and plaques with overlying excoriation marks over her lower abdomen.

Bill, aged 84 years, presents with his wife with six weeks of widespread blisters. Bill resides in an aged care home. Bill and his wife are concerned the rash is progressively worsening.

TOPICS

Medical dermatology

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