This article focuses on the management of early breast cancer, highlighting recent changes and the role of the general practitioner in supporting women in their decision making and treatment.

This clinical challenge is based on this month’s Focus articles. To complete this activity, go to gplearning and log in with the username and password you use to log in to the RACGP website.

Poikiloderma of Civatte is a common benign condition of the sun-exposed areas of the neck characterised by atrophy, telangiectasia and pigmentation changes.

In children and adolescents, there exist a variety of congenital and acquired naevi and other pigmented skin lesions that can be diagnostically problematic.

Over the past 10 years significant improvements in technology underlying ophthalmic diagnosis and treatment have led to marked improvements in visual outcomes for patients.

General practice registrars use a dermatoscope in a modest majority of skin checks and pigmented skin lesion consultations, which influences registrars’ diagnoses and increases their confidence.

Understanding patient-related factors associated with poor glycaemic control is essential to communicate better with patients, motivate them to self-care and provide better patient-centred care.

Developments in ophthalmic diagnosis and treatment have led to marked improvements in visual outcomes for patients in general practice.

The advice and decision of the general practitioner at the initial presentation of microbial keratitis is crucial for optimal management, with urgent referral potentially sight-saving for the patient.

The aim of this article is to provide a guide to clarifying complaints of visual distortions, outlining the common ocular causes, with a focus on macular pathologies.

Although most eyelid lumps are benign, accurate diagnosis and early recognition of sinister lesions leads to improved patient outcomes.

If a benefit of oral corticosteroids is not proven, then physicians currently prescribing it need to be advised of this finding.

Visual problems commonly reported after concussion can be diagnosed with office-based assessment; with appropriate rehabilitation, the disruption to daily activities can be minimised.

Early diagnosis of superior oblique palsy in general practice can improve visual acuity and prevent complications including torticollis.

Local anaesthetic eye drops have recently been advocated as a safe analgesic following eye injuries, but the evidence is limited and the risks are significant.