Dermatology

Question 1

atopic eczema when and who

Answer 1

1 in 5 children in UK
80% before 5

Question 2

atopic eczema pathophysiology

Answer 2

impairment of epidermis - due to mutation of FLG gene encoding filaggrin gene…the protein contributes to stratum corneum
so allergens penetrate…IgE sensitisation, pathogen entry + water loss

Question 3

more T helper 2 cells (compared to 1)

Answer 3

more production of IgE…more mast cell hypersensitivity

Question 4

triggers atopic eczema

Answer 4

allergens
clothing
skin infection - staph
contact allergens
inhalant allergens
hormonal
climate
teethin
stress
diet

Question 5

atopic triad

Answer 5

atopic eczema
asthma
allergic rhinitis
…describes genetic predisposition

Question 6

exam atopic eczema

Answer 6

erythema
dry skin
bleeding
water blisters on hand and feet
hair loss

Question 7

where affected atopic eczema

Answer 7

infants - scalp, face and extensors more likely
toddlers - flexural, mouth

Question 8

licenification define

Answer 8

scratching leads to…. evidence of chronic, poorly controlled eczema

Question 9

asian, black caribbean and black african patterns atopic eczema

Answer 9

discoid and follicular

Question 10

atopic eczema ddx

Answer 10

psoriasis
allergic contact dermatitis
seborrhoeic dermatitis

Question 11

contributing factors in hx diagnose atopic eczema

Answer 11

visible
personal hx of dry skin, atopic
onset before 2 yrs old

Question 12

moderate and severe eczema

Answer 12

mod - frequent itching, excorations and lichenification
severe - widespread, severe, bleeding , oozing, cracking, pigment changes, systemic sx

Question 13

eczema daily care

Answer 13

emollient
fragrance free and alcohol free - aveeno
avoid trauma
topical steroids
topical tacrolimus
education
non sedating antihistamines

Question 14

management flares eczema

Answer 14

mild - hydrocortisone 1%
mod - betamethason 0.025%, cetirizine
severe - betamethasone valerate 0.1%, certirizine, chlorphenamine

Question 15

eczema complications

Answer 15

infection with staph
herpes simplex virus (grouped vesicles and punched out erosions) ..when disseminated eczema herpeticum (can lead to herpes and DIC)
PSYCHOSOCIAL

Question 16

atopic marsh

Answer 16

one third of children with eczema will develop asthma or hayfever in future

Question 17

when psoriasis develop

Answer 17

1 third before 20

Question 18

psoriasis patho

Answer 18

T cell infiltration of epidermis, secreting substances that activate uncontrolled proliferation of keratinocytes

Question 19

risk fx psoriasis

Answer 19

infection - strep throat
stress
koebner phenomenon
obesity
fhx
drug induced

Question 20

koebner phenomenon

Answer 20

appearance of new lesions on previously unaffected areas of skin, secondary to trauma

Question 21

types of psoriasis

Answer 21

chronic plaque- most common
guttate
flexural
scalp and facial
pustular
erythrodermic
nail changes

Question 22

psoriasis children

Answer 22

guttate, flexural and scalp

Question 23

chronic plaque

Answer 23

raised
thick silvery white scale
well defined
auspitz - pin point bleeding after scale is scratched

Question 24

guttate

Answer 24

small red plaques across torso
raindrop appearance
following infection

Question 25

older children and adolescents psoriasis

Answer 25

older - face, ears and nails
adolescents - elbows, knees and scalp

Question 26

psoriasis ddxq

Answer 26

eczema
lichen planus
pityriasis rosea

Question 27

investigations can be used psoriasis

Answer 27

skin biopsy
PASI (psoriasis area and severity index) - severity and psychological impact

Question 28

psoriasis management

Answer 28

emollients
topical vit d analogues - calcipotriol
topical steroids
dithranol
coal tar preparation - shampoos
phototherapy
methotrexate
biologic therapy - adalimumab, etanercept

Question 29

psoriasis complications

Answer 29

juvenile psoriatic arthritis
secondary skin infections
mental health

Question 30

worse prognosis psoriasis

Answer 30

psoriatic arthropathy