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next question what is the question telling us come let's read it together it's basically a small child presents with small high pigment red scaly Mike use on the cheek friends also have similar vision what is the diagnosis so basically the text is just telling us that it's a child who has these scaly hyper pigmented lesions on the cheeks what is the diagnosis if it is hypo pigmented mckuhn on the face or maybe the body what could be the possible differentials one possible differential is P Alba second partial possible differential is P versicolor or maybe here I should take it as in the terminate leprosy third would be P versicolor fourth will be P Rosia this would be the main differentials in case of a hypo pigmented my Q now let us go through them P and one being mainly seen on face in a child it will be hypo pigmentation there will be no signs and symptoms and it will be episodic there might be history of a topi in the patient in indeterminate leprosy this will also be a face it will be a child and these will be multiple occasions this will generally be a solitary lesion this will be hypo pigmented scaling may or may not be there sensation will be normal and this will generally be a resident of the heart or any other endemic area and it might self resolve okay P versicolor will be predominantly on the upper body which includes chest plus back face may sometimes be involved then these lesions will again be high popping mental these will be scaly but they will have more of polycyclic margins there will be multiple lesions and these will also be episodic increase in summers this will increase in winters okay and here you will have typical Koh appearance and would slap appearance okay Pierrot Xia will have history of a hair ironed patch and these will actually be added the meters not hyper pigmented these will be added the meters annular plaques with choler 8 scaling with your Christmas tree appearance right so this is what you have to know when a lesion which is hyper pigmented on the face on the upper body comes to you in the exam the Alber will almost always be on the face of a child there will be a fine scaling multiple lesions episodic is there there's a history of allergic to Nancy they will keep coming and going and it is just a form of endogenous eczema doesn't require any treatment okay this will be mainly a solitary lesion hypo pigmented despite being leprosy sensation will be normal in this patient it will be an endemic area in the history as a resident of bihar and jharkhand or Chattisgarh and 75% of indeterminate leprosy resolves on their own okay P versicolor upward body chest and back polycyclic increase in summers spaghetti and meatball appearance on K which a pale blue or a pale green appearance on the woods lamp okay clear how do you treat you treated with topical and oral and different girls P rosea is a tall patch Colorado scaling you know it very well right so this is about these kind of lesions I hope I have made it clear for you please go through this page it is very important one of these food is always there in the exam so we come back to the question what do we see here we see that it's a child lesions are there on the face they are multiple they are hyper pigmented and scaly there is something in this question which is trying to confuse you it is trying to tell you that other friends have it so it might be an infection but no it is not an infection it is normal for a lot of children to have it the diagnosis here is P and the rest of the are the three options we've already discussed clear to everyone yes got any doubts

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