This award-winning picture shows a 72-year old man with Favre-Racouchot syndrome - a disorder consisting of multiple open and closed comedones in actinically damaged skin.
This picture was a silver award winner in the 2009 Institute of Medical Illustrators awards and was taken by Tom Kersey, Royal Gwent Hospital.
This is the latest in our series of clinical pictures which will be published every week. Click here to see all the pictures.