Ambulatory conditions

Question 1

When should you refer psoriasis?

Answer 1

Red flag symptoms, <18, pregnant, any type other than mild plaque psoriasis, face, scalp, genitals, palms and/or soles, medicines that exacerbate psoriasis, no response to treatment or worsens.

Question 2

What are red flag symptoms for psoriasis?

Answer 2

• infected lesions
• severe
• immunocompromised

Question 3

What medicines can exacerbate psoriasos?

Answer 3

Lithium, beta-blockers, antimalarials, NSAIDs, antibiotics, ace I, TNF-a inhibitors, stopping steroids.

Question 4

What is plaque psoriasis?

Answer 4

Plaque psoriasis, the most common form of psoriasis, causes dry, raised skin patches (plaques) covered with gray or silver scales. It may look different depending on your skin color, ranging from pink on white skin to brown or gray on brown or Black skin.

Question 5

What is the differential diagnosis for psoriasis?

Answer 5

Atopic dermatitis, seborrheic dermatitis, tinea corporis.

Question 6

What is the treatment for psoriasis?

Answer 6

Topical corticosteroids, start with hydrocortisone.

Question 7

What is the differential diagnosis for dermatitis?

Answer 7

Bacterial, fungal, rosacea, cellulitis.

Question 8

When should you refer dermatitis?

Answer 8

• red flag symptoms
• <6mths, >65
• pregnant
• immunocompromised
• no response to treatment

Question 9

What are referral points for acne?

Answer 9

• <12
• pregnant
• PCOS, obesity
• negative emotional and social effect
• severe, cystic, scarring
• condition worsens, resistant to treatment
• > 6 mths antibiotic therapy

Question 10

Red flag symptoms for dermatitis?

Answer 10

• widespread rash with painful skin
• raised puruple rash that doesn’t blanch
• erythema that covers 90% of skin
• blistering
• systemic illness
• chronic sores of ulcers

Question 11

Treatment options for acne?

Answer 11

Topical retinoids (benzoyl peroxide)
Topical antibiotics
Oral antibiotics

Question 12

Treatment options for impetigo?

Question 13

Treatment for benzoyl peroxide?

Answer 13

Benzac gel 2.5%, 5% or 10%
wash skin before applying a thin layer. Avoid eyes, lips, hair. Wash hands after. 6 weeks for efficacy - if irritation occurs use lower strength or stop for allergy like reaction.

Question 14

Treatment for limited impetigo in non-endemic area?

Answer 14

1. mupirocin 2% ointment Q8h for 5/7
   or
2. hydrogen peroxide 1% cream q8h for 5/7