Sandbox:AyeshaFJ

Acne vulgaris
Clinical features	Comedonal acne: Closed or open comedones on forehead, nose and chin. Inflammatory acne: Small, erythematous papules and pustules. Nodular acne: Large painful nodules; sinus tracts and scarring.
Pathogenesis	Hyperkeratinization and obstruction of the pilosebacous follicles. Sebaceous gland enlargement and increased sebum production. Metabolism of sebaceous lipids by Cutibacterium acnes and release of inflammatory fatty acid. Follicular inflammation and rupture,
Risk factors	i) Increased circulating androgen (e.g. PCOS, puberty) ii) Mechanical trauma/friction (excessive scrubbing, tight clothing) iii) Comedogenic oil based skin and hair products. iv) Excessive heat. v) Obesity

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Criteria for the diagnosis of SLE
Clinical features	Characteristics
1)Malar rash	Fixed erythema, flat or raised, sparing the nasolabial folds
2)Discoid rash	Erythematous raised patches with adherent keratotic scarring and follicular plugging.
3)Photosensitivity	Rash due to unusual reaction to sunlight.
4)Oral ulcer	Oral or nasopharyngeal ulcers, which may be painless.
5)Arthritis	Non-erosive arthritis, involving >2 peripheral joints.
6)Serositis	Pleuritis or pericarditis
7)Renal disorder	Persistent proteinura ( >0.5g/24hrs) or cellular casts (red cell, granular or tubular).
8)Neurological disorder	Seizure or psychosis, in the absence of provoking drugs or metabolic derangement.
9)Hematological disorder	Haemolytic anemia or leucopenia (<4 x109) or lymphopenia (<1x109) or thrombocytopenia (<100x109) in the absence of offending drugs.
10)Immunological	Abnormal titre of Anti-DNA antibodies or presence of Sm antigen or positive antiphospholipid antibodies.
11)Anti-nuclear Antibody (ANA)	Abnormal ANA titre measured by immunofluorescence
Diagnosis of SLE is made in an adult if 4 out of 11 features are present either serially or simultaneously.

• Erythematous raised patches with adherent keratotic scarring and follicular plugging.

Congenital anomalies of the urinary system

Kidneys

Renal pelvis

Ureter

Renal agenesis

Duplication of renal pelvis

Duplication of ureter

Renal ectopia

Congenital megaureter

Horseshoe kidney

Post-caval ureter

Unilateral fusion

Ureterocele

Congenital cystic kidney

Infantile polycystic kidney

Unlilateral Multicystic Kidney

Simple cyst of the kidney

Aberrant renal vessels

T

Mycosis fungoides

Stage IA-IIA

Stage IIA

Stage III

Stage IV

• Expectane policy • Topical steroides [IV-A] • nb-UVB[III,A] • PUVA [III-A] • Topical mechlorethamine [II,B] • Local RT [IV,A]

• Skin direct therapy(SDT) + local radiotherapy • ST[III+A] • (SDT+) retiods[III,B] • (SDT+) IFN a {III,B] • TSEBT [III,A]

• (SDT+) retinoides • (SDT+) IFNa • ECPI INFa +/- rtinoides • Low dose MTX • [IV-B]

• Gemcitabine • Liposomal doxorubicin • Brentuximab vedotin[II,B]

• (SDT+) retinoides [III,B] • (SDT+) IFNa [III,B] • Retinoides +IFN a [II,B] • TSEBT [IV,A]

• Gemcitabin [IV,B] • Liposomal doxorubicin [IV,B] • Brentuximabvedotin [II,B] • Combinatio Cht [Iv,B] • AlloSCT[V,C]

TSEBT[LV,B]

• Combination Cht [IV,B] • AlloSCT [V,C]